The relationship of food addiction with chronotype, sluggish cognitive tempo and internet addiction in adolescents diagnosed with overweight and obesity

Introduction and Aim: Eating attitudes and behaviors that may contribute to eating disorders are prevalent among overweight/obese children and adults. Food addiction has been considered one of the significant factors in the development of obesity. This study aimed to compare food addiction, chronotype types, internet addiction, sluggish cognitive tempo (SCT), and attention deficit hyperactivity disorder (ADHD) symptoms in overweight/obese adolescents with controls, and to examine the relationship of these variables with food addiction in the entire sample. Based on the findings, we aimed to contribute to the optimization of treatment planning in overweight/obese adolescents. Additionally, we sought to investigate factors associated with SCT and risky internet use, as well as their relationship with overweight/obesity. Materials and Methods:The study included 128 overweight or obese subjects aged 12-18 years, classified according to body mass index (BMI) standard deviation (SD) values, and 125 normal-weight controls. Parents of the subjects completed the Child and Adolescent Behavior Inventory—Sluggish Cognitive Tempo subscale, the Childhood Chronotype Questionnaire, and the DSM-IV-Based Screening and Assessment Scale for ADHD and Disruptive Behavior Disorders subscales assessing inattention and hyperactivity/impulsivity. Adolescents completed the Yale Food Addiction Scale for Children 2.0, and the Young Internet Addiction Scale. Results: Food addiction and SCT levels were significantly higher in the overweight/obese group compared to controls (p < 0.001). No significant differences were found between groups in terms of chronotype types (p = 0.139) with the intermediate chronotype being the most common in both groups. Overweight/obesity, female gender, risky internet use, and evening chronotype significantly predicted higher food addiction levels (F = 11.06, p < 0.001, R² = 0.267). Furthermore, hierarchical multiple regression analysis revealed that overweight/obesity, female sex, and increased inattention symptoms were associated with higher SCT symptoms (F = 27.558, p < 0.001, R² = 0.459). Conclusion: Our findings emphasize the importance of assessing food addiction and related risk factors in obesity treatment. The significantly elevated SCT levels in overweight/obese adolescents compared to controls suggest a potential association between SCT and obesity. The association of female gender with food addiction and SCT indicates that female adolescents may be at higher risk for obesity and SCT. These results underscore the necessity of considering factors such as food addiction, chronotype, internet use, and inattention in the development of treatment approaches for overweight/obese adolescents. Future research should focus on exploring causal relationships among these variables to inform more effective therapeutic strategies.