{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:56:10Z","timestamp":1790751370359,"version":"4.1.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the associations of sociocultural appearance pressure, depressive and anxiety symptoms and body appreciation with food addiction status and symptom count among Chinese candidates for bariatric surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 240 candidates for bariatric surgery. Food addiction status and symptom count were assessed using the Yale Food Addiction Scale 2.0 (YFAS 2.0); psychosocial measures included the depressive symptoms (PHQ-9), anxiety (GAD-7), body appreciation (BAS-2), sociocultural attitudes toward appearance (SATAQ-4). Logistic regression was used to analyze food addiction status, and negative-binomial regression was used to analyze food addiction symptom count. The primary analysis used the full Model 3, which simultaneously included demographic, lifestyle and psychological variables. Hierarchical comparisons of Models 1 and 2 were treated as exploratory analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 240 participants, 95 (39.6%) met the criteria for food addiction. In the full logistic model, BMI (OR per SD\u202f=\u202f1.549, 95% CI 1.094\u20132.193;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.014) and family pressure (OR per SD\u202f=\u202f1.516, 95% CI 1.030\u20132.232;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.035) were positively associated with food addiction status. PHQ-9 (OR per SD\u202f=\u202f1.421, 95% CI 0.886\u20132.278;\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.145) and BAS-2 (OR per SD\u202f=\u202f0.719, 95% CI 0.511\u20131.011;\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.058) were not statistically significant. In the full negative-binomial model, family pressure (IRR per SD\u202f=\u202f1.171, 95% CI 1.023\u20131.340;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.022) and PHQ-9 (IRR per SD\u202f=\u202f1.284, 95% CI 1.087\u20131.518;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.003) were positively associated with symptom count, whereas BAS-2 was inversely associated (IRR per SD\u202f=\u202f0.883, 95% CI 0.785\u20130.992;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.037). Formal tests did not distinguish the coefficients for the three pressure sources. The apparent AUC of the logistic model was 0.761, and the optimism-corrected AUC was 0.707.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Associations differed by outcome. BMI and family pressure were associated with food addiction status, whereas family pressure, depressive symptoms and body appreciation were associated with symptom count. Family pressure was the only pressure source with a statistically significant independent coefficient in the full models, but its coefficient did not differ significantly from peer or media pressure. These cross-sectional findings describe associations and require prospective research and external validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1942332","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:05:17Z","timestamp":1790748317000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multidimensional psychosocial correlates of food addiction status and symptom count in Chinese candidates for bariatric surgery: a cross-sectional study"],"prefix":"10.3389","volume":"17","author":[{"given":"Yuyang","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Bariatric and Metabolic Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People\u2019s Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Bariatric and Metabolic Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People\u2019s Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yacong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Bariatric and Metabolic Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People\u2019s Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luyao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Bariatric and Metabolic Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People\u2019s Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Bariatric and Metabolic Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People\u2019s Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linwei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Bariatric and Metabolic Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People\u2019s Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianzhong","family":"Di","sequence":"additional","affiliation":[{"name":"Department of Bariatric and Metabolic Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People\u2019s Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1186\/s40337-025-01428-2","article-title":"Understanding food addiction through the lens of psychological well-being, self-control, and eating behavior: a cross-sectional study","volume":"13","author":"A\u00e7ik","year":"2025","journal-title":"J. Eat. Disord."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1007\/s11695-020-05010-4","article-title":"Food addiction and binge eating during one year following sleeve gastrectomy: prevalence and implications for postoperative outcomes","volume":"31","author":"Ben-Porat","year":"2021","journal-title":"Obes. Surg."