Skip to main content

Advertisement

SpringerLink
Log in

Validation of the Yale Food Addiction Scale 2.0 in Patients Seeking Bariatric Surgery

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

The Yale Food Addiction Scale (YFAS) was developed in 2009 to assess food addiction (FA); a revised version was released in 2016 (YFAS 2.0). The objective of this study was to determine the statistical and clinical validity of the YFAS 2.0 in adults seeking bariatric surgery.

Methods

Patients who underwent a preoperative psychological evaluation in preparation for bariatric surgery from 2015 to 2018 were included. The YFAS 2.0 was administered as part of routine clinical care and validated against an assessment battery of standardized clinical measures. Statistical analyses included chi-square and Wilcoxon rank sum tests and calculation of Spearman’s rank correlation coefficients.

Results

Overall, 1061 patients were included. Mean age and BMI were 47.5 ± 12.9 years and 46.9 ± 13.4 kg/m2, respectively. There were 196 (18%) patients who screened positive on the YFAS 2.0 (21% mild, 23% moderate, and 56% severe FA). The YFAS 2.0 demonstrated strong convergent validity where patients who met criteria for FA had significantly increased levels of binge eating (p < 0.001), emotional eating (p < 0.001), and lower self-efficacy (p < 0.001). Discriminant validity was demonstrated by lack of association with alcohol use (p = 0.319). The YFAS 2.0 was significantly correlated with total scores for depression (p < 0.001), anxiety (p < 0.001), bipolar disorder symptoms (p < 0.001), and trauma history (p < 0.001).

Conclusions

The prevalence of FA in a large sample of patients seeking bariatric surgery was consistent with previous literature. These data suggest that the YFAS 2.0 is psychometrically valid, demonstrating strong construct validity, and is a clinically useful measure of FA severity in patients pursuing bariatric surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Davis C, Carter JC. Compulsive overeating as an addiction disorder. A review of theory and evidence. Appetite. 2009;53(1):1–8.

    Article  Google Scholar 

  2. Gearhardt AN, Corbin WR, Brownell KD. Food addiction: an examination of the diagnostic criteria for dependence. J Addict Med. 2009;3(1):1–7.

    Article  Google Scholar 

  3. Gearhardt AN, Corbin WR, Brownell KD. Preliminary validation of the Yale Food Addiction Scale. Appetite. 2009;52(2):430–6.

    Article  Google Scholar 

  4. Avena NM, Gold JA, Gold MS. Further developments in the neurobiology of food and addiction: update on the state of the science. Nutrition. 2012;28(4):341–3.

    Article  Google Scholar 

  5. Gearhardt AN, Yokum S, Orr PT, et al. Neural correlates of food addiction. Arch Gen Psychiatry. 2011;68(8):808–16.

    Article  Google Scholar 

  6. Umberg EN, Shader RI, Hsu LK, et al. From disordered eating to addiction: the “food drug” in bulimia nervosa. J Clin Psychopharmacol. 2012;32(3):376–89.

    Article  Google Scholar 

  7. Hebebrand J, Albayrak O, Adan R, et al. “Eating addiction”, rather than “food addiction”, better captures addictive-like eating behavior. Neurosci Biobehav Rev. 2014;47:295–306.

    Article  Google Scholar 

  8. Ruddock HK, Christiansen P, Halford JCG, et al. The development and validation of the addiction-like eating behaviour scale. Int J Obes. 2017;41(11):1710–7.

    Article  CAS  Google Scholar 

  9. Meule A. A critical examination of the practical implications derived from the food addiction concept. Curr Obes Rep. 2019;8(1):11–7.

    Article  Google Scholar 

  10. Guerrero Pérez F, Sánchez-González J, Sánchez I, et al. Food addiction and preoperative weight loss achievement in patients seeking bariatric surgery. Eur Eat Disord Rev. 2018;26(6):645–56.

