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 = 0.422, F(9, 978.51) = 46.286, p <0.001, np2 = 0.250, and univariate analyses of variance demonstrated that depression F(3, 408) = 159.891, p <0.001, np2 = 0.543, anxiety F(3, 408) = 127.419, p <0.001, np2 = 0.486, and stress scores F(3, 408) = 129.714, p <0.001, np2 = 0.491, 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 <0.001, anxiety χ2 (12) = 271.805, p <0.001, and stress χ2 (12) = 240.875, p <0.001, 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.