Clinical correlates of depressed adolescents comorbid with food addiction: a cross-sectional study

Abstract

Background Food addiction (FA) involves the excessive intake of ultra-processed foods and is prevalent among individuals with major depressive disorder (MDD). Despite this association, evidence regarding FA in adolescents with MDD is limited. This investigation sought to examine the relationship between FA and clinical features in this demographic, aiming to clarify the prevalence of FA and offer theoretical insights for clinical management. Methods A total of 194 depressed adolescents were recruited at the Fourth Affiliated Hospital of Anhui Medical University between September 2022 and June 2025. Validated multidimensional scales were used to assess FA, depression, anxiety, perceived stress, and internet addiction (IA). Subsequently, stepwise regression analysis was performed to identify independent factors of FA, and receiver operating characteristic (ROC) curve analysis was conducted for these predictors, with the area under the curve (AUC) calculated. Results The prevalence of FA in depressed adolescents was 17.5%. Multivariate logistic regression identified BMI (OR = 1.149, 95% CI = 1.051 - 1.257, P = 0.002), anxiety (OR = 1.116, 95% CI = 1.039 - 1.198, P = 0.002), perceived stress (OR = 1.137, 95% CI = 1.030 - 1.254, P = 0.011), and IA (OR = 1.051, 95% CI = 1.020 - 1.083, P = 0.001) as independent risk factors of FA. Furthermore, ROC curve analysis demonstrated that a combined model comprising these four factors exhibited superior discriminatory ability for identifying FA (AUC = 0.861, 95% CI = 0.801 - 0.921, P < 0.001). Conclusion FA affects some adolescents with MDD and is closely associated with BMI, anxiety, perceived stress, and IA. Clinicians should integrate screening for this abnormal eating behavior and related psychosocial factors into routine care.