Obezitesi olan ve olmayan bireylerin yeme bağımlılığı durumlarının karşılaştırılması: kesitsel bir çalışma

Abstract

Amaç: Obezitesi olan ve olmayan yetişkinlerde yeme bağımlılığı prevalansını ve ilişkili faktörleri karşılaştırmak ve Yale Gıda Bağımlılığı Ölçeği (YFAS) ölçütlerinden hangilerinin obezite ile bağımsız olarak ilişkili olduğunu belirlemektir. Yöntemler: Bu kesitsel, analitik çalışma Ocak–Nisan 2024 tarihleri arasında Türkiye’de bir aile hekimliği polikliniğinde yürütülmüştür. Tüm anketleri tamamlayan 18–64 yaş arası yetişkinler çalışmaya dahil edilmiştir. Obezite, BKİ ≥ 30 kg/m² olarak tanımlanmıştır. FA, orijinal YFAS tanı algoritması kullanılarak değerlendirilmiştir (≥3 semptom ve klinik olarak anlamlı bozulma/sıkıntı). Demografik özellikler, yaşam tarzı, obezite öyküsü ve belirli yiyeceklerin aşırı tüketiminin kişisel beyanı kaydedilmiştir. Grup karşılaştırmalarında uygun parametrik/parametrik olmayan ve χ²/Fisher testleri; lojistik regresyonda ayarlanmış olasılık oranları (aOR, %95 GA) hesaplanmıştır. Bulgular: 340 katılımcı arasında (ortalama yaş 36,0 yıl; %70,0 kadın) FA prevalansı %21,8 (74/340) bulunmuştur. FA negatif katılımcılara kıyasla FA pozitif katılımcıların BKİ’si daha yüksek (ortanca 31,8’e karşı 26,25 kg/m²) ve obezite oranı daha fazlaydı (%59,5’e karşı %30,1; her ikisi p<0,001). Ayrıca çocuklukta obezite (%59,5’e karşı %10,2; p<0,001), obezite aile öyküsü (%45,9’a karşı %24,8; p<0,001), kronik hastalık (%43,2’ye karşı %28,9; p=0,020) ve rafine ya da aşırı lezzetli yiyeceklerin (örneğin, donut, ekmek, makarna, kola, çikolata) aşırı tüketimi (tümü p≤0,002) daha sık bildirildi. Çok değişkenli analizde yalnızca çocukluk çağı obezite öyküsü FA ile ilişkili kaldı (aOR 8,182; 4,047–16,542; p<0,001). Obezite için daha yüksek eğitim (aOR 0,430; p=0,010) ve haftada ≥3 gün egzersiz yapma (aOR 0,271; p<0,001) koruyucu iken, çocukluk (aOR 2,829; p=0,004) ve aile öyküsü (aOR 2,124; p=0,011) riski artırdı; FA bağımsız bir etken değildi (aOR 1,851; p=0,079). Semptom düzeyinde ise tolerans (aOR 1,659; p=0,041) ve klinik olarak anlamlı bozulma (aOR 2,126; p=0,022) obezite ile ilişkili bulundu. Sonuç: Gıda bağımlılığı yaygındı ve daha yüksek vücut yağ oranı ile birlikte görülmekteydi; ancak erken dönem obezite FA’nın en güçlü belirleyicisi oldu. Klinik olarak işlev bozukluğuna yol açan FA ile tolerans belirtileri, FA’nın obeziteyle bağlantısını açıklayabilir. Yaşam boyu kilo öyküsünü dikkate alan ve klinik olarak anlamlı FA’ya öncelik veren taramalar, obezite bakımında danışmanlığı geliştirebilir.

Keywords

• Obezite
• Vücut kitle indeksi
• Yeme Bozuklukları
• Birinci Basamak Sağlık Hizmetleri
• Yeme Bağımlılığı
• Yale Yeme Bağımlılığı Ölçeği

Comparison of food addiction status between obese and non-obese individuals: a cross sectional study

Abstract

Aims: To compare the prevalence and correlates of food addiction (FA) between adults with and without obesity and to identify which Yale Food Addiction Scale (YFAS) criteria are independently associated with obesity. Methods: This cross-sectional, analytical study was conducted at a family medicine outpatient clinic in Turkiye (January–April 2024). Adults aged 18–64 years who completed all questionnaires were included. Obesity was defined as body mass index (BMI) ≥30 kg/m². FA was assessed using the original YFAS diagnostic algorithm (≥3 symptoms plus clinically significant impairment/distress). Demographics, lifestyle, obesity history, and self-reported overconsumption of specific foods were recorded. Group comparisons used appropriate parametric/non-parametric and χ²/Fisher tests; logistic regression estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI). Results: Among 340 participants (mean age 36.0 years; 70.0% female), FA prevalence was 21.8% (74/340). Compared with FA negative peers, FA-positive participants had higher BMI (median 31.8 vs 26.25 kg/m²) and more obesity (59.5% vs 30.1%; both p<0.001), and more often reported childhood obesity (59.5% vs 10.2%; p<0.001), family history of obesity (45.9% vs 24.8%; p<0.001), chronic disease (43.2% vs 28.9%; p=0.020), and overconsumption of refined or hyper-palatable items (e.g., donuts, bread, pasta, cola, chocolate; all p≤0.002). In multivariable analysis, only childhood obesity history remained associated with FA (aOR 8.182; 4.047-16.542; p<0.001). For obesity, higher education (aOR 0.430; p=0.010) and exercising ≥3 days/week (aOR 0.271; p<0.001) were protective, whereas childhood (aOR 2.829; p=0.004) and family history (aOR 2.124; p=0.011) increased odds; FA was not an independent correlate (aOR 1.851; p=0.079). At the symptom level, tolerance (aOR 1.659; p=0.041) and clinically significant impairment (aOR 2.126; p=0.022) were associated with obesity. Conclusion: FA was common and co-occurred with higher adiposity; however, early-life obesity was the most robust correlate of FA, while impairment and tolerance linked FA to obesity. Screening that prioritizes clinically impairing FA and considers life course weight history may improve counseling in obesity care.

Keywords

• Obesity
• eating disorders
• addictive behavior
• body mass index
• cross sectional studies
• primary health care

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