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1016\/j.psychres.2018.05.087","article-title":"Food addiction, in obese patients seeking bariatric surgery, is associated with higher prevalence of current mood and anxiety disorders and past mood disorders","volume":"267","author":"Benzerouk","year":"2018","journal-title":"Psychiatry Res."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1650","DOI":"10.1007\/s11695-016-2189-x","article-title":"Food addiction in bariatric surgery candidates: prevalence and risk factors","volume":"26","author":"Brunault","year":"2016","journal-title":"Obes. Surg."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"54","DOI":"10.3390\/bs7030054","article-title":"Food addiction, binge eating disorder, and obesity: is there a relationship?","volume":"7","author":"Burrows","year":"2017","journal-title":"Behav Sci (Basel)"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"3474","DOI":"10.3390\/nu15153474","article-title":"Associations of food addiction symptomatology and disordered eating behaviors in a pre-surgical bariatric population","volume":"15","author":"Butt","year":"2023","journal-title":"Nutrients"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1146\/annurev-nutr-071715-050909","article-title":"The neurobiology of \"food addiction\" and its implications for obesity treatment and policy","volume":"36","author":"Carter","year":"2016","journal-title":"Annu. Rev. Nutr."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1001\/jama.2015.18118","article-title":"Mental health conditions among patients seeking and undergoing bariatric surgery: a meta-analysis","volume":"315","author":"Dawes","year":"2016","journal-title":"JAMA"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"101947","DOI":"10.1016\/j.bodyim.2025.101947","article-title":"Testing the tripartite influence model on body image among pregnant women","volume":"54","author":"Di Gesto","year":"2025","journal-title":"Body Image"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1963","DOI":"10.1007\/s40519-021-01354-7","article-title":"Disentangling binge eating disorder and food addiction: a systematic review and meta-analysis","volume":"27","author":"di Giacomo","year":"2022","journal-title":"Eat. Weight Disord."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1002\/erv.2857","article-title":"No addiction transfer from preoperative food addiction to other addictive behaviors during the first year after bariatric surgery","volume":"29","author":"Dickhut","year":"2021","journal-title":"Eur. Eat. Disord. Rev."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"4042","DOI":"10.1007\/s11695-026-08812-0","article-title":"Individuals with food addiction after metabolic and bariatric surgery show higher consumption of ultra-processed foods, sedentary lifestyle, anxiety, and sub-optimal body weight trajectories","volume":"36","author":"Farias Tavares da Silva","year":"2026","journal-title":"Obes. Surg."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1037\/adb0000136","article-title":"Development of the Yale food addiction scale version 2.0","volume":"30","author":"Gearhardt","year":"2016","journal-title":"Psychol. Addict. Behav."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/j.neubiorev.2014.08.016","article-title":"\"eating addiction\", rather than \"food addiction\", better captures addictive-like eating behavior","volume":"47","author":"Hebebrand","year":"2014","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"101892","DOI":"10.1016\/j.bodyim.2025.101892","article-title":"Behind the mirror: An exploration of the tripartite influence model among Italian adolescent boys and girls","volume":"53","author":"Iannattone","year":"2025","journal-title":"Body Image"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1111\/obr.12685","article-title":"The complexity of body image following bariatric surgery: a systematic review of the literature","volume":"19","author":"Ivezaj","year":"2018","journal-title":"Obes. Rev."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e13729","DOI":"10.1111\/obr.13729","article-title":"Influence of mental and behavioral factors on weight loss after bariatric surgery: a systematic review and meta-analysis","volume":"25","author":"Jacobs","year":"2024","journal-title":"Obes. Rev."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1392","DOI":"10.1016\/j.soard.2017.03.021","article-title":"Alcohol and other substance use after bariatric surgery: prospective evidence from a U.S. multicenter cohort study","volume":"13","author":"King","year":"2017","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"2516","DOI":"10.1001\/jama.2012.6147","article-title":"Prevalence of alcohol use disorders before and after bariatric surgery","volume":"307","author":"King","year":"2012","journal-title":"JAMA"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J. Gen. Intern. Med."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1007\/s40429-020-00315-x","article-title":"Considering food addiction through a cultural Lens","volume":"7","author":"Lawson","year":"2020","journal-title":"Curr. Addict. Rep."