Received: 2 May 2018 Revised: 12 August 2018 Accepted: 2 September 2018

DOI: 10.1002/erv.2642

ORIGINAL ARTICLE

Compulsive “grazing” and addictive tendencies

towards food

Revi Bonder1 | Caroline Davis1 | Jennifer L. Kuk1 | Natalie J. Loxton2

1
School of Kinesiology and Health
Sciences, York University, Toronto, ON,
Canada
2
School of Applied Psychology, Griffith
University, Brisbane, QLD, Australia
Correspondence
Revi Bonder, School of Kinesiology and
Health Sciences, York University, 223
Bethune College, 4700 Keele Street,
Toronto, Ontario M3J1P3, Canada.
Email: rbonder@yorku.ca
Abstract
Evidence suggests that palatable foods can promote an addictive process akin
to drugs of abuse. To date, research in the field of food addiction has focused
largely on binge eating as a symptom of this condition. The present study
investigated relationships between food addiction and other patterns of over-
eating, such as compulsive grazing—a behaviour with high relevance to bariat-
ric surgery outcomes. Adults between the ages of 20 and 50 years (n = 232)
were recruited for the study. Participants completed questionnaires to assess
various eating behaviours and related personality measures. Regression analy-
sis employed the Yale Food Addiction Scale (YFAS) as the dependent variable.
Results indicated that addictive personality traits, reward‐driven eating, and
compulsive grazing each contributed unique variance to the YFAS symptom
score. These findings provide novel insight into the association between a graz-
ing pattern of overeating and food addiction, and emphasize that similar to tra-
ditional addiction disorders such as alcoholism, binge consumption is not the
only pattern of compulsive intake.

KEYWORDS
binge eating, food addiction, grazing, reward drive

1 | INTRODUCTION self‐regulate what and how much is eaten—has gained

Decades of research have demonstrated that dieting and
exercise strategies are largely ineffective for long‐term,
sustained weight loss (see Dulloo, Jacquet, Montani, &
Schutz, 2015). Moreover, invasive surgical procedures to
treat recalcitrant obesity have also increased in recent years
(Angrisani et al., 2015). One perspective is that recent envi-
ronmental changes poorly serve our inherent biological
predisposition to consume highly palatable, high‐glycaemic
index foods beyond daily caloric needs (Treasure, Leslie,
Chami, & Fernández‐Aranda, 2018). The consequence is
an evolutionary “mismatch” that can foster excessive intake
in many vulnerable individuals (Davis, 2014 for a review).
Loss‐of‐control (LOC) eating—a pattern of disordered
overeating characterized by the diminished ability to
increasing clinical relevance due to its association with
poor outcomes following bariatric surgery (Kalarchian &
Marcus, 2018). The compulsivity of such patterns of
overeating has also been likened to an addictive process
akin to what occurs with the heavy use of drugs such as
alcohol, cocaine, and opioids (Avena, Rada, & Hoebel,
2008; Davis, 2013). In particular, responses to processed
foods high in sugar, fat, and salt can lead to escalation
of intake and pronounced cravings—a syndrome that
has come to be known as food addiction1 (Avena et al.,
2008; Davis & Carter, 2014).
1
Although this term has generated substantial debate, with some arguing
for the use of labels like “food use disorder,” its familiarity in research
and clinical reporting has persuaded us to retain it in this paper.

