Obesity is a global issue and it has been suggested that an addiction to certain foods could be a factor contributing to overeating and subsequent obesity. Only one tool, the Yale Food Addiction Scale (YFAS) has been developed to specifically assess food addiction. This review aimed to determine the prevalence of food addiction diagnosis and symptom scores, as assessed by the YFAS. Published studies to July 2014 were included if they reported the YFAS diagnosis or symptom score and were published in the English language. Twenty-five studies were identified including a total of 196,211 predominantly female, overweight/obese participants (60%). Using meta-analysis, the weighted mean prevalence of YFAS food addiction diagnosis was 19.9%. Food addiction (FA) diagnosis was found to be higher in adults aged >35 years, females, and overweight/obese participants. Additionally, YFAS diagnosis and symptom score was higher in clinical samples compared to non-clinical counterparts. YFAS outcomes were related to a range of other eating behavior measures and anthropometrics. Further research is required to explore YFAS outcomes across a broader spectrum of ages, other types of eating disorders and in conjunction with weight loss interventions to confirm the efficacy of the tool to assess for the presence of FA.
Twenty-three studies reported the prevalence of FA diagnosis. As shown in Table 3, the proportion of the population samples meeting the diagnostic criteria for FA ranged from 5.4%  to 56.8% . Twenty studies reported the mean prevalence of FA for the whole sample and were meta-analyzed (Table 4). Meta-analysis identified significant heterogeneity in the included studies and thus the random effects model is reported. Meta-analysis revealed that this review was not subject to publication bias.
The Prevalence of Food Addiction as Assessed by the Yale Food Addiction Scale
Pursey, Kirrilly; Stanwell, Peter; Gearhardt, Ashley N.; Collins, Clare E.; Burrows, Tracy L.
A systematic literature review was undertaken to identify published studies that used the YFAS to assess FA diagnosis or symptom score from the year of tool development, 2009, to July 2014. Electronic databases were searched to identify relevant publications. These included: MEDLINE, The Cochrane Library, EMBASE (Excerpta Medica Database), CINAHL (Cumulative Index to Nursing and Allied Health), Informit Health Collection, Proquest, Web of Science, Scopus and PsycINFO. Keywords were informed by preliminary literature searches and were searched including: Yale Food Addiction Scale, YFAS, questionnaire; food addiction, behavioral addiction, eating behavior, obesity, food, eat, feeding behavior, food preferences, food habits, body mass index, overeat, hyperphagia, substance related disorders, binge eating, hedonic eating. Both the English and American spellings of behavior/behaviour were searched. Database searches were supplemented by cited reference checks and systematic checking of reference lists of identified articles for additional relevant publications. The search strategy was registered with PROSPERO . To determine eligibility for inclusion in the review, titles and abstracts of identified studies were assessed by two independent reviewers using a predetermined inclusion criterion. Studies were included if they used the YFAS or a modified form of the YFAS to assess FA, reported either the YFAS diagnosis or symptom score, reported the population demographics in detail and were published in the English language. The articles for all studies meeting the inclusion criteria were retrieved. If a study’s eligibility for inclusion was unclear, the article was retrieved for further clarification.
1148 articles were initially identified using the search strategy. Following the removal of duplicate references and assessment of articles using the predefined inclusion criterion, 28 relevant articles describing 25 studies were identified.
196,211 participants were examined across reviewed studies ranging from one to 134,175 participants. Participants were predominantly female, with six studies investigating females exclusively [11,35,40,41,42,50,52] and an additional nine studies investigating a population with >70% female participants
This study systematically reviewed all studies that used the YFAS to assess FA. Meta-analysis indicated that overweight/obese females aged over 35 years may be more predisposed to FA, as assessed by the YFAS. Additionally, participants with disordered eating had a much higher prevalence of FA, as assessed by the YFAS compared to their non-clinical counterparts. Notably, populations included in the reviewed studies were predominantly female, overweight/obese and adults aged over 35 years, and may not be representative of the general population. Further research is required to explore YFAS outcomes across a broader spectrum of ages, particularly children and adults aged >65 years, other types of eating disorders and in conjunction with weight loss interventions to confirm the efficacy of the tool to assess for the presence of FA. Additionally, future studies should investigate whether YFAS scores can be validated using a quantitative measure. This will provide further evidence to confirm or refute existence of FA and potentially help to develop appropriate treatment approaches to target FA specifically.
food addiction; Yale Food Addiction Scale; YFAS; obesity; eating disorders; substance dependence; addiction
Pursey, Kirrilly, et al. “The Prevalence of Food Addiction as Assessed by the Yale Food Addiction Scale: A Systematic Review.” Nutrients, vol. 6, no. 10, Oct. 2014, pp. 4552–90. DOI.org (Crossref), https://doi.org/10.3390/nu6104552.