Validation of the Yale Food Addiction Scale among a weight-loss surgery population

The Yale Food Addiction Scale (YFAS), recently validated in college students and binge eaters, is a means to assess “food addiction” in accordance with DSM-IV criteria for substance dependence. Using online survey methodology, we aimed to validate the use of the YFAS among weight loss surgery (WLS) patients. Participants completed measures about pre-WLS food addiction (YFAS), emotional and binge eating, behavioral activation and inhibition, and pre- and post-WLS substance use. A sample of 67 WLS patients (59.7% Roux-en-Y) was recruited; participants were 62.7% female, 86.6% Caucasian, had a mean age of 42.7; and 53.7% met the criteria for pre-WLS food addiction. Convergent validity was found between the YFAS and measures of emotional eating (r = .368, p < .05) and binge eating (r = .469, p < .05). Discriminant validity was supported in that problematic substance use, behavioral activation, and behavioral inhibition were not associated with YFAS scores. Incremental validity was supported in that the YFAS explained a significant proportion of additional variance in binge eating scores, beyond that predicted by emotional eating (EES) and disordered eating behavior (EAT-26). Those meeting the food addiction criteria had poorer percent total weight loss outcomes (32% vs. 27%). There was a nonsignificant trend towards those with higher food addiction being more likely to admit to post-WLS problematic substance use (i.e., potential “addiction transfer”; 53% vs. 39%). Results support the use of the YFAS as a valid measure of food addiction among WLS patients. Future research with a larger sample may shed light on potentially important relationships between pre-surgical food addiction and both weight and substance use outcomes.

► Bariatric patients have high rates of pre-surgical food addiction.
► The Yale Food Addiction Scale (YFAS) is valid for use with bariatric patients.
► Bariatric patients' YFAS scores are related to binge eating.
► YFAS scores predict variance in binge eating over other forms of disordered eating.