Eur Eat Disorders Rev. 2018;26:569–573. wileyonlinelibrary.com/journal/erv © 2018 John Wiley & Sons, Ltd and Eating Disorders Association. 569
570
In an effort to operationally define food addiction for
research purposes, Gearhardt, Corbin, and Brownell
(2009) developed the Yale Food Addiction Scale (YFAS).
Since its development, considerable research has pro-
vided validation for the food addiction construct as a
bona fide substance use disorder, showing, for instance,
that individuals who meet the YFAS diagnostic criteria
are more likely to display impulsivity and elevated sensi-
tivity to reward (Davis & Carter, 2014). Although there
are also strong links between binge eating disorder and
food addiction (Davis et al., 2011), it is notable that their
overlap is only about 50%, indicating that many with food
addiction do not report clinically significant symptoms of
binge eating. Importantly, varied patterns of consumption
are typically found in other addiction disorders. For
example, although some alcoholics engage in episodic
binge drinking, others show patterns of hazardous drink-
ing throughout the day (Rehm et al., 2017). The same var-
ied patterns of use are seen in those who gamble
pathologically (Cowlishaw, Nespoli, Jebadurai, Smith, &
Bowden‐Jones, 2018).
Inspired by such evidence, we sought to examine
other LOC patterns of consumption in those with food
addiction, with a primary focus on compulsive grazing.
This pattern of LOC overeating has high relevance to
bariatric surgery outcomes and is commonly defined as
the consumption of relatively small amounts of food over
an extended period of time and, importantly, the inability
to resist such repetitive snacking despite having inten-
tions to stop (Conceição et al., 2017). The onset of post‐
operative grazing has also been associated with greater
weight regain and lower weight loss (Pizato, Botelho,
Gonçalves, Dutra, & De Carvalho, 2017). To date, how-
ever, no studies have investigated grazing as a possible
clinical component of food addiction. Therefore, the
purpose of this exploratory study was to examine the
relationships of food addiction with compulsive grazing,
as well as with binge eating and reward‐driven eating,
after controlling for well‐established risk factors for food
addiction such as addictive personality traits (Davis,
2013), impulsivity (Davis et al., 2011), and body mass
index (BMI; Pedram et al., 2013).
2 | METHODS
2.1 | Participants and procedures
Student volunteers at a Canadian university took part in
the study (n = 174). In addition, 81 participants were
included from an independent online collaborative
Australian study where recruitment occurred via a web
link posted on social media sites. Participants ranged
BONDER ET AL.
from 20 to 50 years. Exclusion criteria were pregnancy
or lactation and/or severe physical disabilities. Twenty
participants were excluded from the total study due to
missing data.
Canadian participants were assessed individually in a
university laboratory where height and weight were
measured, and demographic information was obtained
via face‐to‐face interview. The self‐report questionnaires
were then completed. To avoid response bias, question-
naire order was randomized across participants. Online
participants self‐reported their height and weight.
Criteria for a YFAS diagnosis were met by 32 partici-
pants (14%). Most participants reported not smoking
(90%), not using recreational drugs (90%), and not drink-
ing alcohol (71%).
2.2 | Measures
2.2.1 | Food addiction
Food addiction was assessed by the 25‐item YFAS,
which reflect the seven symptoms of a substance‐depen-
dence disorder in the Diagnostic and Statistical Manual
– IV‐Text Revision (American Psychiatric Association,
2000) modified for eating behaviours (Gearhardt
et al., 2009). Similar to the Diagnostic and Statistical
Manual, a food addiction diagnosis is indicated by
endorsement of three or more symptoms and by the
“clinically significant impairment” criterion. The YFAS
also provides a continuous symptom‐count score rang-
ing from 0 to 7. Cronbach's α for the symptom‐count
score was 0.84.
2.2.2 | Binge eating
Binge eating was assessed by the 5‐item subscale of the
Binge Eating Questionnaire, which assesses severity of
binge eating (Halmi, Falk, & Schwartz, 1981). Cronbach's
α was 0.75.
2.2.3 | Grazing
Grazing was assessed by the Rep(eat) Questionnaire, a
12‐item measure used to operationalize the behaviours
and cognitions of grazing (Conceição et al., 2017). Items
differentiate two sub‐types of grazing: (a) non‐compulsive
and (b) compulsive, and are scored on a 6‐point Likert‐
type scale. Subscale scores reflect the average of individ-
ual item scores. Cronbach's α for the compulsive grazing
score was 0.90.
BONDER ET AL. 571

2.2.4 | Reward‐driven eating TABLE 2 Regression coefficients for the multiple regression
analysis with YFAS symptom score as the dependent variable
Reward‐driven eating was assessed by the 9‐item, Likert‐
scored, Reward‐Based Eating Drive Scale (Epel et al., Variable B SE β t p VIF

