2.3.4. Food Addiction

The modified Yale Food Addiction Scale (*mYFAS*) is a short version of the original YFAS [43,44] designed to assess the behavioral indices of addictive-like eating [45]. This 9-item self-report questionnaire was developed for epidemiologic studies. Seven items are based on DSM-IV-TR symptoms of addiction: *Loss of control* (substance taken in larger amount and for a longer period than intended); *Cut down* (persistent desire or repeated unsuccessful attempt to quit); *Time spent* (much time/activity to obtain, use, recover); *Impact activities* (important social, occupational, or recreational activities given up or reduced); *Withdrawal* (characteristic withdrawal symptoms; substance taken to relieve withdrawal); *Despite problems* (use continues despite knowledge of adverse consequences) and *Tolerance* (marked increase in amount; marked decrease in effect). Two additional items (*Clinical distress* and *Clinical impairments*) are used to assess *Clinical significance*. This questionnaire includes five frequency response options that range from 0 ("*Never*") to 4 ("*More than 4 times*/*week*"). The mYFAS provides two scoring options: a "Symptom Count" scoring option (i.e., a count of food addiction symptoms, ranging from 0 to 7) and a "Diagnostic" scoring option (presence of 3 or more symptoms in addition to the presence of *Clinical significance*) [45]. In addition, a severity score above the cut-off was calculated for each item of the mYFAS. In this sample, Cronbach's alpha for the mYFAS was 0.73.
