How is food addiction diagnosed?

Food addiction is currently assessed using the Yale Food Addiction Scale (YFAS), a self-report questionnaire featuring 35 questions with responses ranging from ‘never’ to ‘every day’. The YFAS was designed by adapting the criteria for substance use disorder (drug addiction) found in the DSM-5 to the context of addictive-like eating behaviors. Individuals can be defined as affected by food addiction when they meet two or more of the 11 YFAS criteria and experience significant clinical impairment or distress as a result.^[1] The YFAS has been tailored for various demographics (e.g., adults, and children) and is available in 13 languages.^[2]

An alternative assessment tool for food addiction is the Addiction-like Eating Behavior Scale (AEBS), which doesn’t draw a direct parallel to drug addiction. Instead, this scale evaluates food addiction from a behavioral standpoint rather than a substance-addiction one.^[3]

It’s worth noting that not everyone who perceives themselves as addicted to specific foods fulfills the YFAS “diagnostic” criteria. Because self-perceived food addicts may be at risk of developing problematic eating behaviors, diagnostic tools for food addiction may inadvertently prevent individuals in this category from receiving diagnoses and treatments for other eating disorders.^[4]

Another limitation of the YFAS is that some studies reported frequent overlaps between positive scores of food addiction and other eating disorders, such as binge eating. Some researchers argue that rather than being considered a separate “disorder,” FA should instead be seen as a mechanistic explanation for binge eating.^[5]