Yale Food Addiction Scale Research Articles

The Genetic Base for Drug Addiction.

Objective: There are many evidences about relationship between eating behavior and drug addiction. A number of susceptibility loci that point to shared higher order genetic pathways underling addiction were found in genetic studies. This study assumed that a genome-wide association study (GWAS) of food addiction would produce important enrichment in genes and pathways related to addiction. Methods: This study done among 314 women of European ancestry, by using a GWAS of food addiction, which is determined by the modified Yale Food Addiction Scale (mYFAS). Results for enrichment of single nucleotide polymorphisms (SNPs) (n 5 44), genes (n 5 238) and pathways (n 5 11) involved in drug addiction were tested. Results: Two loci met GW-significance (P< 2.5 10 -8) with no obvious roles in eating behavior, they are mapping to 17q21.31 and 11q13.4. GW results were significantly enriched for gene members of the MAPK signaling pathway (P = 0.02). After adjustment for multiple testing, candidate SNP or gene for drug addiction was not linked with food addiction. Conclusions: limited support was delivered for shared genetic underpinnings of drug addiction and food addiction, although the GWAS of mYFAS, need further investigation and follow up.

The Genetic Base for Drug Addiction.

Objective: There are many evidences about relationship between eating behavior and drug addiction. A number of susceptibility loci that point to shared higher order genetic pathways underling addiction were found in genetic studies. This study assumed that a genome-wide association study (GWAS) of food addiction would produce important enrichment in genes and pathways related to addiction. Methods: This study done among 314 women of European ancestry, by using a GWAS of food addiction, which is determined by the modified Yale Food Addiction Scale (mYFAS). Results for enrichment of single nucleotide polymorphisms (SNPs) (n 5 44), genes (n 5 238) and pathways (n 5 11) involved in drug addiction were tested. Results: Two loci met GW-significance (P< 2.5 10 -8) with no obvious roles in eating behavior, they are mapping to 17q21.31 and 11q13.4. GW results were significantly enriched for gene members of the MAPK signaling pathway (P = 0.02). After adjustment for multiple testing, candidate SNP or gene for drug addiction was not linked with food addiction. Conclusions: limited support was delivered for shared genetic underpinnings of drug addiction and food addiction, although the GWAS of mYFAS, need further investigation and follow up.

French validation of the addiction-like eating behavior scale and its clinical implication.

The first conception of food addiction (FA) as substance addiction, measured by the Yale Food Addiction Scale (YFAS), is controversial. Some proposed that FA would be better conceptualized with a behavioral approach. In accordance with this conceptualization, Ruddock and colleagues published a new self-reported scale for food addiction, the Addiction-like Eating Behavior Scale (AEBS). Overall, preliminary validation of the scale demonstrated good psychometric properties with a community sample. The aim of the present study is twofold, to validate the French-Canadian version of the AEBS with a community sample and to examine how well the instrument fits into a clinical sample with overweight/obesity. A community sample (N = 466) and a clinical sample with overweight/obesity seeking help for their eating difficulties (N = 126) completed an online survey regarding FA, binge eating, dietary restraint, depression, and BMI. Factor analysis, internal consistency, and construct validity were assessed. With the community sample, factorial structure, and psychometric properties of the AEBS were replicated. With the clinical sample, proper convergent validity was demonstrated with the YFAS 2.0 and binge eating, and proper divergent validity was demonstrated with dietary restraint. Among the clinical sample, AEBS explain similar variance of BMI and depression level when compared to YFAS 2.0. This study provided evidence that the French-Canadian version of the AEBS is a valid measure of food addiction, but it did not permit to establish advantages over YFAS 2.0 with a clinical sample. Clinical implications of the AEBS and FA characteristic are discussed. Level V, cross-sectional, descriptive study.

Validity and reliability of the Iranian version of the Yale Food Addiction Scale for obese women.

