Does food insecurity elucidate the relationship between food addiction and binge eating among bariatric surgery candidates?

Food addiction symptoms and binge eating symptoms both include the experience of loss of control eating and emotional dysregulation and are prevalent among adult metabolic and bariatric surgery (MBS) candidates. To examine whether food insecurity elucidates the relationship between food addiction symptoms and binge eating symptoms. We hypothesized an indirect effect through food insecurity on the relationship between food addiction symptoms and binge eating symptoms. We also hypothesized that food insecurity moderates the relationship between food addiction symptoms and binge eating symptoms. Academic medical center, United States Participants were 866 consecutive adult MBS candidates who completed a battery of self-report questionnaires assessing demographic information, food addiction symptoms, food insecurity, and binge eating symptoms prior to MBS during a routine clinic visit. In both statistical models, a strong relationship between food addiction symptoms and binge eating symptoms emerged; however, overall food insecurity did not mediate or moderate this relationship. Exploratory analyses indicated that use of food assistance from family or friends moderated the relationship between food addiction symptoms and binge eating symptoms. Food insecurity may not be relevant in understanding the relationship food addiction symptoms and binge eating symptoms in pre-surgical bariatric populations. Food addiction symptoms and binge eating symptoms continue to demonstrate a strong relationship; however, the extent to which they have unique differences requires additional examination.