2014). Items reflect (a) diminished control over pleasur- Block 1

able eating, (b) weakened satiety, and (c) a preoccupation Age −0.01 0.02 −0.03 −0.49 0.628 1.02
with palatable food. Cronbach's α was 0.87.
AP 0.12 0.02 0.37 5.72 <0.0001 1.35
IMP 0.04 0.01 0.23 3.53 0.001 1.33
2.2.5 | Impulsivity BMI 0.07 0.02 0.18 3.21 0.002 1.03
Impulsivity was measured by the 30‐item, Barratt Impul- Block 2
siveness Scale (Patton, Stanford, & Barratt, 1995). Age −0.01 0.01 −0.05 −1.13 0.259 1.03
The scale conceptualizes impulsivity according to three AP 0.04 0.02 0.12 2.04 0.042 1.62
dimensions: (a) attentional impulsiveness, (b) non‐plan-
IMP 0.00 0.01 0.01 0.20 0.845 1.53
ning impulsiveness, and (c) motor impulsiveness.
BMI 0.02 0.02 0.04 0.94 0.348 1.11
Cronbach's α was 0.82 for the total score.
BE 0.11 0.07 0.10 1.53 0.128 2.01
RED 0.30 0.14 0.16 2.11 0.036 2.92
2.2.6 | Addictive personality traits CG 0.58 0.09 0.48 6.34 < 0.0001 2.88
Addictive personality traits were assessed by the Addiction Note. AP: addictive personality; B: unstandardized coefficient; BE: binge eat-
Scale of the Eysenck Personality Questionnaire‐Revised ing; CG: compulsive grazing; IMP: impulsivity; RED: reward‐driven eating;
(Eysenck & Eysenck, 1991). This scale was derived by iden- VIF: variance inflation factor; YFAS: Yale Food Addiction Scale; β: standard-
ized coefficient.
tifying items on the Eysenck Personality Questionnaire‐
Block 1: Adjusted R2 = 0.32.
Revised that differentiated drug addicts from controls at a
Block 2: Adjusted R2 = 0.57.
probability level less than or equal to 0.001. Items are scored
using a yes–no format. Cronbach's α was 0.79.
than the online participants (p < 0.0001). Since no other
differences were found, the datasets were merged.
3 | RESULTS Table 1 presents the means, standard deviations, and
independent samples t test results for the quantitative
Independent samples t tests were performed on quantita- variables used in the study, listed separately for males
tive demographic variables and scale scores to assess group and females. Males had higher BMI values than females,
differences between university and online participants. whereas the reverse was found for grazing scores.
The university participants were significantly younger

TABLE 1 Means, standard deviations, and independent samples

t tests for the quantitative variables, listed separately for males and 3.1 | Multiple regression analysis
females
Summary statistics for the regression model are shown in
Female (158) Male (77)
Table 2. On the basis of the strength of previous evidence
_ _
Variable x SD x SD t p (Davis, 2013; Loxton & Tipman, 2017; Pedram et al.,
Age 25.1 7.0 23.9 5.8 1.22 0.223 2013), BMI, impulsivity, and addictive personality traits
were included as covariates in Block 1 of the model with
AP 14.0 5.6 12.6 5.1 1.84 0.067
age, followed by the eating behaviour measures in Block
BE 1.9 1.6 1.6 1.5 1.46 0.145
2. Greater symptom severity was associated with higher
IMP 63.3 10.7 62.2 9.3 0.77 0.440 addictive personality traits, greater reward‐driven eating,
BMI 24.8 4.4 26.5 4.2 −2.72 0.007 and more compulsive grazing, with compulsive grazing
RED 1.6 1.0 1.3 0.8 1.86 0.064 making the largest contribution to the model.
CG 1.8 1.5 1.4 1.3 2.05 0.042
The logistic regression analysis, with YFAS diagnosis
a
as the dependent variable, produced null results.2
YFAS 2.7 1.9 2.4 1.7 1.07 0.287