The face and construct validity of the Iranian version of the Yale Food Addiction Scale (YFAS) was evaluated, and the convergent validity and test-retest reliability of both Iranian and original versions of YFAS for obese women were assessed. The internal consistency of the YFAS was analysed. Exploratory factor analysis for dichotomous data was performed by varimax rotation, polychoric correlation coefficients and confirmatory factor analysis (CFA). Convergent validity was established by evaluating the correlation between the original and the Iranian versions of YFAS and the Binge Eating Scale (BES). The intraclass correlation coefficient (ICC) was measured between test-retest results. A weight management clinic in Tehran. 450 obese women. The single-factor structure indicated that the factor loadings for all the items were > 0·5, except for three items (explained proportion variance = 51 %). Based on CFA, the single factor had a better fit to the data after excluding three items. The Kuder-Richardson-20 coefficient was 0·86 for the total twenty-two items. The symptom count and diagnostic version of both the Iranian (ICC = 0·92 and 0·87, respectively) and original YFAS (ICC = 0·92 and 0·86, respectively) were stable over 2 weeks. Both the symptom count and the diagnostic version of these two scales had significant correlations with the measures of BES (P < 0·001). The initial reliability and validity of the Iranian version of the YFAS among obese women are supported. Further studies should be conducted on men and normal/overweight samples.

Association between food addiction and body dissatisfaction among college students: The mediating role of eating expectancies

A positive association between food addiction (i.e., an addiction to compulsively overeat highly palatable foods) and body dissatisfaction in college students exists. However, little is known about the underlying mechanisms. Eating expectancies, one's learning history regarding the association between eating and its consequences, may provide potential pathways linking food addiction and body dissatisfaction. In the current study, five eating expectancies (i.e., eating helps manage negative affect, eating is pleasurable and useful as a reward, eating leads to feeling out of control, eating enhances cognitive competence, and eating alleviates boredom) were evaluated as potential mediators between food addiction and body dissatisfaction in 738 college students (mean age = 19.21 ± 1.63, 61.4% female). Students completed the Eating Pathology Symptoms Inventory, Yale Food Addiction Scale, and Eating Expectancy Inventory. Adjusting for sex, age, race, and body mass index, structural equation modeling was used to examine the bi-directional mediation effects of the eating expectancies between food addiction and body dissatisfaction. Results showed a bi-directional positive association between food addiction and body dissatisfaction (β = 0.12–0.26, standard error [SE] = 0.07–0.03, all p < 0.01) that was partially mediated by the expectancy that eating leads to feeling out of control, regardless of whether body dissatisfaction was included as the independent or dependent variable (β = 0.15–0.36, SE = 0.05–0.02, all p < 0.01). Findings suggest the need to address the influence of expecting eating to lead to feeling out of control in interventions for co-occurring food addiction and body dissatisfaction among college students.

Food Addiction and Binge Eating During One Year Following Sleeve Gastrectomy: Prevalence and Implications for Postoperative Outcomes.

Food addiction and binge eating are common among individuals with obesity. However, a paucity of studies prospectively examined the prevalence and implications of food addiction before and post-bariatric surgery. We aimed to examine the prevalence of food addiction and binge eating before and after sleeve gastrectomy (SG) and to assess their associations with behavioral and weight loss outcomes. We followed at 3 (M3), 6 (M6), and 12 (M12) months postoperative, 54 women who underwent SG. Data collected including anthropometrics, nutritional intake, food tolerance, and physical activity measures. The Yale Food Addiction Scale and the Binge Eating Scale were used to characterize food addiction and binge eating, respectively. The mean baseline age and BMI were 32.1 ± 11.1years and 44.9 ± 4.9kg/m2, respectively. Pre-surgery, food addiction, and binge eating were identified in 40.7% and 48.1% of patients, respectively. The prevalence of food addiction decreased significantly up to M6, but increased to 29.3% at M12. The prevalence of binge eating decreased significantly through the follow-up up to 17.4% at M12. Those who met criteria for food addiction at M12 achieved significantly lower excess weight loss at M12 compared with those not meeting this criterion (P = 0.005). Food addiction scores at M12 negatively correlated with weekly physical activity (r = - 0.559; P < 0.001) and food tolerance scores (r = - 0.428; P = 0.005). The reduction in food addiction observed at M6 was not maintained at M12. Food addiction at M12 was associated with poorer weight loss, eating, and lifestyle behaviors. Clinical practice should focus on the psychological aspects associated with obesity.

