- Title
- Addictive eating in adults: an investigation into treatment, experience, and the feasibility of a personality-targeted intervention
- Creator
- Collins, Rebecca Anne
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2022
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Addictive eating is an area of research that continues to increase despite the topic being somewhat divisive in the scientific community. The rise in obesity with overconsumption of processed foods, altered food environments, and increased incidence of mental health diagnoses, mainly anxiety, depression, post-traumatic stress disorder, and eating disorders, prompted the investigation of causal factors for food addiction or addictive-like eating behaviours. The aim of this thesis was to research current treatment options for addictive eating and at-risk population groups. This research would then guide the development of an intervention based on behaviour change theories and successful evidence-based models in other addictive behaviours to form a possible treatment option for addictive eating in adults. This thesis is highly novel as it applies principles of substance use and related addictive disorders treatment to the eating domain. Chapter 2 outlines the current literature around food addiction, diagnosis, mental health and eating disorders, personality traits, foods associated with food addiction, dietary assessment methods, and food addiction treatment. Chapter 3 reports on the findings of a scoping review undertaken of online support options for adults with self-reported food addiction. Key results from the 13 online treatment options for food addiction showed that very few support options included health professionals (such as dietitians and psychologists) (n=4), despite nine treatment options including the use of food plans. Twelve of the available treatments had the option of phone or online support delivery; however, none of the treatment options included evaluating the service they provided. The inclusion of scientific evidence or behaviour change theories was minimal. A scoping review (Chapter four) was undertaken to determine what is known about assessing and reporting dietary intakes in military and veteran populations, who are identified as being vulnerable to overeating. The majority of included studies used one dietary assessment method (n = 76, 85%), with fewer using multiple methods (n = 13, 15%). The most frequent methodology used was food frequency questionnaires (FFQ) (n = 40, 45%) followed by 24-hour recalls (n = 8, 9%) and food records (n = 8, 9%). The main dietary outcomes reported were macronutrients: carbohydrate, protein, fat, and alcohol, with total energy intake reported in n = 59 (66%). Fifty-four (61%) of studies reported a comparison with country-specific dietary guidelines, and 14 (16%) reported a comparison with the country-specific military guidelines. Studies compared to dietary guidelines highlighted the inadequate dietary intake of these populations, particularly overeating processed foods. A pilot study was developed using key information from Chapter 3 and an adaptation from a previous effective study for alcohol misuse. The development and adaptation of the program are outlined in Chapter 5. A feasibility study known as “FoodFix” using a randomised control trial design of a personality-targeted, motivational interviewing intervention to adults above the healthy weight range with symptoms of addictive eating behaviours was undertaken. The aim of the FoodFix intervention was to determine feasibility and acceptability in adults with addictive eating to improve health by reducing symptoms of addictive eating. FoodFix also featured a semi-structured interview component to collect qualitative data from participants. This was undertaken in session one of the FoodFix intervention. This data was used for a qualitative study, described in Chapter 6. Through data coding and thematic analysis, the two themes to emerge from the analysis were compulsion and control. The theme of compulsion had three sub-themes: Not being able to resist, justification then regret, and social forces. The theme of control also had three subthemes of controlling actions around food, weight, and in time. The findings of this study will help to inform further development of targeted interventions for food addiction and guidance for larger scale qualitative research in the experience of food addiction. In particular, qualitative research is imperative in future research due to the importance of co-design frameworks in the mental health setting. Key results from the secondary data analysis of the dietary outcomes of FoodFix are reported in Chapter 7. This chapter highlights that dietary behaviour is amenable to change in those with addictive eating. However, future treatment for addictive eating should ensure attention is given to improving participant diet quality alongside decreases in discretionary or processed food consumption to improve health outcomes and quality of life. This thesis identifies and discusses a need for easily accessible evidence-based interventions to support those with food addiction and highlights the importance of individualised treatment. It contributes new knowledge to whole dietary intake of adults with addictive eating engaged in a feasibility intervention and the possibility of a reduction in overeating highly processed foods via personality-targeted behaviour change methods. This thesis also contributes unique ideas around the strong desire for control of food intake experienced by those with addictive eating.
- Subject
- addictive eating in adults; personality-targeted intervention; addictive eating treatment; eating behaviours; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1512252
- Identifier
- uon:56601
- Rights
- Copyright 2022 Rebecca Anne Collins
- Language
- eng
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