Note. AP: addictive personality; BE: binge eating; CG: compulsive grazing; IMP:
impulsivity; RED: reward‐driven eating; YFAS: Yale Food Addiction Scale. 2
Detailed results of the logistic regression analysis are available upon
a
Symptom scores. request from the corresponding author.
572
4 | DISC USS I ON
This study is the first to investigate compulsive grazing in
the context of food addiction and the severity of its symp-
toms. Results indicated that addictive personality traits,
reward‐driven eating, and compulsive grazing each con-
tributed unique variance to the YFAS symptom score.
Unexpectedly, however, these variables were not signifi-
cant correlates of the binary YFAS diagnostic variable.
The statistical significance of addictive personality
traits in the symptom‐score model underscores the psycho-
logical risk‐factor similarity between food addiction and
conventional addiction disorders—as others have found
(Davis, 2013)—and reinforces the view that in severe cases,
compulsive overeating may be best conceptualized as an
addictive process. Although the current study was the first
to assess the relationship between reward‐driven eating
and food addiction, these results mesh with previous evi-
dence that those with food addiction reported an elevated
reward sensitivity and experienced greater food cravings
(Davis, 2013) than their control counterparts.
Our results are also the first to show a strong positive
relationship between compulsive grazing and food addic-
tion symptom severity. Interestingly, after accounting for
compulsive grazing and reward‐driven eating, binge
eating added no further unique variance to the YFAS
symptom score. These findings support the view that
binge eating and addictive tendencies towards food are
not necessarily synonymous facets of problematic over-
eating and that other patterns of overconsumption
characterize food addiction, as seen in other substance
use disorders (Rehm et al., 2017).
The discrepancy in findings between the symptom‐
score and the diagnosis models highlights the marked
difference between these variables from a clinical per-
spective. For example, some of the YFAS symptoms, such
as “eating more than planned”, are likely to be endorsed
by many in today's highly palatable food environment—
that is, are more like normative behaviour than a symp-
tom of disordered overeating. Therefore, although the
YFAS symptom score is useful in explaining a risk profile,
and/or the extent to which an individual is likely to
engage in excessive and compulsive food‐related behav-
iours, it does not necessarily assess the severe impact on
life quality that is associated with an addiction disorder.
Regrettably, the two scoring methods are frequently used
interchangeably in research studies as conceptually
equivalent constructs, despite the statistical, psychologi-
cal, and behavioural evidence to the contrary—as seen
in the current study and elsewhere.
Despite the novelty of our findings, it is important
to emphasize the preliminary nature of the data and to
acknowledge the limitations of the study design.
BONDER ET AL.
Although the mean BMI of the sample fell in the low
overweight range, it would behove future researchers to
test our model with participants characterized by more
severe overweight or obesity, as well as with those seek-
ing treatment for compulsive overeating. It may be that
binge eating, as a more disordered eating pattern, would
then remain a significant effect in the food addiction
model. In addition, although the proportion of our
sample meeting YFAS criteria for food addiction was
commensurate with its prevalence in a sample represen-
tative of the American population (Schulte & Gearhardt,
2018), a larger sample would allow for assessment of the
possible moderating effect of sex/gender. Such investiga-
tions are important because the global increase in obesity
(especially in the severe classes; World Health Organiza-
tion, 2018), and in binge eating disorder prevalence rates
(Davis, 2015), is greatest in women.
In summary, our findings add to the increasing simi-
larities between addictive‐like overeating and traditional
substance use disorders by demonstrating that continual
consumption throughout the day—in the form of graz-
ing—is a prominent pattern of intake, in addition to pre-
viously demonstrated links between binge episodes and
addictive tendencies towards food (Davis, 2013). The cur-
rent results also have particular relevance for bariatric
patients, where grazing and mindless eating have been
associated with poor dietary adherence post‐operatively
(Pizato et al., 2017).
CONFLICT OF INTEREST
None.
ORCID
Revi Bonder http://orcid.org/0000-0002-9711-851X
Caroline Davis http://orcid.org/0000-0002-4412-5396
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How to cite this article: Bonder R, Davis C, Kuk
JL, Loxton NJ. Compulsive “grazing” and addictive
tendencies towards food. Eur Eat Disorders Rev.
2018;26:569–573. https://doi.org/10.1002/erv.2642