    Article  Google Scholar 

  11. Benzerouk F, Gierski F, Ducluzeau PH, et al. Food addiction, in obese patients seeking bariatric surgery, is associated with higher prevalence of current mood and anxiety disorders and past mood disorders. Psychiatry Res. 2018;267:473–9.

    Article  Google Scholar 

  12. Müller A, Leukefeld C, Hase C, et al. Food addiction and other addictive behaviours in bariatric surgery candidates. Eur Eat Disord Rev. 2018;26(6):585–96.

    Article  Google Scholar 

  13. Brunault P, Ducluzeau PH, Courtois R, et al. Food addiction is associated with higher neuroticism, lower conscientiousness, higher impulsivity, but lower extraversion in obese patient candidates for bariatric surgery. Subst Use Misuse. 2018;53(11):1919–23.

    Article  Google Scholar 

  14. Lawson JL, Goldman RL, Swencionis C, et al. Examining food addiction and acculturation among a Hispanic bariatric surgery-seeking participant group. Obes Surg. 2019;29(7):2151–7.

    Article  Google Scholar 

  15. Clark SM, Saules KK. Validation of the Yale Food Addiction Scale among a weight-loss surgery population. Eat Behav. 2013;14(2):216–9.

    Article  Google Scholar 

  16. Koball AM, Clark MM, Collazo-Clavell M, et al. The relationship among food addiction, negative mood, and eating-disordered behaviors in patients seeking to have bariatric surgery. Surg Obes Relat Dis. 2016;12(1):165–70.

    Article  Google Scholar 

  17. Miller-Matero LR, Bryce K, Saulino CK, et al. Problematic eating behaviors predict outcomes after bariatric surgery. Obes Surg. 2018;28(7):1910–5.

    Article  Google Scholar 

  18. Holgerson AA, Clark MM, Ames GE, et al. Association of adverse childhood experiences and food addiction to bariatric surgery completion and weight loss outcome. Obes Surg. 2018;28(11):3386–92.

    Article  Google Scholar 

  19. Ivezaj V, Wiedemann AA, Lawson JL, et al. Food addiction in sleeve gastrectomy patients with loss-of-control eating. Obes Surg. 2019;29(7):2071–7.

    Article  Google Scholar 

  20. Ivezaj V, Wiedemann AA, Grilo CM. Food addiction and bariatric surgery: a systematic review of the literature. Obes Rev. 2017;18(12):1386–97.

    Article  CAS  Google Scholar 

  21. Gearhardt AN, Corbin WR, Brownell KD. Development of the Yale Food Addiction Scale version 2.0. Psychol Addict Behav. 2016;30(1):113–21.

    Article  Google Scholar 

  22. Clark SM, Martens K, Smith-Mason CE, et al. Validation of the Yale Food Addiction Scale 2.0 among a bariatric surgery population. Obes Surg. 2019;29(9):2923–8.

    Article  Google Scholar 

  23. Belle SH, Berk PD, Chapman WH, et al. Baseline characteristics of participants in the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study. Surg Obes Relat Dis. 2013;9(6):926–35.

    Article  Google Scholar 

  24. Sogg S, Lauretti J, West-Smith L. Recommendations for the presurgical psychosocial evaluation of bariatric surgery patients. Surg Obes Relat Dis. 2016;12(4):731–49.

    Article  Google Scholar 

  25. Goodpaster KPS. The role of psychological testing in pre-surgical bariatric evaluations. J Health Serv Psychol. 2017;43(2):67–73.

    Article  Google Scholar 

  26. Schulte EM, Gearhardt AN. Development of the modified Yale Food Addiction Scale version 2.0. Eur Eat Disord Rev. 2017;25(4):302–8.

    Article  Google Scholar 

  27. Yanovski SZ, Marcus MD, Wadden TA, et al. The Questionnaire on Eating and Weight Patterns-5: an updated screening instrument for binge eating disorder. Int J Eat Disord. 2015;48(3):259–61.

