The findings:
Food addiction (FA) is increasingly recognized as a maladaptive eating pattern characterized by compulsive consumption of highly palatable, ultra-processed foods despite negative consequences—paralleling substance use disorders (SUDs) in clinical features, neurobiology, and reward circuitry involvement (e.g., striatal and orbitofrontal activation). Although its nosological status remains debated, FA has shown consistent associations with elevated BMI, emotional dysregulation, and impulsivity. This study explored the prevalence and clinical correlates of FA across behavioral addictions (BAs)—specifically gaming disorder, compulsive buying-shopping disorder (CBSD), and compulsive sexual behavior disorder—in 209 treatment-seeking adults without comorbid eating disorders. FA was present in 22.5% of the sample, with the highest prevalence in CBSD (31.3%) and gaming disorder (24.7%). Compared to FA− individuals, those with FA+ status were more likely to be female and demonstrated greater general psychopathology, emotional impulsivity (e.g., positive/negative urgency), emotion regulation difficulties, and elevated BMI. FA was associated with higher harm avoidance and lower persistence and self-directedness, suggesting a distinct and more clinically severe subgroup within the BA population.

Strength and weaknesses:
A major strength of this study lies in its comprehensive phenotyping using validated psychometric instruments that align food addiction with DSM-5 substance use disorder criteria (e.g., YFAS-2) while simultaneously assessing core transdiagnostic constructs such as impulsivity (UPPS-P), emotion regulation (DERS), and temperament (TCI-R). By excluding individuals with diagnosed eating disorders, the authors isolate FA as a construct distinct from classic eating pathology and explore its interaction with behavioral addictions often overlooked in the literature. The findings support the growing consensus that FA—though not formally recognized in DSM-5—reflects a clinically meaningful phenotype with parallels to other compulsive behaviors. However, several methodological limitations temper generalizability. The reliance on self-report measures (including BMI), cross-sectional design, and modest FA+ sample size (n = 47) limit the ability to infer causality or trajectory. Recruitment from a specialized addiction treatment setting may also bias the sample toward individuals with more severe psychopathology. Furthermore, while the study identifies robust associations between FA and clinical severity, it does not assess functional outcomes or treatment responsiveness—gaps that are highly relevant for clinical decision-making.

Relevance:
The study’s transdiagnostic framing of food addiction has clear relevance to consultation-liaison psychiatrists, particularly in settings where medical and psychiatric comorbidities intersect. Patients presenting with obesity, somatic distress, chronic pain, or refractory metabolic conditions may also exhibit compulsive eating behaviors that reflect underlying FA. The finding that FA frequently co-occurs with behavioral addictions and is associated with heightened emotional distress and dysregulation suggests that these individuals may be using food as an affect regulation strategy—akin to the self-medication model of SUDs. For CL psychiatrists, especially those embedded in bariatric, transplant, or general medical units, systematic assessment for FA may uncover an important driver of both psychiatric burden and medical nonadherence. Importantly, the authors advocate for transdiagnostic treatment approaches that target shared mechanisms—such as impulsivity and emotion regulation—across addictive behaviors. This is aligned with emerging integrative care models in CL psychiatry that seek to bridge psychiatric and behavioral medicine using cognitive-behavioral, motivational, or pharmacologic strategies tailored to complex, high-utilizing populations.