Validation of the Yale Food Addiction Scale 2.0 and estimation of the population prevalence of food addiction

Christina Horsager; Emil Færk; Marlene Briciet Lauritsen; Søren Dinesen Østergaard

doi:10.1016/j.clnu.2019.12.030

Validation of the Yale Food Addiction Scale 2.0 and estimation of the population prevalence of food addiction

Clin Nutr. 2020 Sep;39(9):2917-2928. doi: 10.1016/j.clnu.2019.12.030. Epub 2020 Jan 13.

Authors

Christina Horsager¹, Emil Færk², Marlene Briciet Lauritsen³, Søren Dinesen Østergaard⁴

Affiliations

¹ Aalborg University Hospital, Psychiatry, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. Electronic address: christina.pedersen@rn.dk.
² Aalborg University Hospital, Psychiatry, Aalborg, Denmark.
³ Aalborg University Hospital, Psychiatry, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
⁴ Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.

PMID: 31983504
DOI: 10.1016/j.clnu.2019.12.030

Abstract

Background & aims: Food addiction (FA) is likely to contribute to the global obesity epidemic. Most studies of FA have been conducted within clinical and/or highly selected populations, suggesting that prevalence estimates of FA may be biased. This is problematic as valid estimates of the population prevalence of FA is a requirement for informing and designing public health initiatives focusing on this phenotype. Therefore, we aimed to estimate the weighted prevalence of food addiction in the adult general population of Denmark.

Methods: A random sample of 5000 individuals aged 18 to 62 from the Danish population was invited to participate in a survey, which included the Yale Food Addiction Scale (YFAS 2.0) and several rating scales measuring eating pathology and other psychopathology. Health, demographic and socioeconomic data from the Danish registers were linked to all invitees to allow for attrition analysis. The analysis had three steps: I) Psychometric validation of the Danish version of YFAS 2.0 II) Attrition analysis to examine selection bias, and III) Estimation of the weighted prevalence of FA taking attrition into account.

Results: The confirmatory factor analysis of the YFAS 2.0 supported a one-factor model, and the scale had good internal consistency. The YFAS 2.0 score correlated with eating pathology including binge eating frequency, impulsivity and body mass index (BMI). The survey response rate was 34.0% (n = 1699) with a slight overrepresentation of respondents with higher socioeconomic status. The crude prevalence of FA was 9.0%. When taking attrition into account, the weighted prevalence of FA was 9.4% CI 95% [7.9-10.9].

Conclusions: The psychometric properties of the Danish version of the YFAS 2.0 were good. The weighted prevalence of FA was very similar to the crude prevalence estimate. This suggests that attrition may not be a large problem when estimating the prevalence of FA with the YFAS 2.0.

Keywords: Food addiction; Obesity; Psychometrics; Surveys and questionnaires.

Publication types

Research Support, Non-U.S. Gov't
Validation Study

MeSH terms

Adolescent
Adult
Body Mass Index
Denmark / epidemiology
Feeding Behavior / psychology
Feeding and Eating Disorders / psychology
Female
Food Addiction / diagnosis
Food Addiction / epidemiology*
Food Addiction / psychology
Humans
Male
Middle Aged
Prevalence
Psychometrics
Reproducibility of Results
Surveys and Questionnaires
Young Adult