Obesity as a part of general addiction syndrome in Italian adolescents

Purpose: The mounting prevalence of obesity and of drug abuse in the youth preludes an epidemics in the related cardiovascular complications. Overeating in obese individuals shares similarities with the loss of control and compulsive behaviour observed in drug-addicted subjects. The aim of this Nationwide survey was to investigate the clustering of obesity and addictive attitudes concerning the abuse of substances with proven cardiovascular side effects, and its relationship with social interactions. Methods: Data were collected by anonymous self-administered questionnaires in 40,407 adolescents aged 15-19. Obesity and normal weight were defined as body mass index (BMI) >90th and 10th<=BMI<=90th percentile, respectively. An addictive attitude was defined as use of cocaine, heroin, hallucinogens, stimulants, psychoactive agents >=10 times and/or cannabis >=20 times in the last year and/or binge drinking >=3 times and/or cigarette smoking >=11/day in the last month. Results: Obesity was associated with use of cocaine (in females), heroin, hallucinogens, binge drinking, cigarette smoking (<0.05 vs normal weight). When the obese category was stratified according to the additional presence vs absence of an addictive attitude, two groups were identified, one without and one with addictive behaviour. Obesity and substance abuse clustered in a significant proportion of 25% obese adolescents, with a predominance in males (M=29%; F=20%; p<0.01). Addictive-obesity was frequently associated with social or personal maladaptive traits (p<0.01). Conclusions: Obesity and food abuse can be part of a general addiction vulnerability, likely associated with other cardio-toxic substance abuse and social and personal maladaptation. An interdisciplinary therapeutic approach is warranted in the effective prevention.