GENDER-BASED EVALUATION OF THE RELATIONSHIP BETWEEN FOOD ADDICTION, EATING BEHAVIORS, AND METABOLIC INDICATORS IN INDIVIDUALS WITH OBESITY

Öz

Objective: This study aimed to investigate the gender-specific associations between food addiction (FA), eating attitudes, emotional eating, insulin resistance, and nutritional status in individuals with obesity. Methods: A cross-sectional study was conducted with 240 individuals with obesity (149 women, 91 men). Participants were assessed using the Modified Yale Food Addiction Scale Version 2.0 (mYFAS 2.0), Emotional Eater Questionnaire (EEQ), Eating Attitudes Test-26 (EAT-26), and Food Craving Questionnaire-Trait-reduced (FCQT-R). Anthropometric measurements were obtained and biochemical markers including fasting blood glucose, insulin, glycated hemoglobin (HbA1c), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), vitamin D, and cortisol levels were analyzed. Results: Food addiction was identified in 54.2% (n=130) of the participants, with a significantly higher prevalence in women than in men (65.8% vs. 35.2%, p<0.001). Individuals with FA demonstrated significantly higher levels of food craving and loss of control over eating (p<0.001). Among women with FA, HOMA-IR values were significantly higher (p=0.004), while vitamin D levels were significantly lower (p=0.035) compared with women without FA. In men with FA, visceral fat percentage was significantly higher than in non-addicted men (p<0.001). Conclusion: Food addiction is highly prevalent among individuals with obesity, particularly among women, and is associated with gender-specific psychological and metabolic alterations. These findings highlight the importance of incorporating gender-sensitive approaches into the assessment and management of obesity-related eating behaviors and metabolic risk.

Anahtar Kelimeler

• Obesity
• Food Addiction
• Feeding Behavior
• Emotional Eating

Obez Bireylerde Yeme Bağımlılığı: Yeme Davranışları ve Metabolik Göstergeler Arasındaki İlişkinin Cinsiyete Dayalı Değerlendirilmesi

Öz

Amaç: Bu çalışmada, obezitesi olan bireylerde yeme bağımlılığı (YB) ile yeme tutumları, duygusal yeme, insülin direnci ve beslenme durumu arasındaki ilişkilerin cinsiyete özgü olarak incelenmesi amaçlanmıştır. Yöntem: Kesitsel nitelikteki araştırma, obezitesi olan 240 birey (149 kadın, 91 erkek) üzerinde yürütülmüştür. Katılımcılar Modifiye Edilmiş Yale Yeme Bağımlılığı Ölçeği Sürüm 2.0 (mYFAS 2.0), Duygusal Yeme Ölçeği (EEQ), Yeme Tutum Testi-26 (YTT-26) ve Yeme Arzusu Ölçeği–Özellik (kısaltılmış form) (FCQT-R) kullanılarak değerlendirilmiştir. Antropometrik ölçümler alınmış; açlık kan şekeri, insülin, HbA1c, HOMA-IR, D vitamini ve kortizol düzeyleri analiz edilmiştir. Bulgular: Katılımcıların %54,2’sinde yeme bağımlılığı saptanmış olup, prevalans kadınlarda erkeklere göre anlamlı düzeyde daha yüksektir (p < 0,001). Yeme bağımlılığı olan bireylerde yeme arzusu ve yeme kontrol kaybı düzeyleri anlamlı olarak daha yüksek bulunmuştur (p < 0,001). Yeme bağımlılığı olan kadınlarda HOMA-IR değerleri daha yüksek, D vitamini düzeyleri ise daha düşük saptanmıştır (p < 0,05). Erkeklerde yeme bağımlılığı varlığı, daha yüksek visseral yağ oranı ile ilişkili bulunmuştur (p < 0,001). Sonuç: Yeme bağımlılığı, obezitesi olan bireylerde yüksek sıklıkta görülmekte ve cinsiyete özgü psikolojik ve metabolik farklılıklarla ilişkilidir. Bu bulgular, obezitenin değerlendirilmesi ve yönetiminde cinsiyete duyarlı yaklaşımların önemini ortaya koymaktadır.