The Impact of Retrospective Childhood Maltreatment on Eating Disorders as Mediated by Food Addiction: A Cross-Sectional Study.

Background: The current study aimed to test whether food addiction (FA) might mediate the relationship between the presence of a history of childhood maltreatment and eating disorder (ED) symptom severity. Methods: Participants were 231 patients with ED presenting between May 2017 and January 2020 to a daycare treatment facility for assessment and management with mainly the Eating Disorder Inventory-2 (EDI-2), the Child Trauma Questionnaire (CTQ), and the Yale Food Addiction Scale (YFAS 2.0). Results: Participants had a median age of 24 (interquartile range (IQR) 20–33) years and manifested anorexia nervosa (61.47%), bulimia nervosa (16.88%), binge-eating disorders (9.09%), and other types of ED (12.55%). They were grouped into those likely presenting FA (N = 154) and those without FA (N = 77). The group with FA reported higher scores on all five CTQ subscales, as well as the total score of the EDI-2 (p < 0.001). Using mediation analysis; significant indirect pathways between all CTQ subscales and the EDI-2 total score emerged via FA, with the largest indirect effect emerging for physical neglect (standardized effect = 0.208; 95% confidence interval (CI) 0.127–0.29) followed by emotional abuse (standardized effect = 0.183; 95% CI 0.109–0.262). Conclusion: These results are compatible with a model in which certain types of childhood maltreatment, especially physical neglect, may induce, maintain, and/or exacerbate ED symptoms via FA which may guide future treatments.

The feasibility of a personality targeted intervention for addictive overeating: FoodFix

Recent reviews have identified potential treatment targets for addictive overeating. These include: motivational interviewing, development of specific coping strategies for emotional regulation and the use of harm minimisation strategies based on interventions for substance use disorders. However, there is very little experiential evidence. The aim of this study was to determine the feasibility of a personality-targeted motivational interviewing intervention in adults above the healthy-weight range with symptoms of addictive eating, to reduce symptoms of addictive overeating and improve dietary profiles. Individuals with overweight and obesity (BMI >25 kg/m2) with addictive eating as defined by the modified Yale Food Addiction Scale (mYFAS) were recruited to a three-session intervention held over 3 months. Sessions were conducted by telehealth and facilitated by dietitians. Fifty-two individuals were randomised to either intervention or control (mean age 43.6 ± 12.2yrs, mean BMI 36.7 ± 6.8 kg/m2, 96% female). At three month follow up, there were significant reductions from baseline (BL) for both groups in total YFAS 2.0 symptoms, however, these changes were not significantly different between groups (intervention BL 8.0 ± 2.7; 3-months 6.5 ± 3.8, control BL 8.1 ± 2.5; 3-months 6.9 ± 3.9, p > 0.05). At 3 months the intervention group significantly reduced their energy from non-core foods compared with control (intervention BL 48% energy/day; 3-months 38%, control BL 41% energy/day; 3-months 38%, p < 0.01). The FoodFix intervention provides insight to the development of future management interventions for addictive eating.

The Psycho-Affective Roots of Obesity: Results from a French Study in the General Population.

