Psychometric Properties of the Persian Version of the Yale Food Addiction Scale 2.0 (P-YFAS 2.0) in an Iranian Clinical Sample

The aim of this study was to assess the psychometric aspects of Persian version of Yale Food Addiction Scale 2.0 (YFAS 2.0) and the prevalence of Food Addiction (FA) among Iranian obese population seeking bariatric surgery.  In this cross-sectional study, psychometric aspects of the YFAS 2.0 including validity and reliability were assessed. Convergent and discriminant validity of the YFAS 2.0 was evaluated using Eating Disorder Inventory-3, Referral form (EDI-3 RF), Dutch Eating Behavior Questionnaire (DEBQ), Difficulties in Emotion Regulation Scale (DERS), and Barratt Impulsiveness Scale (BIS-15) and reliability of the scale was examined by test-retest analysis and internal consistency. Among 124 patients (48.6%) who met FA criteria, 2 patients (1.6%) received a mild, 12 (9.6%) a moderate, and 110 (88.7%) a severe FA diagnosis. FA was more prevalent and severe in females, unmarried individuals, unemployed patients, and those with higher Body Mass Index (BMI) or binge eating disorder/bulimia nervosa diagnoses. Reliability analysis showed high internal consistency (Cronbach’s α = 0.89) and test-retest reliability (ICC = 0.88). Content validity was 0.8 or higher in terms of convergent validity. Except for one criterion, a one-factor structure was confirmed for the P-YFAS 2.0 (above 0.42). FA prevalence was higher in participants with BED or bulimia nervosa, and FA severity was correlated with scores on measures of impulsivity, emotion regulation difficulties, eating behaviors and psychopathology. These findings support the reliability and validity of the P-YFAS 2.0 in assessing FA as defined by Diagnostic and Statistical Manual of Mental Disorders-fifth (DSM-5). The high rate of FA identified highlights the need for targeted interventions in this clinical population.