Anahtar Kelimeler

• Obezite
• Yeme Bağımlılığı
• Yeme Davranışı
• Duygusal Yeme

Kaynakça

1. World Health Organization. (2025). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
2. Adams RC, Sedgmond J, Maizey L, Chambers CD, Lawrence NS. Food addiction: implications for the diagnosis and treatment of overeating. Nutrients. 2019;11(9):2086. doi:10.3390/nu11092086
3. Tarman VI. One size does not fit all: understanding the five stages of ultra-processed food addiction. J Metab Health. 2024;7(1):90. doi:10.4102/jmh.v7i1.90
4. Alqahtani RM, Alhazmi A. Association between cognitive restraint, emotional eating, uncontrolled eating, and body mass index among health care professionals. Sci Rep. 2025;15(1):2570. doi:10.1038/s41598-025-86419-8.
5. Casari MA, Pires VP, Pureza IM, Busnello FM. Does restriction lead to binge eating? A scoping review on restrictive diets in the development and maintenance of binge eating disorder. Nutr Rev. 2025;84(1):189-206. doi:10.1093/nutrit/nuaf163
6. Li M, Chi X, Wang Y, Setrerrahmane S, Xie W, Xu H. Trends in insulin resistance: insights into mechanisms and therapeutic strategy. Sig Transduct Target Ther. 2022;7(1):216. doi:10.1038/s41392-022-01073-0
7. Rania M, Caroleo M, Carbone EA, et al. Reactive hypoglycemia in binge eating disorder, food addiction, and the comorbid phenotype: unravelling the metabolic drive to disordered eating behaviours. J Eat Disord. 2023;11(1):162. doi:10.1186/s40337-023-00891-z
8. Contreras-Bolívar V, García-Fontana B, García-Fontana C, Muñoz-Torres M. Mechanisms involved in the relationship between vitamin D and insulin resistance: impact on clinical practice. Nutrients. 2021;13(10):3491. doi:10.3390/nu13103491