The aim of the study was to examine the extent to which obese people differ in their emotionally driven and addictive-like eating behaviors from normal-weight and overweight people. A total of 1142 participants were recruited from a general population, by a web-based cross-sectional survey assessing anxiety/depression (Hospital Anxiety and Depression Scale), emotional eating (Emotional Appetite Questionnaire), food addiction (modified Yale Food Addiction Scale), and intuitive eating (Intuitive Eating Scale-2). The statistical design was based on analyses of (co)variance, correlograms, and mediations. A set of Body Mass Index (BMI) group comparisons showed that obese people reported higher levels of depression and emotional eating and that they experienced more severe and frequent food addiction symptoms than overweight and normal-weight people. Associations between anxiety, depression, food addiction symptoms’ count, and the difficulties to rely on hunger and satiety cues were found across all weight classes, suggesting that addictive-like eating may represent a unique phenotype of problematic eating behavior that is not synonymous with high BMI or obesity. Conversely, the interrelation between anxiety/depression, emotional eating, and the difficulties to rely on hunger and satiety cues was found only among obese participants, and negative emotional eating mediated the association between depression and anxiety and the difficulties to rely on hunger and satiety cues. This study emphasizes the necessity to develop more comprehensive approaches integrating emotional dysregulation and addictive-like eating behaviors to improve weight management and quality of life of obese people.

Improvement in Uncontrolled Eating Behavior after Laparoscopic Sleeve Gastrectomy Is Associated with Alterations in the Brain-Gut-Microbiome Axis in Obese Women.

Background: Bariatric surgery is proven to change eating behavior and cause sustained weight loss, yet the exact mechanisms underlying these changes are not clearly understood. We explore this in a novel way by examining how bariatric surgery affects the brain–gut–microbiome (BGM) axis. Methods: Patient demographics, serum, stool, eating behavior questionnaires, and brain magnetic resonance imaging (MRI) were collected before and 6 months after laparoscopic sleeve gastrectomy (LSG). Differences in eating behavior and brain morphology and resting-state functional connectivity in core reward regions were correlated with serum metabolite and 16S microbiome data. Results: LSG resulted in significant weight loss and improvement in maladaptive eating behaviors as measured by the Yale Food Addiction Scale (YFAS). Brain imaging showed a significant increase in brain volume of the putamen (p.adj < 0.05) and amygdala (p.adj < 0.05) after surgery. Resting-state connectivity between the precuneus and the putamen was significantly reduced after LSG (p.adj = 0.046). This change was associated with YFAS symptom count. Bacteroides, Ruminococcus, and Holdemanella were associated with reduced connectivity between these areas. Metabolomic profiles showed a positive correlation between this brain connection and a phosphatidylcholine metabolite. Conclusion: Bariatric surgery modulates brain networks that affect eating behavior, potentially through effects on the gut microbiota and its metabolites.

FOOD ADDICTION AS A PROXY FOR ANOREXIA NERVOSA SEVERITY: NEW DATA BASED ON THE YALE FOOD ADDICTION SCALE 2.0

The contribution of an addictive process to anorexia nervosa (AN) is an area of growing interest. Yet, little is known about how the food addiction concept (FA) may be of interest in understanding AN. This study investigates prevalence of FA diagnostic and its association with markers of severity in individuals with AN. We conducted a retrospective study in a sample of 73 patients with AN. We assessed FA with the Yale Food Addiction Scale 2.0, depressive and anxiety disorders, impulsivity (Beck Depression Inventory, STAI, BIS-11) and eating behavior (BITE, EDE-Q). Prevalence of FA in our sample was 47%. FA was significantly associated and positively correlated with the binge-eating/purging subtype of AN, higher levels of depression, anxiety and greater eating psychopathology. FA was not associated with level of impulsivity nor leptin and IGF-1 blood levels. The relationship between FA severity and AN severity was mediated by the severity of binge eating behaviors. Our results suggest that the presence of FA may represent a more severe variant of AN. Longitudinal studies are needed to better understand the etiologic process between FA and AN.

Reward-related eating, self-regulation, and weight change in pregnancy and postpartum: the Pregnancy Eating Attributes Study (PEAS).

