Yale addiction scale (YFAS 2.0): Free PDF template

The Yale addiction scale (YFAS 2.0) is a 35-item self-report questionnaire that measures addictive-like eating against the 11 DSM-5 substance use disorder criteria. Scoring returns a symptom count out of 11 plus a severity band of mild, moderate, or severe. Mental health, obesity, and behavioral health services use it to turn a vague presentation into a number they can repeat.

The count alone never settles the band, because impairment or distress is scored separately. Below you can download a clinician record for scoring the scale and filing the result. The sections after it cover the criteria, the scoring decision, administration, and where the licensed items come from.

Key takeaways

The Yale addiction scale (YFAS 2.0) is a 35-item self-report questionnaire. It measures addictive-like eating against the 11 DSM-5 substance use disorder criteria.

Scoring counts how many of the 11 criteria the patient endorses, which gives a symptom count from 0 to 11. Impairment or distress is scored separately, and a classification needs both.

Severity runs mild at 2 to 3 criteria, moderate at 4 to 5, and severe at 6 or more. Every band also requires the impairment or distress criterion.

The scale screens and measures severity. It does not diagnose, so the result belongs alongside the history, the clinical interview, and any other measures you use.

Practice management software like Pabau can send the questionnaire before the appointment and file the scored result in the patient record.

What the Yale addiction scale actually measures

The scale places addictive-like eating on a continuum rather than sorting patients into a yes or a no. Each of the 11 criteria is scored as met or not met, which gives you a symptom count. That count then maps onto a mild, moderate, or severe band.

Gearhardt, Corbin, and Brownell published the original YFAS in 2009, built on the DSM-IV substance dependence criteria. The 2016 revision realigned all 11 criteria with the DSM-5 substance use disorder criteria. That change is why the current version reports severity at all, and why obesity and eating disorder programs adopted it.

YFAS or YFAS 2.0: Which version to score

Both versions still turn up in the literature, so it pays to know which one you are holding before you score anything.

Use YFAS 2.0 for every new assessment. The larger item set and the DSM-5 alignment give you stronger psychometrics and a severity band you can defend in a note. Treat an older YFAS score as historical context, never as a baseline a 2.0 score can be compared against.

The 11 DSM-5 criteria behind every item

The 35 items roll up into 11 criteria. Each one mirrors a DSM-5 substance use disorder criterion, applied to food rather than a substance:

• Tolerance – needing to eat more of the same food to get the same effect
• Withdrawal – negative emotional or physical symptoms when cutting back on certain foods
• Loss of control – eating larger amounts, or for longer, than intended
• Failed reduction efforts – repeatedly trying and failing to cut down
• Time spent – excessive time obtaining, consuming, or recovering from eating particular foods
• Reduced activities – giving up work, social, or recreational activities because of eating
• Continued use despite harm – eating on, knowing the food causes physical or psychological problems
• Interpersonal problems – eating on despite conflict with family, friends, or partners
• Risky use – eating in physically hazardous ways, such as eating while driving
• Failure to fulfill major role obligations – eating that interferes with duties at work, school, or home
• Craving – an intense urge or desire to eat a particular food

A classification needs 2 or more of the 11 criteria, plus clinically significant impairment or distress. The impairment answer sits outside the count, so both have to be present. That keeps an occasional dietary struggle below the line, exactly as DSM-5 handles a substance use disorder.

How to score it, and where the band gets misread

Scoring runs in two steps, and the order matters. First you count the criteria met. Then you check whether the patient reported clinically significant impairment or distress. A count of six with no impairment is not a severe presentation.

Record the count and the band together, every time. That pairing is what makes the next administration comparable.

What’s inside the Yale addiction scale template

The download is a four-page clinician record for scoring an administered YFAS 2.0 and filing the result. It does not reproduce the 35 questionnaire items, which stay with the research lab that holds the instrument.

Patient and administration details

Name, date of birth, record number, the date the patient completed the questionnaire, and the date you scored it. There is a line for the version used, because scores from the 35-item YFAS 2.0 and the 13-item short form are not interchangeable.

The 11-criteria checklist

The checklist gives one row per DSM-5 criterion, with a met or not met box and space to note which items reached threshold. A plain-language summary sits beside each criterion, ready for the conversation with the patient.

Symptom count and severity bands

This page holds a box for the count out of 11, a separate box for the impairment or distress answer, and the classification table. Keeping the two apart stops a count of six with no impairment being read as a severe presentation.

Plan and administration log

The last page carries tick-box actions for referral and review, a free-text plan, and a log with a row per administration. The log records the count and the classification together. A drop from six criteria to four then shows up, even when the band has not moved.

Where to get the 35 YFAS 2.0 items

The Food and Addiction Science & Treatment Lab at the University of Michigan distributes the questionnaire itself. Its short forms, the translated versions, and the scoring spreadsheets come from the same place. Request them from the lab, then use this record to score and file what comes back.

Which practices get the most out of it

Any clinician running a behavioral health assessment can use the scale. It earns its place fastest in five settings:

• Weight loss and obesity treatment – to tell weight-related binge eating apart from food addiction
• Eating disorder programs – to assess addictive features alongside bulimia or binge eating disorder
• Addiction medicine and recovery – to spot cross-addiction and food-seeking patterns during substance use recovery
• Mental health and therapy – to explore impulsivity, compulsivity, and reward dysregulation in anxiety, depression, or ADHD
• Metabolic health and functional medicine – to surface the behavioral barriers holding up a cardiovascular or diabetes plan

Psychiatrists, therapists, and registered dietitians all administer it. So do physician assistants, nurse practitioners, and health coaches running patient intake.

