Cross Cultural Validation of the Yale Food Addiction Scale 2.0 and Evaluation of Food Addiction in Hispanic Bariatric Surgery-Seeking Patients

Abstract

Background: The construct of food addiction (FA) continues to gain interest given observed parallels in biological and behavioral addictive models. The Yale Food Addiction Scale 2.0 (YFAS 2.0) was developed to examine addictive eating by applying the DSM-5 diagnostic criteria for substance-related and addictive disorders. There is a current lack of research exploring the prevalence of FA and psychometric properties of the scale cross culturally. This study examined the prevalence of FA symptoms in a clinical Hispanic bariatric surgery-seeking population and provides validation for use of the scale in this patient population.;Method: A sample of 444 participants, comprised of English-speaking (n=215) and Spanish-speaking (n=229) Hispanic adults presenting for bariatric surgery at two city hospitals in NY, NY, completed the YFAS 2.0, the Eating Disorder Diagnostic Scale, Food Neophobia Scale, Three Factor Eating Questionnaire-Revised and the Short Acculturation Scale for Hispanics. Exploratory, confirmatory and multi-group confirmatory factor analyses were conducted.;Results: Within the overall sample, 35.8% met criteria for FA, with 39.6% of the English-speaking sample and 32.4% of the Spanish-speaking sample meeting criteria. FA was significantly associated with acculturation level to the U.S., r=.15,p<.01, and BMI, r=.24, p<.001. Confirmatory factor analysis demonstrated that the scale loaded most adequately onto a one-factor model. The YFAS 2.0 demonstrated appropriate convergent validity, incremental validity, and excellent internal consistency (alpha = .96). Discriminant validity measures were not supported as hypothesized. Multi-group confirmatory factor analysis yielded measurement invariance supporting the hypothesis that the scale is appropriate for English and Spanish-speaking participants.;Conclusion: Results provide further psychometric support for the YFAS 2.0. The measure appears to be appropriate to use with both English and Spanish-speaking Hispanic patients seeking to have bariatric surgery.