YFAS 2.0 Scoring: Yale Food Addiction Scale 2.0 Symptom Count and Severity

The YFAS (Yale Food Addiction Scale, version 2) is a 35-item self-report questionnaire that counts 11 addiction-style symptoms in eating over the past 12 months, with severity levels that apply only when eating causes clinically significant impairment or distress ².

What does the YFAS 2.0 measure?

The YFAS 2.0 measures addictive-like eating: whether the DSM-5 criteria for substance use disorders describe a person's relationship with certain foods ¹. Gearhardt and colleagues updated the original YFAS ⁵ when DSM-5 changed the substance-related and addictive disorders section ¹.

The 11 criteria cover, in summary ²:

• Loss of control. Eating more than intended, being unable to cut down, and spending a lot of time obtaining food, eating or recovering.
• Impact on life. Giving up activities, failing role obligations, and continuing despite physical, emotional or social problems.
• Risk. Eating in physically hazardous situations.
• Physiological and craving. Tolerance, withdrawal and craving.

A separate criterion asks about clinically significant impairment or distress ².

Food addiction is not a DSM-5-TR diagnosis. The scale describes a research construct; it does not identify a recognized disorder.

How do you give the YFAS 2.0?

• Format. 35 items, each answered on an 8-point frequency scale from 0 (never) to 7 (every day), about the past 12 months ².
• Who completes it. The client, on paper or on screen.
• Versions. Translations such as Japanese have been validated with input from the original author ². A 13-item modified version (mYFAS 2.0) also exists ³.
• Approach. Use non-stigmatizing language: the scale is about the client's experience of eating, not about body size or willpower.

How do you score and interpret the YFAS 2.0?

1. Score each item. Each item counts as met when the answer reaches the threshold set for that item in the validation paper; thresholds differ between items ².
2. Score each criterion. A criterion is met if any of its items is met ².
3. Symptom count. Add the criteria met, from 0 to 11 ².
4. Threshold. The YFAS 2.0 threshold needs 2 or more criteria and the impairment or distress criterion ^{2 3}.
5. Severity. Above threshold, 2 to 3 criteria are classed mild, 4 to 5 moderate and 6 to 11 severe ^{2 3}. The scorer at the top of this page shows these levels; each applies only if impairment or distress is present.
6. Document carefully. Record the symptom count and whether the threshold was met. Do not record food addiction as a diagnosis.

Psychometric properties

• Development. In 550 participants, the YFAS 2.0 showed good internal consistency and convergent, discriminant and incremental validity; 14.6% of that sample met the threshold. Higher scores were linked to higher rates of obesity and more severe binge eating ¹.
• Distinct construct. It captured something related to, but not the same as, traditional eating disorder measures ¹.
• Comparison with the original YFAS. In a separate 209-person sample, both versions were similarly linked to body mass index, binge eating and weight cycling ¹.
• Japanese version. In 731 undergraduates, a one-factor structure was supported with Kuder-Richardson α 0.78 ².
• Severity levels. In 1,854 online participants, people above threshold had more eating disorder symptoms than those below, but the mild, moderate and severe groups differed little from each other; the authors questioned the usefulness of symptom-count severity ³.

Limitations

• Not a diagnosis. Food addiction is not in DSM-5-TR, and a score above threshold is not a diagnosis.
• Overlap with eating disorders. 96% of a sample with bulimia nervosa met the YFAS 2.0 threshold, against 14% of controls ⁴. Screen for bulimia nervosa and binge eating disorder directly, for example with the EDDS or BES.
• Severity levels are weakly supported. Symptom-count severity separated groups poorly ³.
• Long recall. The 12-month window is less suited to tracking change over weeks.
• Weight framing. Links with body mass index in research samples ¹ describe groups, not individuals; avoid using the scale to make judgments about a client's body.
• Related measures. For broader eating disorder screening, see the EDE-Q, EAT-26 and SCOFF.