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, n=0.250, and univariate analyses of variance demonstrated that depression F(3,408)=159.891, p<0.001, n=0.543, anxiety F(3,408)=127.419, p<0.001, n=0.486, and stress scores F(3,408)=129.714, p<0.001, n=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 χ (12)=297.820, p<0.001, anxiety χ (12)=271.805, p<0.001, and stress χ (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.