Abstract
ObjectivesThe modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) was designed to assess food addiction using a shorter version than the YFAS 2.0. We lack data about the psychometric properties of the mYFAS 2.0 in patients with obesity, as well as studies comparing the psychometric properties of the mYFAS 2.0 versus the full YFAS 2.0. This study aimed to validate the French-language mYFAS 2.0 in a non-clinical population (study 1, n = 250), to determine the yet unknown psychometric properties of this scale in patients with obesity (study 2, n = 345), and to compare the full YFAS 2.0 and the mYFAS 2.0 in terms of food addiction (FA) prevalence and symptoms detection in both populations.MethodStudy 1 included 250 non-clinical individuals (non-underweight and non-obese persons screened negative for eating disorders). Study 2 included 345 bariatric surgery candidates recruited in three centers (Québec, Canada; Reims and Tours, France). The mYFAS 2.0 structure was investigated using confirmatory factorial analyses with tetrachoric correlations. Convergent validity was tested using the full YFAS 2.0, the Binge Eating Scale (both studies), the revised 18-item Three Factor Eating Questionnaire (study 1), the Beck Depression Inventory (study 2), and the body mass index (BMI; both studies).ResultsThe mYFAS 2.0 was unidimensional, and had adequate (study 1: KR-20 = .78) and acceptable (study 2: KR-20 = .73) internal consistency. In study 1, the mYFAS 2.0 had good convergent validity with the YFAS 2.0, BMI, binge eating, cognitive restraint, uncontrolled eating and emotional eating; in study 2, the mYFAS 2.0 had good convergent validity with the YFAS 2.0, binge eating, depression, but not BMI. Participants endorsed fewer symptoms with the mYFAS 2.0 than with the YFAS 2.0; FA prevalences were similar between questionnaires in the non-clinical, but not in the clinical sample. A FA ‘diagnosis’ and risk of binge eating disorder were associated but did not completely overlap.ConclusionsThe mYFAS 2.0 has close psychometric properties to the YFAS 2.0 in non-clinical and clinical samples. However, the use of the mYFAS 2.0 in bariatric surgery candidates might lead to a significant underestimation of FA prevalence and number of FA symptoms.
Highlights
In the modern food environment, some but not all individuals struggle to control their food intake [1]
MYFAS 2.0 Factor Structure and Internal Consistency The confirmatory factor analysis (CFA) yielded the following goodness of fit indices: c2 = 43.68, df = 44, c2/df = .99, p = .49; Comparative fit index (CFI) = 1.00, and root mean square error of approximation (RMSEA) = .00 90% CI [.001–.042]
MYFAS 2.0 Factor Structure and Internal Consistency The CFA yielded the following goodness of fit indices: c2 = 46.53, df = 40, c2/df = 1.16, p = .22; CFI = .989, and RMSEA = .022 90% CI [.001–.045]
Summary
In the modern food environment, some but not all individuals struggle to control their food intake [1]. Like for drug misuse, it has been proposed that the loss of control over some specific foods (i.e., highly palatable/processed foods that are high fat, high refined carbohydrates, and/or high salt) may be conceptualized as an addictive disorder [2,3,4]. It is not clear whether high FA scores are a marker of disordered eating problems generally or a specific assessment of “FA” [6]. Some other authors have argued that food and drug addiction share similar features that may reflect common underlying mechanisms, paving the way for better tailor-based treatment for these patients [for an updated review of the opposing positions on the concept of FA, see Fletcher and Kenny [6]]. The recent increases in non-homeostatic eating and diet-induced obesity, in addition to the development of assessment tools to operationalize FA, have enhanced scientific interest for this topic [7, 8]
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