Exploring obesity in behavioral addictions: a neglected field and new empirical insights

Abstract Previous research suggests a possible association between obesity and behavioral addictions; however, findings remain inconsistent and the psychological mechanisms underlying this relationship remain poorly understood. This study examined the prevalence of overweight and obesity across different behavioral addictions (gambling disorder, internet gaming disorder, and compulsive buying-shopping disorder), compared sociodemographic, clinical, and psychological characteristics according to weight status, and explored pathways between personality, psychological distress, emotion dysregulation, food addiction, and body mass index (BMI). This cross-sectional study included 1,265 adults seeking treatment for behavioral addictions at a specialized public hospital. Sociodemographic variables, psychopathology, impulsivity, emotion regulation, personality features, and food addiction were assessed using validated psychometric instruments. Overweight and obesity were prevalent across behavioral addictions. Compared to participants without obesity, those with obesity were older, more frequently women, reported higher somatization and harm avoidance, lower sensation seeking, and greater food addiction symptomatology. Structural equation modeling showed that food addiction was the only direct statistical predictor of BMI, mediating indirect effects of impulsivity, harm avoidance, psychological distress, and emotion dysregulation. These findings suggest that features of food addiction may act as a link between emotional vulnerability and obesity across behavioral addictions, highlighting the importance of assessing food addiction symptomatology in clinical contexts .