Background/Objectives.Reward-related eating is hypothesized to underlie risk for weight gain in obesogenic environments, but its role is unknown during pregnancy and postpartum when weight change is normative, but excess weight gain and weight retention are common. This study examined associations of self-reported reward-related eating, self-regulation, and the home food environment with excessive gestational weight gain (GWG) and postpartum weight change.Subjects/Methods.Participants in the Pregnancy Eating Attributes Study observational cohort were enrolled at ≤12 weeks pregnancy and followed through one-year postpartum (458 recruited; 367 retained through delivery). Participants completed four measures of reward-related eating – Modified Yale Food Addiction Scale, Power of Food Scale, Multiple Choice Procedure, and a Reinforcing Value of Food Questionnaire; two measures of self-regulation – Barratt Impulsiveness Scale and Delay of Gratification Inventory; and a Home Food Inventory. Measured weight and skinfolds were obtained. Multinomial logistic and multiple linear regression analyses estimated associations of reward-related eating, self-regulation, and home food environment with excessive GWG, gestational fat gain, postpartum weight change, and percent of GWG retained.Results.Excessive GWG was associated with food reinforcement intensity, but not with any other measure of reward-related eating, self-regulation, or home food environment. Greater gestational fat gain was associated only with higher Multiple Choice Procedure. Postpartum weight change and percent of GWG retained were associated with greater Delay of Gratification and obesogenic home food environment, but not with any measure of reward-related eating or with impulsivity.Conclusions.Findings do not support the hypothesis that self-reported reward-related eating is associated with weight outcomes in pregnancy and postpartum but indicate a relation of Delay of Gratification with postpartum weight retention. Further research using both surveys and objective measures of reward-related eating is needed to advance our understanding of the relation of reward-related eating with weight changes during this critical period of a woman’s life.

Prevalence of social, cognitive, and emotional impairment among individuals with food addiction.

The clinical utility of the construct of food addiction has been heavily debated. Though food addiction has been associated with psychosocial impairment in clinical samples, it is critical to examine these associations in non-clinical samples, to obtain unbiased evidence regarding this phenomenon's clinical significance. It is also unknown which types of impairment are most common in food addiction. This observational study explored the association of self-reported food addiction with impairment in the domains of social, cognitive, and emotional functioning. Participants (356 university students and 544 adults recruited through Mechanical Turk) completed the Yale Food Addiction Scale 2.0 and Clinical Impairment Assessment 3.0 questionnaire, as well as measures of emotional eating, reward-driven eating, binge eating, and general disordered eating. Food addiction scores showed large correlations with emotional (r = 0.55, 0.57), social (r = 0.56, 0.59), and cognitive impairment (r = 0.58, 0.53) in the student and Mechanical Turk samples, respectively. The most common difficulties endorsed were emotional (e.g., feeling ashamed or critical of oneself, upset, or worried due to one's eating habits), followed by social and cognitive. Food addiction was strongly associated with psychosocial impairment in two non-clinical samples, suggesting this phenomenon merits further investigation. We found substantial associations of food addiction with emotional as well as social and cognitive impairment.

The Modified Yale Food Addiction Scale 2.0: Validation Among Non-Clinical and Clinical French-Speaking Samples and Comparison With the Full Yale Food Addiction Scale 2.0

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.

Systematically lower structural brain connectivity in individuals with elevated food addiction symptoms

Symptoms of food addiction have been observed in both obesity and eating disorders. The food addiction model may therefore posit a continuum of dysfunctional personality traits, including increased impulsivity and poor decision-making. The current study explored the neuroanatomy of addictive-like eating behavior from a novel triadic model of addiction. Specifically, we focused on three interacting neural systems; a sensitized impulsive, reward system associated with striatal structures, a desensitized reflective control system governed by prefrontal cortex, and a disrupted insula-mediated interoceptive system responsible for integrating and translating interoceptive, somatic signals into feelings of anticipation, desires, or cravings. Sixty-four healthy-weight Chinese university students were scanned for high-resolution structural and diffusion imaging. Data from the Yale Food Addiction Scale (YFAS), Binge Eating Scale, Eating Attitude Test-26, UPPS-P Impulsive Behavior Scale, and Delay Discounting Task were collected. Based on YFAS-score, participants were divided into a High Food Addiction group (HFA) and a Low Food Addiction group (LFA). Diffusion tensor imaging results revealed that compared to LFA, HFA had lower structural connectivity between insula and anterior cingulate cortex, insula and caudate, and ventromedial Prefrontal Cortex (vmPFC) and putamen. The Voxel-Based Morphometry analysis suggested marginally lower gray matter volume in the left vmPFC in HFA. Finally, behavioral results, indicated that higher food addiction symptoms were associated with personality traits exhibited in eating disorders including impulsive decision-making. These findings suggest that even in a healthy population, some individuals may be more susceptible to develop unhealthy relationships to food, which at least partially is manifested in lower structural connectivity between brain regions associated with interoceptive awareness, decision-making, and reward.