The scoring is identical in every setting, and what changes is the follow-up. It helps to keep the scale inside the same therapy practice management system that holds the chart.

Administering the questionnaire without chasing it

The YFAS 2.0 is self-report and takes a patient five to 10 minutes. Five steps keep it from becoming another form to hunt down:

1. Send it before the appointment: add the questionnaire to the intake packet you already send, or push it out through your patient intake software. The patient completes it at home, so you review a scored form rather than a blank one.
2. Explain what it measures: a short cover note helps. Tell the patient it asks about eating patterns over the past 12 months, and that no answer is right or wrong.
3. Score it before you sit down: count the criteria met, record the impairment answer, then apply the band. Five minutes of prep changes the shape of the conversation.
4. Walk the patient through it: name the criteria that were met, then ask which ones bother them most. Their answer usually points straight at the first treatment target.
5. File it where the chart lives: store the scored record with the rest of the patient’s notes, under the same access controls. A score in a spreadsheet is a score nobody finds at the next review.

How well the evidence holds up

The YFAS 2.0 has been tested across a large body of peer-reviewed work. These are the headline figures:

• Internal consistency: the largest meta-analysis to date, covering 65 studies, reports a pooled Cronbach’s alpha of 0.85 (95% CI 0.83 to 0.86)
• Test-retest reliability: the same analysis reports a pooled intraclass correlation of 0.77 (95% CI 0.70 to 0.84), with individual studies ranging from 0.56 to 0.95
• Factor structure: confirmatory factor analysis supports a single latent factor of food addiction, which backs the construct
• Translations: validated German, Spanish, French, Italian, Portuguese, and Japanese versions are published
• Criterion validity: scores correlate with binge eating severity, BMI, and eating disorder features

Reliability holds up well, then, but it is not uniform. The individual test-retest figures span a wide range, so read a single retest against the sample it came from. You can work through the primary studies in PubMed’s YFAS 2.0 validation literature.

One caveat worth repeating: the scale screens and measures severity. It does not diagnose. Read the result alongside the history, the clinical interview, and whatever other measures you already use.

Where the scale falls short

Four limitations are worth knowing before you quote a band to a patient:

• The construct is still argued over: researchers disagree on whether food addiction is a distinct entity. The alternative reading treats it as a dimensional feature of other eating or impulse control disorders. The YFAS measures the traits without settling that question.
• It overlaps with binge eating disorder: loss of control and continued eating despite harm appear in both, which can inflate comorbidity estimates. Running a binge eating scale alongside it helps you separate the two presentations.
• Cut-offs get applied more firmly than the design supports: the instrument yields dimensional scores, and the bands are working conventions rather than validated diagnostic thresholds.
• Clinical utility is understudied: the YFAS 2.0 grew out of research. How well its bands steer treatment decisions has had less study than the established eating disorder screening tools.

Before you use it: A five-point check

Run through this before the questionnaire goes out. It takes a minute and saves a rescore:

• You are sending the 35-item YFAS 2.0, not the 13-item short form, unless you mean to.
• Your copy carries the published item wording, with nothing reworded to suit a form builder.
• The patient knows the questions cover the past 12 months.
• Your record has somewhere to log the impairment answer separately from the count.
• A review date is already booked, so the second administration has a reason to happen.

Three mistakes come up again and again. Reading a high count as severe when no impairment was reported is the first. Comparing a 2.0 score against an older YFAS score is the second. Third is treating the band as a diagnosis, which it was never designed to be.

How Pabau handles the send, the score, and the follow-up

Handing out paper questionnaires, chasing them back, scoring them, and filing them eats hours across a caseload. The clinician loses time and so does the front desk.

Pabau runs that sequence for you, and a mental health EMR keeps the scored result beside the chart it belongs to.

You upload or recreate the questionnaire as an interactive form, and patients receive it at booking time through the Client Portal. Their answers save straight to the clinical record. Automated workflows then fire the follow-up, so a moderate or severe band books the nutrition consultation on its own.

The paper disappears, the wording stays consistent between administrations, and every food addiction assessment sits in one searchable record. That is what makes outcome tracking across a treatment episode workable.

Digitize your clinical assessments

Pabau’s digital forms and Client Portal send the Yale addiction scale before the appointment. Automated workflows collect the responses and store the scored result in the patient record.

Book a demo

Conclusion

The Yale addiction scale earns its keep because it turns a vague presentation into a number you can act on and then repeat. Score it, log the impairment answer beside the count, and the next administration tells you whether the plan is working.

One trade-off is worth remembering. A band is a measurement the plan gets checked against, and it does not replace the history or the clinical interview. Download the record above for the checklist, the bands, and the log, then request the questionnaire itself from the FAST Lab.

Book a demo to see the send, the score, and the follow-up run in one system.

Continue your research

Screening for binge eating alongside it? Binge eating disorder quiz gives you a short screener to run before the full assessment.

Need something for the therapy room? Eating disorder worksheet turns the assessment findings into structured work with the patient.

Looking for a behavioral intervention for a mild band? Mindful eating worksheet suits early-stage addictive-like eating that responds to behavioral work.

Seeing food-seeking patterns in substance use recovery? Cross-addiction worksheet helps you map how one dependence shifts into another.

Planning the follow-up after a severe band? Relapse prevention plan worksheet gives the patient triggers, warning signs, and a written plan.

Frequently asked questions