9. Barton MB, Jacob S, Shafiq J, et al. Estimating the demand for radiotherapy from the evidence: a review of changes from 2003 to 2012. Radiother Oncol. 2014;112(1):140-144. doi:10.1016/j.radonc.2014.03.024
10. World Health Organization. Global action plan on physical activity 2018-2030: more active people for a healthier world. 2018. https://www.who.int/publications/i/item/9789241514187
11. Tok Ş, Ekerbiçer H, Yazıcı E. The validity and reliability of the Turkish version of the modified Yale Food Addiction Scale version 2.0. Sakarya Med J. 2023;13(2):236-245. doi:10.31832/smj.1221917
12. Traş Z, Gökçen G. Yeme arzusu ölçeği kısa formunun Türk kültürüne uyarlanması: geçerlilik ve güvenirlik çalışması. AKEF Derg. 2021;4(3):745-763. doi:10.38151/akef.2021.17
13. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Publishing.2013.
14. Bouillon R, Manousaki D, Rosen C, Trajanoska K, Rivadeneira F, Richards JB. The health effects of vitamin D supplementation: evidence from human studies. Nat Rev Endocrinol. 2021;18(2):96-110. doi:10.1038/s41574-021-00593-z
15. Praxedes DRS, Silva-Júnior AE, Macena ML, et al. Prevalence of food addiction determined by the Yale Food Addiction Scale and associated factors: a systematic review with meta-analysis. Eur Eat Disord Rev. 2021;30(2):85-95. doi:10.1002/erv.2878
16. Guerrero-Hreins E, Stammers L, Wong L, Brown RM, Sumithran P. A comparison of emotional triggers for eating in men and women with obesity. Nutrients.2022;14(19):4144.doi:10.3390/nu14194144
17. Mento C, Rizzo A, Bruno A, et al. Sex differences in emotions and eating behaviors among people affected by obesity. Brain Sci. 2022;12(12):1663. doi:10.3390/brainsci12121663
18. Chen IH, Huang PC, Lin YC, et al. The Yale Food Addiction Scale 2.0 and the modified Yale Food Addiction Scale 2.0 in Taiwan: Factor structure and concurrent validity. Front Psychiatry. 2022;13:1014447. doi:10.3389/fpsyt.2022.1014447
19. Rossi AA, Pietrabissa G, Castelnuovo G, Mannarini S. Cognitive restraint, uncontrolled eating, and emotional eating. The Italian version of the Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18): a three-step validation study. Eat Weight Disord. 2024;29(1):16. doi:10.1007/s40519-024-01642-y
20. Rossi A. Tying food addiction to uncontrolled eating: the roles of eating-related thoughts and emotional eating. Nutrients. 2025;17(3):369. doi:10.3390/nu17030369
21. Devoto F, Mariano M, Gornetti E, Paulesu E, Zapparoli L. Trait food craving predicts functional connectivity between dopaminergic midbrain and the fusiform food area during eating imagery. Front Psychiatry. 2024;15:1396376. doi:10.3389/fpsyt.2024.1396376
22. EBSCO. Food addiction. Research Starters. 2024. https://www.ebsco.com/research-starters/psychology/food-addiction
23. Cavaleri J, Stefanescu K, Lee D, Mason X. Deep brain stimulation access in 2025: geographic, gender, racial, and socioeconomic disparities re-examined. Curr Opin Neurol. 2025;38(4):330-336. doi:10.1097/wco.0000000000001377
24. Madieta L, Scocard A, Rozet M, et al. Emotion regulation among bariatric seeking patients with obesity and food addiction: a cross-sectional, unmatched nested case-control comparison. J Eat Disord. 2025;13(1):283. doi:10.1186/s40337-025-01424-6
25. Linardon J, Messer M, Shatte A, et al. Targeting dietary restraint to reduce binge eating: a randomised controlled trial of a blended internet- and smartphone app-based intervention. Psychol Med. 2021;53(4):1277-1287. doi:10.1017/s0033291721002786
26. Mason TB, Dolgon-Krutolow A, Smith KE. A systematic review of moderators of the association between dietary restraint and binge eating. Obesities. 2024;4(2):132-144. doi:10.3390/obesities4020013
27. Pramono A, Fitranti DY, Nugroho KH, Sobirin MA, Syauqy A. The association between unhealthy food consumption and impaired glucose metabolism among adults with overweight or obesity: a cross-sectional analysis of the Indonesian population. J Obes. 2023;2023:1-10. doi:10.1155/2023/2885769
28. James KA, Stromin JI, Steenkamp N, Combrinck MI. Understanding the relationships between physiological and psychosocial stress, cortisol and cognition. Front Endocrinol (Lausanne). 2023;14:1085950. doi:10.3389/fendo.2023.1085950
29. Yücel HE, Konar NM, Dulkadiroğlu E. The relationship between insulin resistance and vitamin D deficiency with blood parameters. Halic Med J. 2025;8(1):45-52. doi:10.58961/hmj.1651475
30. AlGhamdi SA. Effectiveness of vitamin D on neurological and mental disorders. Diseases. 2024;12(6):131. doi:10.3390/diseases12060131
31. Peng Z, Jia Q, Mao J, et al. Neurotransmitters crosstalk and regulation in the reward circuit of subjects with behavioral addiction. Front Psychiatry. 2025;15:1439727. doi:10.3389/fpsyt.2024.1439727
32. Sharma P, Singh AK, Raushan A, Rajput R. Effects of processed food consumption on obesity. Eur J Nutr Food Saf. 2025;17(4):317-328. doi:10.9734/ejnfs/2025/v17i41702
33. Russell H, Aouad P, Le A, et al. Psychotherapies for eating disorders: findings from a rapid review. J Eat Disord. 2023;11(1):175. doi:10.1186/s40337-023-00886.