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Funding: We thank CERCA Programme/Generalitat de Catalunya for institutional support. This manuscript and research was supported by grants from the Ministerio de Economía y Competitividad (PSI2015-68701-R), by the Delegación del Gobierno para el Plan Nacional sobre Drogas (2017I067), by the Instituto de Salud Carlos III (ISCIII) (FIS PI14/00290 and PI17/01167), by the SLT006/17/00246 grant, funded by the Department of Health of the Generalitat de Catalunya by the call "Acció instrumental de programes de recerca orientats en l'àmbit de la recerca i la innovació en salut", and co-funded by FEDER funds/European Regional Development Fund (ERDF), a way to build Europe. CIBERObn and CIBERSAM are both initiatives of ISCIII. Food addiction (FA) has been associated with greater psychopathology in individuals with eating disorders (ED) and obesity (OBE). The current study aims to provide a better phenotypic characterization of the FA construct by conducting a clustering analysis of FA in both conditions (ED and OBE). The total sample was comprised of 234 participants that scored positive on the Yale Food Addiction Scale 2.0. (YFAS-2) (119 bulimia nervosa (BN), 50 binge eating disorder (BED), 49 other specified feeding or eating disorder (OSFED) and 16 OBE). All participants completed a comprehensive battery of questionnaires. Three clusters of FA participants were identified. Cluster 1 (dysfunctional) was characterized by the highest prevalence of OSFED and BN, the highest ED severity and psychopathology, and more dysfunctional personality traits. Cluster 2 (moderate) showed a high prevalence of BN and BED and moderate levels of ED psychopathology. Finally, cluster 3 (adaptive) was characterized by a high prevalence of OBE and BED, low levels of ED psychopathology, and more functional personality traits. In conclusion, this study identified three distinct clusters of ED-OBE patients with FA and provides some insight into a better phenotypic characterization of the FA construct when considering psychopathology, personality and ED pathology. Future studies should address whether these three food addiction categories are indicative of therapy outcome.

Difficulties in emotion regulation (ER) are common in females with eating disorders (ED). However, no study to date has analyzed ER in males with ED. In the study at hand, we assessed ER in males with ED and compared results to both females with ED and healthy controls (HC). We also examined associations between ER difficulties, personality, and psychopathology. A total of 62 males with ED were compared with 656 females with ED, as well as 78 male and 286 female HC. ER was assessed by means of the Difficulties in Emotion Regulation Scale (DERS). We found that males and females with ED showed greater ER difficulties compared to HC. Pronounced general psychopathology was a shared factor associated with higher ER difficulties in both males and females with ED. However, whereas higher novelty seeking, higher cooperativeness, lower reward dependence, and lower self-directedness were related to higher ER difficulties in females with ED, lower persistence was associated with ER difficulties in males with ED. In sum, males and females with ED show similar ER difficulties, yet they are distinct in how ER deficits relate to specific personality traits. Research on strategies promoting ER in the treatment of males with ED is warranted.