Prevalence and determinants of food addiction among Palestinian university students: a cross-sectional study

Abstract

Background: Food addiction (FA) is characterized by an insatiable urge to consume high-calorie, sugary, hyper-palatable foods beyond energy needs. This condition is associated with having obesity, binge eating, and comorbid physical, psychological, and social complications. While FA shares characteristics with other eating disorders, it is still understudied in many populations, especially university students. This study aims to assess the prevalence of FA among Palestinian university students and identify associated nutritional, social, psychological, and lifestyle factors. Methods: A cross-sectional study was conducted on university students using a random sampling technique. A paper-based structured questionnaire was used to collect data related to sociodemographic, medical history, FA using the Yale Food Addiction Scale (YFAS), and mental health using the Depression Anxiety and Stress Scale-21 (DASS-21). Dietary behaviour was assessed using the Mediterranean Lifestyle Index (MEDLIFE), while Body Mass Index (BMI) was used to evaluate weight status. The assessed lifestyle habits included quality of sleep using the Sleep Hygiene Index (SHI), physical status using the International Physical Activity Questionnaire (IPAQ), and smoking status. Data were analyzed using one-way ANOVA and Chi-square tests and multiple linear regression. Results: The study involved 1435 participants, mostly female (66.2%), single (91.0%), and nonsmokers (71.1%). The study found that 79% of participants had no FA, 18% had mild addiction, and 3% had moderate to severe addiction. There was a significant relationship between smoking, chronic disease, SHI, or previous surgery and FA. However, there was no association between FA and other sociodemographic factors, medical history, lifestyle characteristics, or nutritional characteristics. The multiple linear models found that age (B = 0.080), anxiety (B = 0.120), depression (B = 0.154), SHI (B = 0.225), BMI (B = 0.153), Mediterranean diet (B = 0.106), and previous surgery (B = − 0.064) are significant predictors of FA risk at p ≤ 0.001. Conclusion: Our study identified a notable presence of FA among university students. Key factors associated with FA included smoking, chronic disease, history of surgery, higher BMI, and adherence to the Mediterranean diet, as well as psychological factors such as stress, anxiety, depression, and poor sleep hygiene. These findings elaborate on the complex relationship of physical, psychological, and lifestyle factors contributing to FA. Further research is recommended to clarify the causal relationships behind these associations. Level of evidence: level Ⅳ Plain English summary: Food addiction (FA), a disorder defined by an insatiable need to consume high-calorie, sugary, and highly appealing meals more than energy requirements, is linked to having obesity, binge eating, and other medical, psychological, and social issues. The purpose of this study is to determine the prevalence of FA among Palestinian university students, as well as the dietary, social, psychological, and lifestyle aspects that contribute to it. The study discovered a 21% FA prevalence in the sample group, with 18% having mild FA and 3% suffering from moderate to severe addiction. These rates are greater than in the overall population but lower than in previous research including university students. The study discovered a link between FA and a variety of variables, including smoking, chronic disease, a history of surgery, and a higher BMI. Individuals with a history of chronic illness and surgery were likely connected to FA, possibly due to the psychological impact of long-term illness and body image concerns. A Mediterranean diet was associated with lower levels of FA. Stress, anxiety, sadness, and poor sleep hygiene were all also increasing the likelihood of FA. These findings emphasize the diverse character of FA, which is influenced by biological, psychological, and environmental factors, as well as the need for additional research to investigate these complicated relationships.