Background

The Yale Food Addiction Scale (YFAS) was developed in 2009 to assess food addiction; a revised version was released in 2016 (YFAS 2.0). Little research has examined food addiction in a bariatric surgery population specifically. The objective of this study was to validate the YFAS 2.0 in a sample of adults seeking bariatric surgery.

Methods

This multi-center study included patients who underwent a preoperative psychological evaluation during 2015-2018. Only those who completed the YFAS 2.0 were included. Responses to the YFAS 2.0 were validated against the PHQ-9, GAD-7, MDQ, ACES, AUDIT, WEL-SF, and EOQ. Statistical analysis included chi-square tests and Spearman Correlations.

Results

Overall, 1208 patients were included; 74% female. Mean age and BMI were 47.2 ± 12.7 years and 46.9 ± 12.9 kg/m2, respectively. There were 195 (16%) patients who screened positive on the YFAS 2.0 (21% mild, 24% moderate, and 56% severe food addiction). More women screened positively on the YFAS 2.0 compared to men (18% vs. 12%; P<0.01). Of patients who screened positive on the YFAS 2.0, 15% also met criteria for binge eating disorder. Mean scores for the PHQ-9, GAD-7, MDQ, ACES, and EOQ were highest among those who screened positive for food addiction (Table).

Conclusions

The YFAS 2.0 was significantly correlated with total scores for the PHQ-9, GAD-7, MDQ, ACES, WEL-SF, and EOQ. Consistent with previous literature, the YFAS 2.0 did not correlate with patient BMI or AUDIT. The YFAS 2.0 is a valid measure to assess food addiction in patients pursuing bariatric surgery.