Food addiction mediates the relationship between perceived stress and body mass index in Taiwan young adults

Perceived stress is the degree of stress experienced by an individual in the face of a stressor. Studies have shown that stress affects emotions, leads to behavioral changes, and is likely to trigger physical illnesses. According to the World Health Organization (WHO), stress is classified as a health epidemic of the 21st century; in the meantime, the percentage of adults being overweight and with obesity has continued to grow after reaching 38.9% in 2016. Hence, it is unclear whether perceived stress has become a factor affecting progressive obesity and whether food addiction (FA) is an intermediate factor. The purposes of this study were to (1) investigate the FA prevalence among young adults in Taiwan, (2) understand correlations among perceived stress, FA, and the body mass index (BMI), and (3) determine the potential mediating effect of FA due to perceived stress on BMI. The study was conducted through an online questionnaire, composed of a basic data form, the Perceived Stress Scale (PSS), and the Yale Food Addiction Scale (YFAS). We received 1994 responses and analyzed 1780 valid samples. Results showed that 231 participants met the FA criteria, accounting for 12.98%. Perceived stress was positively correlated with BMI (95% confidence interval (CI) 0.013~0.088, p-value 7.8 × 10 -3), and perceived stress was positively associated to FA (95% CI 1.099~1.154, p-value < 10 -4), which was also positively correlated with BMI (95% CI 0.705~2.176, p-value 10 -4). FA significantly mediated the relationship between PSS and BMI with an indirect effect size of 25.18% and 25.48% in the group that scored 31~40 on the PSS. The study concluded that among people seeking weight loss, proper stress management and screening for FA in order to apply related therapies may be an effective method for weight management.