Development of the Food Addiction Symptom Inventory: The First Clinical Interview to Assess Ultra-Processed Food Addiction

Prior research on ultra-processed food addiction (FA) has utilized the self-report Yale Food Addiction Scale (YFAS) measures to identify individuals who experience indicators of substance-use disorders with respect to their consumption of ultra-processed foods. Studies using the YFAS have provided insight into the clinical utility of FA as both a distinct construct and an indicator of more severe psychopathology among individuals with eating disorders. However, the absence of clinician-administered assessment tools for FA has been identified as a barrier to the evaluation of FA as a novel clinical syndrome. Thus, the present study reflects the development of the Food Addiction Symptom Inventory (FASI), a clinician-administered assessment of FA, adapted from the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fifth editon modules for diagnosing substance-use disorders. The psychometric properties of the FASI and its concordance with the YFAS 2.0 were evaluated in a cross-sectional study of adults (n = 53) with binge-type eating disorders. The FASI performed appropriately on indices of reliability and validity. Concordance between the FASI and YFAS 2.0 was established for the symptom scores (r = .53, p < .001), and >70% agreement was achieved for FA categorization. Using the FASI, 80% of individuals with bulimia nervosa and 91.7% of those with binge eating disorder were identified as exhibiting FA. While the YFAS 2.0 and FASI both lead to similar assessments of FA symptoms, the FASI provides an essential approach for clinician-guided identification of this phenotype, which may be particularly important when participants have high levels of dietary restraint or limited insight into the impact of their eating behavior.