    Article  Google Scholar 

  28. Masheb RM, Grilo CM. Emotional overeating and its associations with eating disorder psychopathology among overweight patients with binge eating disorder. Int J Eat Disord. 2006;39(2):141–6.

    Article  Google Scholar 

  29. Ames GE, Heckman MG, Grothe KB, et al. Eating self-efficacy: development of a short-form WEL. Eat Behav. 2012;13(4):375–8.

    Article  Google Scholar 

  30. Ames GE, Heckman MG, Diehl NN, et al. Further statistical and clinical validity for the Weight Efficacy Lifestyle Questionnaire-Short Form. Eat Behav. 2015;18:115–9.

    Article  Google Scholar 

  31. Saunders JB, Aasland OG, Babor TF, et al. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption--II. Addiction. 1993;88(6):791–804.

    Article  CAS  Google Scholar 

  32. Reinert DF, Allen JP. The alcohol use disorders identification test (AUDIT): a review of recent research. Alcohol Clin Exp Res. 2002;26(2):272–9.

    Article  Google Scholar 

  33. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.

    Article  CAS  Google Scholar 

  34. Spitzer RL, Kroenke K, Williams JB, et al. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–7.

    Article  Google Scholar 

  35. Hirschfeld RM, Williams JB, Spitzer RL, et al. Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. Am J Psychiatry. 2000;157(11):1873–5.

    Article  CAS  Google Scholar 

  36. Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study. Am J Prev Med. 1998;14(4):245–58.

    Article  CAS  Google Scholar 

  37. Dube SR, Williamson DF, Thompson T, et al. Assessing the reliability of retrospective reports of adverse childhood experiences among adult HMO members attending a primary care clinic. Child Abuse Negl. 2004;28(7):729–37.

    Article  Google Scholar 

  38. Meule A. Food addiction and body-mass-index: a non-linear relationship. Med Hypotheses. 2012;79(4):508–11.

    Article  Google Scholar 

  39. Meule A, Gearhardt AN. Ten years of the Yale Food Addiction Scale: a review of version 2.0. Curr Addict Rep. 2019;6(3):218–28.

    Article  Google Scholar 

  40. Mitchell JE, Selzer F, Kalarchian MA, et al. Psychopathology before surgery in the longitudinal assessment of bariatric surgery-3 (LABS-3) psychosocial study. Surg Obes Relat Dis. 2012;8(5):533–41.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Behavioral Health, Gundersen Health System, 1900 South Avenue, H04-004, La Crosse, WI, 54601, USA

    Afton M. Koball

  2. Department of Medical Research, Gundersen Health System, La Crosse, WI, USA

    Andrew J. Borgert & Kara J. Kallies

  3. Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA

    Karen Grothe

  4. Department of Psychiatry & Psychology, Mayo Clinic Florida, Jacksonville, FL, USA

    Gretchen Ames

  5. Department of Psychology, University of Michigan, Ann Arbor, MI, USA

    Ashley N. Gearhardt

Authors
  1. Afton M. Koball
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrew J. Borgert
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kara J. Kallies
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Karen Grothe
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gretchen Ames
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ashley N. Gearhardt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Afton M. Koball.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Statement

All of the study authors adhere to and acknowledge the ethical responsibilities for authorship. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was a retrospective review of prospectively collected data and IRB approval was obtained. For this type of study, formal consent from each individual was not required.

Consent Statement

All of the study authors take responsibility for the content of this manuscript and agree to its submission. This study was a retrospective review of prospectively collected data and IRB approval was obtained. For this type of study, individual informed consent does not apply.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Koball, A.M., Borgert, A.J., Kallies, K.J. et al. Validation of the Yale Food Addiction Scale 2.0 in Patients Seeking Bariatric Surgery. OBES SURG 31, 1533–1540 (2021). https://doi.org/10.1007/s11695-020-05148-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-020-05148-1

Keywords

Search

Navigation