A Graduated Food Addiction Classifications Approach Significantly Differentiates Depression, Anxiety and Stress among People with Type 2 Diabetes

Aims: To examine differences in depression, anxiety, and stress across people with type 2 diabetes mellitus (t2d) classified according to a four level processed food addiction (PFA) severity indicator dichotomy. Methods: Four hundred and eight participants with a t2d diagnoses completed an online survey including the Yale Food Addiction Scale (YFAS) and the DASS-21. Based on YFAS symptom counts participants were classified as either: non-PFA; mild-PFA; moderate-PFA; or severe-PFA. Results: Multivariate, λ = .422, F(9, 978.51) = 46.286, p < .001, np2 = .250, and univariate analyses of variance demonstrated that depression F(3, 408) = 159.891, p < .001, np2 = .543, anxiety F(3, 408) = 127.419, p < .001, np2 = .486, and stress scores F(3, 408) = 129.714, p < .001, np2 = .491, significantly and meaningfully increased from one PFA classification level to the next. Furthermore, the proportion of participants with more severe classifications of depression χ2 (12) = 297.820, p < .001, anxiety χ2 (12) = 271.805, p < .001, and stress χ2 (12) = 240.875, p < .001, were significantly higher in the more severe PFA groupings. Conclusion: For people with t2d, PFA is an important and meaningful associate of depression, anxiety, and stress, and that the adopted four level PFA severity indicator dichotomy is valid and useful