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"101678","DOI":"10.1016\/j.bodyim.2023.101678","article-title":"A systematic review of weight stigma and disordered eating cognitions and behaviors","volume":"48","author":"Levinson","year":"2024","journal-title":"Body Image"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/j.bodyim.2022.07.003","article-title":"Body appreciation and its psychological correlates: a systematic review and meta-analysis","volume":"42","author":"Linardon","year":"2022","journal-title":"Body Image"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.bodyim.2023.02.011","article-title":"Translation and psychometric properties of the Chinese version of the sociocultural attitudes towards appearance Questionnaire-4 (SATAQ-4) in college students","volume":"45","author":"Ma","year":"2023","journal-title":"Body Image"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1002\/eat.23568","article-title":"Internalization of body shape ideals and body dissatisfaction: a systematic review and meta-analysis","volume":"54","author":"Paterna","year":"2021","journal-title":"Int. J. Eat. Disord."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/10640266.2025.2551457","article-title":"A mediational model on how yoga self-efficacy may improve eating disorder symptoms: the roles of mindfulness, self-compassion, and body appreciation","author":"Perry","year":"2025","journal-title":"Eat. Disord."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e13529","DOI":"10.1111\/obr.13529","article-title":"Prevalence of food addiction among patients undergoing metabolic\/bariatric surgery: a systematic review and meta-analysis","volume":"24","author":"Praxedes","year":"2023","journal-title":"Obes. Rev."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"9582","DOI":"10.1007\/s00464-023-10353-x","article-title":"Depression as a risk factor for adverse outcomes and increased healthcare utilization in bariatric surgery patients","volume":"37","author":"Ramirez","year":"2023","journal-title":"Surg. Endosc."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1002\/erv.2897","article-title":"Food addiction in anorexia nervosa: implications for the understanding of crossover diagnosis","volume":"30","author":"Sanchez","year":"2022","journal-title":"Eur. Eat. Disord. Rev."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1037\/a0037917","article-title":"Development and validation of the sociocultural attitudes towards appearance Questionnaire-4 (SATAQ-4)","volume":"27","author":"Schaefer","year":"2015","journal-title":"Psychol. Assess."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.appet.2016.10.033","article-title":"A commentary on the \"eating addiction\" versus \"food addiction\" perspectives on addictive-like food consumption","volume":"115","author":"Schulte","year":"2017","journal-title":"Appetite"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.psychres.2016.07.022","article-title":"Food addiction and the outcome of bariatric surgery at 1-year: prospective observational study","volume":"244","author":"Sevin\u00e7er","year":"2016","journal-title":"Psychiatry Res."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1016\/j.soard.2016.02.008","article-title":"Recommendations for the presurgical psychosocial evaluation of bariatric surgery patients","volume":"12","author":"Sogg","year":"2016","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.bodyim.2016.04.005","article-title":"Translation and psychometric evaluation of a standard Chinese version of the body appreciation Scale-2","volume":"18","author":"Swami","year":"2016","journal-title":"Body Image"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"107890","DOI":"10.1016\/j.appet.2025.107890","article-title":"Examining how sociocultural appearance pressures relate to positive and negative facets of body image and eating behaviors in adolescents: An exploratory person-centered approach","volume":"207","author":"Tanguay","year":"2025","journal-title":"Appetite"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.eplepsyres.2015.11.019","article-title":"Validation of the generalized anxiety Disorder-7 (GAD-7) among Chinese people with epilepsy","volume":"120","author":"Tong","year":"2016","journal-title":"Epilepsy Res."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.bodyim.2014.09.006","article-title":"The body appreciation Scale-2: item refinement and psychometric evaluation","volume":"12","author":"Tylka","year":"2015","journal-title":"Body Image"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1016\/s0022-3999(02)00499-3","article-title":"The tripartite influence model of body image and eating disturbance: a covariance structure modeling investigation testing the mediational role of appearance comparison","volume":"53","author":"van den Berg","year":"2002","journal-title":"J. Psychosom. Res."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1016\/j.genhosppsych.2014.05.021","article-title":"Reliability and validity of the Chinese version of the patient health questionnaire (PHQ-9) in the general population","volume":"36","author":"Wang","year":"2014","journal-title":"Gen. Hosp. 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