Validation of the Yale Food Addiction Scale 2.0 Among a Bariatric Surgery Population

Addictive eating, a highly debated problematic eating behavior, may contribute to obesity and impede the success of individuals seeking bariatric surgery. The original Yale Food Addiction Scale (YFAS) was validated for use among patients who underwent bariatric surgery; however, the YFAS was revised to reflect changes in substance use criteria in the DSM-5. The purpose of this study was to validate the use of the revised measure, the YFAS 2.0, among patients pursuing bariatric surgery.

A retrospective chart review was conducted of 314 patients who underwent pre-surgical psychological evaluation for bariatric surgery. Information gathered included symptoms of addictive eating (YFAS 2.0), emotional eating (Emotional Eating Scale; EES), and a history of substance use and binge eating.

In this sample, 27.3% met criteria for "food addiction" according to the YFAS 2.0. Of those, more than half met criteria for severe food addiction. The YFAS 2.0 was related to all factors of the EES: anger/frustration (p < .001); anxiety (p < .001); and depression (p < .001). There was no relationship between the YFAS 2.0 and a history of substance use. The YFAS 2.0 accounted for significant variance in history of binge eating after controlling for emotional eating (p < .001; Exp(B) = 1.30).

Results were similar to a prior validation of the YFAS among a bariatric population, and the updated YFAS 2.0 may be useful in assessing addictive eating among bariatric surgery candidates to further explore the concept of "food addiction."