title: Should pathological gambling and obesity be considered addictive disorders? A factor analytic study in a nationally representative sample.
abstract: OBJECTIVE
  Pathological gambling (PG) is now aligned with substance use disorders in the DSM-5 as the first officially recognized behavioral addiction. There is growing interest in examining obesity as an addictive disorder as well. The goal of this study was to investigate whether epidemiological data provide support for the consideration of PG and obesity as addictive disorders.
  
  
  METHODS
  Factor analysis of data from a large, nationally representative sample of US adults (N=43,093), using nicotine dependence, alcohol dependence, drug dependence, PG and obesity as indicators. It was hypothesized that nicotine dependence, alcohol dependence and drug use dependence would load on a single factor. It was further hypothesized that if PG and obesity were addictive disorders, they would load on the same factor as substance use disorders, whereas failure to load on the addictive factor would not support their conceptualization as addictive disorders.
  
  
  RESULTS
  A model with one factor including nicotine dependence, alcohol dependence, drug dependence and PG, but not obesity, provided a very good fit to the data, as indicated by CFI=0.99, TLI=0.99 and RMSEA=0.01 and loadings of all indicators >0.4.
  
  
  CONCLUSIONS
  Data from this study support the inclusion of PG in a latent factor with substance use disorders but do not lend support to the consideration of obesity, as defined by BMI, as an addictive disorder. Future research should investigate whether certain subtypes of obesity are best conceptualized as addictive disorders and the shared biological and environmental factors that account for the common and specific features of addictive disorders.
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA. Electronic address: cb255@columbia.edu.
authors.forename: Carlos
authors.initials: C
authors.lastname: Blanco
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA; Clinical Research Division, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico.
authors.forename: María
authors.initials: M
authors.lastname: García-Anaya
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA; Department of Biostatistics, New York State Psychiatric Institute, Columbia University, New York, NY, USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Wall
authors.affiliation: Addictive Behaviors Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, (IIB Sant Pau) Departament de Psiguiatria i Medicina Legal, Universitat Autonoma de Barcelona, Barcelona, Spain.
authors.forename: José Carlos Pérez
authors.initials: JC
authors.lastname: de Los Cobos
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA.
authors.forename: Ewelina
authors.initials: E
authors.lastname: Swierad
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA.
authors.forename: Shuai
authors.initials: S
authors.lastname: Wang
authors.affiliation: Calhoun Cardiology Center, University of Connecticut Health Center, Farmington, CT, USA.
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Petry
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016739:Behavior, Addictive / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005163:Factor Analysis, Statistical; D005260:Female; D005715:Gambling / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult
keywords: Addictive disorders; Gambling disorder; Obesity; Pathological gambling; Substance use disorders