Examining the construct validity of food addiction severity specifiers.

Food addiction (FA) is related to greater body mass index (BMI), eating-disorder psychopathology, food craving, and psychosocial impairment. Less is known regarding the utility of the FA severity specifiers, as measured by the number of symptoms endorsed on the Yale Food Addiction Scale (YFAS 2.0). Participants (N = 1854) were recruited from Amazon Mechanical Turk to complete an online survey on eating behaviors. Participants completed self-report measures assessing FA, eating-disorder psychopathology (Eating Disorder Examination Questionnaire), and food craving (Food Craving Inventory). Based on the YFAS 2.0 specifiers, participants were classified into four FA groups: No FA (n = 1643), mild (n = 40), moderate (n = 55), and severe (n = 116). There were significant differences found in age, sex, BMI, and frequency of objective binge-eating episodes (OBEs) among the FA groups. Using ANCOVA, adjusted for multiple comparisons and covariates (e.g., BMI, sex, OBEs), the No FA group reported significantly lower levels of shape concern (η2 = 0.05; p < 0.001), weight concern (η2 = 0.04; p < 0.001), eating concern (η2 = 0.15; p < 0.001), and global eating-disorder psychopathology (η2 = 0.06; p < 0.001) than mild, moderate, or severe FA groups. The No FA group reported significantly lower levels of dietary restraint (η2 = 0.01; p < 0.01) than mild and severe FA groups. The severe FA group reported higher food craving scores (η2 = 0.02; p < 0.001) compared to the No FA group. Our findings parallel the severity specifiers literature for eating and substance use disorders by also indicating the limited utility of severity specifiers based on symptom count. Future research should investigate alternative targets for discriminating among levels of FA. Level V, cross-sectional descriptive study.

A Distinct Brain-Gut-Microbiome Profile Exists for Females with Obesity and Food Addiction.

Alterations in brain-gut-microbiome interactions have been implicated as an important factor in obesity. This study aimed to explore the relationship between food addiction (FA) and the brain-gut-microbiome axis, using a multi-omics approach involving microbiome data, metabolomics, and brain imaging. Brain magnetic resonance imaging was obtained in 105 females. FA was defined by using the Yale Food Addiction Scale. Fecal samples were collected for sequencing and metabolomics. Statistical analysis was done by using multivariate analyses and machine learning algorithms. Of the females with obesity, 33.3% exhibited FA as compared with 5.3% and 0.0% of females with overweight and normal BMI, respectively (P = 0.0001). Based on a multilevel sparse partial least square discriminant analysis, there was a difference in the gut microbiome of females with FA versus those without. Differential abundance testing showed Bacteroides, Megamonas, Eubacterium, and Akkermansia were statistically associated with FA (q < 0.05). Metabolomics showed that indolepropionic acid was inversely correlated with FA. FA was also correlated with increased connectivity within the brain's reward network, specifically between the intraparietal sulcus, brain stem, and putamen. This is the first study to examine FA along the brain-gut-microbiome axis and it supports the idea of targeting the brain-gut-microbiome axis for the treatment of FA and obesity.

