Prevalence of food addiction and sex-specific correlates in a large sample of Iranian adults

Obesity is a global health concern, and one potential contributing factor is addictive-like eating behavior. Despite growing interest, the prevalence of food addiction (FA) in large community samples in Iran, and the potential sex-specific correlates of FA, remain unexplored. This study aimed to assess the prevalence of FA in a non-clinical Iranian population and to compare its sociodemographic correlates between males and females. This cross-sectional study, conducted from 2021 to 2022, included valid data from 9,345 adults (82.1% female, 17.9% male). Participants completed the Persian version of the modified Yale Food Addiction Scale 2.0 (mPYFAS 2.0) and demographic surveys. Univariable and multivariable logistic regression analyses were performed to identify FA correlates. Overall, 15.6% of participants met the diagnostic threshold for FA (8.7% males, 17.2% females). Regarding FA severity, 4.0% exhibited mild FA (males: 2.9%; females: 4.3%), 4.1% displayed moderate FA (males: 2.0%; females: 4.6%), and 7.5% demonstrated severe FA (males: 3.8%; females: 8.3%). Multivariable analyses revealed that younger age, female sex, overweight/obesity, and lower education were associated with higher FA prevalence in the overall sample. Sex-specific analyses showed that age and weight status were significant correlates for females, while weight status and education level were significant for males. Notably, underweight status was positively correlated with FA for males but was negatively associated with FA for females. Regarding FA symptoms, females reported higher endorsement of most symptoms except for situation and problems and activities where no sex differences were found. This study highlights the significant prevalence of FA in Iran, emphasizing sex differences in prevalence, symptomatology, and associated sociodemographic factors. These findings provide valuable insights for designing tailored, sex-specific interventions to mitigate FA severity.