Food addiction as a transdiagnostic feature associated with binge-eating symptoms in eating disorders: prevalence and rehabilitation outcomes in an Italian inpatient population

Food addiction (FA) is an emerging construct describing a compulsive and dysregulated pattern of food consumption that parallels mechanisms observed in substance-related addictions. This study aimed to investigate the prevalence and clinical correlates of FA in a sample of 141 Italian adult inpatients diagnosed with eating disorders (ED). Participants completed standardized self-report instruments assessing FA (YFAS 2.0), binge-eating behaviours (BES), ED-related psychopathology (EDI-3), body image distress (BUT), and general psychological symptoms (SCL-90) at admission (T0) and discharge (T1) from a multidisciplinary ED rehabilitation program. FA showed a high prevalence (85.6%), with more than half of the participants (51.1%) classified as severe. YFAS 2.0 scores were significantly higher among patients with binge eating disorder (BED) and bulimia nervosa (BN). FA severity was strongly associated with bulimic and binge-eating symptoms and interoceptive deficits, but not with body dissatisfaction. Regression analyses indicated that FA at admission was significantly associated with the severity of bulimic and binge-eating symptoms, independently of age, BMI, and illness duration. Overall, findings suggest that FA may reflect a dimensional feature associated with symptom severity across eating disorders, particularly in binge-spectrum presentations. Routine assessment of FA could therefore serve as a potentially useful clinical indicator and guide personalized interventions aimed at reducing compulsive eating behaviours and preventing relapse.