Validity of the Yale Food Addiction Scale for Children (YFAS-C): Classical test theory and item response theory of the Persian YFAS-C

PurposeTo examine whether the child/adolescent version of the Yale Food Addiction Scale (YFAS-C) is valid to assess the Iranian adolescents who are overweight.MethodsAfter using an internationally standardized method to translate the YFAS-C into Persian, 1186 overweight/obese adolescents aged between 13 and 18 years participated in the present study [666 males; mean age = 15.5 (SD = 1.9) years; zBMI = 2.5 (1.0) kg/m2]. All the participants completed the Persian YFAS-C alongside Persian versions of the following scales: Eating Disorder Examination Questionnaire (EDEQ), Clinical Impairment Assessment (CIA), Binge Eating Scale (BES), Eating Attitudes Test (EAT-26), and Depression, Anxiety, Stress Scale (DASS-21).ResultsAt the scale level, confirmatory factor analysis verified the single-factor structure of the Persian YFAS-C. Additionally, the Persian YFAS-C had promising properties regarding internal consistency (KR20 = 0.81), test–retest reliability (intraclass correlation coefficient = 0.83), separation reliability (person separation reliability = 0.77; item separation reliability = 0.98), and separation index (person separation index = 2.04; item separation index = 8.01). At the item level, all items had satisfactory properties in factor loadings, corrected item-total correlation, test–retest reliability, and infit and outfit mean square. Moreover, no substantial differential item functioning (DIF) was found concerning gender (male vs. female) or weight status (overweight vs. obesity). Significant and moderate correlations were found between the Persian YFAS-C and other psychometric scales assessing eating symptomatology and general psychopathology (r = 0.352 to 0.484).ConclusionThe Persian YFAS-C is a valid instrument that assists healthcare providers in assessing food addiction among Iranian adolescents.Level of evidenceLevel V, cross-sectional descriptive study.

Mental and physical health-related quality of life and food addiction after obesity surgery: The first 2-year outputs.

The aim of the study was to investigate mental and physical health-related quality of life and food addiction of patients who underwent obesity surgery. A cross-sectional and descriptive design study was included 80 adult patients who completed the Yale Food Addiction Scale and the 36-Item Short-Form Health Survey. It was found that mental and physical health mean scores of the patients were 61.48 and 72.43, respectively. None of the patients were food-addicted. Patients were moderate level in the mental and physical health and were no food addiction in the first 2 years. It is thought that mental health support and follow-up following postoperative should be routinely.

Food Addiction Mediates the Relationship between Perceived Stress and Body Mass Index in Taiwan Young Adults.

Perceived stress is the degree of stress experienced by an individual in the face of a stressor. Studies have shown that stress affects emotions, leads to behavioral changes, and is likely to trigger physical illnesses. According to the World Health Organization (WHO), stress is classified as a health epidemic of the 21st century; in the meantime, the percentage of adults being overweight and with obesity has continued to grow after reaching 38.9% in 2016. Hence, it is unclear whether perceived stress has become a factor affecting progressive obesity and whether food addiction (FA) is an intermediate factor. The purposes of this study were to (1) investigate the FA prevalence among young adults in Taiwan, (2) understand correlations among perceived stress, FA, and the body mass index (BMI), and (3) determine the potential mediating effect of FA due to perceived stress on BMI. The study was conducted through an online questionnaire, composed of a basic data form, the Perceived Stress Scale (PSS), and the Yale Food Addiction Scale (YFAS). We received 1994 responses and analyzed 1780 valid samples. Results showed that 231 participants met the FA criteria, accounting for 12.98%. Perceived stress was positively correlated with BMI (95% confidence interval (CI) 0.013~0.088, p-value 7.8 × 10−3), and perceived stress was positively associated to FA (95% CI 1.099~1.154, p-value < 10−4), which was also positively correlated with BMI (95% CI 0.705~2.176, p-value 10−4). FA significantly mediated the relationship between PSS and BMI with an indirect effect size of 25.18% and 25.48% in the group that scored 31~40 on the PSS. The study concluded that among people seeking weight loss, proper stress management and screening for FA in order to apply related therapies may be an effective method for weight management.