Emotion regulation among patients with obesity and food addiction

Abstract Background: Emotion dysregulation, alexithymia and attentional biases toward food or emotional stimuli have been reported in patients with obesity and food addiction (FA), but the relative contribution of obesity or FA to these characteristics remains unclear. Methods: Our objectives were to compare patients with obesity and FA, patients with obesity without FA and patients without obesity regarding cognitive emotion regulation strategies, alexithymia, emotion regulation difficulties, and attentional biases.We included 37 patients seeking treatment for obesity (18 FA, 19 without FA) and 37 controls. We assessed food addiction (YFAS 2.0); emotional regulation strategies (CERQ), emotion regulation difficulties (DERS), alexithymia (TAS-20), and attentional biases (Stroop and Emotional Stroop tasks). Results: Among patients with obesity, those with FA differed from non-FA only in terms of cognitive emotion regulation strategies: less refocus on planning (p=.04), more catastrophizing (p=.02), and more positive refocusing (p<.001). Having an obesity (with or without FA) was associated with higher scores regarding emotion regulation strategies (p<.05), alexithymia (p<.001) and emotion regulation difficulties (p<.001). Conclusions: Among patients with obesity, having a FA was related to cognitive avoidance toward negative events, but not to change in the saliency of emotional or food stimuli. Alexithymia was more related to obesity than to FA.