1 Department of Health, Kinesiology, and Applied Physiology, Concordia University, and Montréal Behavioural Medicine Centre, CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.
2 Department of Clinical Nutrition & Dietetics, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Department of Psychology, Concordia University, and Montréal Behavioural Medicine Centre, CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.
4 Cardiac primary prevention research center, Cardiovascular Diseases Research Centre, Tehran University of Medical Sciences, Tehran, Iran.
5 Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Obesity is associated with maladaptive eating behaviors, including food addiction (FA) and binge eating disorder (BED). However, the key factors influencing the development of maladaptive eating behaviors remain unknown. Adherence to specified dietary patterns has been suspected of making indirect impacts. This study investigates the association of FA and BED with dietary patterns and anthropometric measurements among 400 Iranian adults (aged 18-60; 66.25% women) living with obesity (body mass index [BMI] = 30 kg/m²). The Binge Eating Scale and Yale Food Addiction Scale were used to measure BED and FA. A validated 147-item semi-quantitative food frequency questionnaire underwent principal component analysis and identified three major dietary patterns: mixed, unhealthy, and healthy dietary pattern. After adjusting for confounders, higher adherence to unhealthy dietary patterns was associated with an increased risk of FA, while higher adherence to healthy dietary patterns was associated with a lower risk of FA. Also, those within obesity class III had a significantly higher risk of FA and BED than those in obesity class I. This study suggests that adherence to an unhealthy dietary pattern may be associated with a higher risk of FA. It also highlights the link between higher BMI and maladaptive eating behaviors.