Introduction
Obesity is a major public health problem, and its prevalence is growing at an alarming rate, especially in children and adolescents. Italy is one of the European countries with the highest number of overweight youth [1]. The hypothesis that obesity implicates food addiction, thus occurring in association or as an alternative to other substance abuse, is attracting attention [2]. Overeating in obese individuals shares similarities with loss of control and compulsive drug-taking behaviour observed in drug-addicted subjects, and people suffering from an eating disorder may also exhibit other addictive behaviours, including alcoholism and drug use. Though studies using functional or metabolic brain imaging may suggest innate alterations in neural circuits controlling reward seeking in subjects with drug addiction, eating disorders and obesity [3], it is important to keep in mind that eating attitudes and self-image perception are greatly dependent on cultural background and social pressure. Both eating disorders and drug addiction may indicate low self-esteem, at least partialy modulated by the subject’s interaction with peers and parents. Eating disorders such as bulimia and anorexia are most commonly found in the upper social classes of industrialized countries, in which being slim reinforces the feeling of social acceptance; immigration from non-industrialized to industrialized countries is associated with an increase in the incidence of abnormal eating attitudes, underlining the importance of the acquired component in the modulation of eating behaviours [4].
Adolescents are an important target of investigation and prevention in this area. First, weight and eating abnormalities in early life are likely carried over into adulthood, since approximately one-third (26-41%) of preschool, half (42-63%) of school-age obese children, and up to 70% of obese adolescents become obese adults [5]. Second, the early appearance of obesity entails the prolonged exposure to related risk factors. Third, drug addiction starts at this age, and teenagers are also extremely susceptible to psychosocial influences.
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Defining the strength of the association between obesity, eating disorders and use of addictive substances, and understanding whether these disorders have similar underlying psychosocial environment is important in identifying modifiable risk elements (e.g self-esteem, relations with parents, friends, etc.) that can and need to be targeted in preventive and treatment programmes.
The aims of the latest nationwide survey (2007) in a large sample of Italian adolescents aged 15-19 years were to a) examine the distribution of gender-stratified body mass index, eating attitudes and use of potentially addictive licit and illicit substances, under the hypothesis of a confluence of weight abnormalities, eating disorders and substance abuse, b) demonstrate the extent to which family, peer-related and educational psychosocial factors are common elements in extreme categories of compulsive behaviour in adolescents.
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Category: WHY
