Italian Version of Food Addiction Interview Shows Strong Psychometric Performance

Researchers have validated an Italian version of the Food Addiction Symptom Inventory (FASI), a clinician-administered semi-structured interview designed to assess addiction-like eating behaviors linked to ultra-processed food consumption. The study, published in Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity, reports that the translated instrument shows satisfactory psychometric properties in a clinical population, while also flagging a diagnostic puzzle in patients with restrictive eating disorders.

The validation involved 118 patients diagnosed with either anorexia nervosa, restrictive subtype, or a binge-eating spectrum disorder. The team, led by Elvira Anna Carbone and Matteo Aloi with contributions from Ashley N. Gearhardt and Erica M. LaFata, used confirmatory factor analysis (CFA) to test whether the FASI behaves as a single dimensional measure, and examined reliability and convergent validity across the sample.

The statistical results supported the instrument’s intended structure. The CFA confirmed a one-factor solution with good model fit, yielding a comparative fit index of 0.958, a Tucker-Lewis index of 0.947, a root mean square error of approximation of 0.064, and a standardized root mean square residual of 0.076. Internal consistency was also solid, with a categorical omega of 0.84. These values indicate that the Italian FASI measures a coherent underlying construct and that its items perform consistently in this clinical group.

Convergent validity was assessed by correlating total FASI symptom criteria with YFAS 2.0 symptom scores, since both instruments target addiction-like eating. In the overall sample the correlation was moderate to strong (r = 0.581). Notably, convergence differed by diagnosis: it was lower in the anorexia nervosa group (r = 0.408) than in the binge-spectrum group (r = 0.505). This pattern suggests the two measures align more closely where binge-type overeating dominates the clinical picture.

The exploratory measurement invariance analyses provided preliminary support for configural and partial metric invariance across the restrictive- and binge-spectrum diagnostic groups. In practical terms, this means the FASI’s underlying structure appears broadly comparable between the two patient groups, although some items may not function identically, and the evidence remains preliminary rather than definitive.

The most clinically significant finding concerns the restrictive-spectrum group. The authors report potential challenges in distinguishing addiction-like intake from restraint-driven subjective overeating in these patients. In other words, when a person with restrictive anorexia nervosa reports feeling out of control around food, it may reflect the psychological effects of dietary restraint rather than an addiction-like pattern of consumption. The researchers emphasize that this distinction warrants particular clinical attention when interpreting FASI scores in restrictive presentations.

The study carries a Level of Evidence III designation, indicating evidence obtained from well-designed cohort or case-control analytic studies. The authors are explicit about the limits of the work: the sample was modest in size and restricted to two diagnostic categories, and the invariance analyses were exploratory. They call for future studies with larger and more diverse samples to further evaluate measurement invariance, as well as inter-rater and test-retest reliability, and the instrument’s predictive validity for clinical outcomes.

As an open-access publication shared ahead of final copyediting, the article is citable under a permanent DOI, with the final version of record to follow. For clinicians and researchers working with Italian-speaking patients, the validated FASI now offers a structured, interviewer-based alternative to self-report food addiction screening, with the caveat that scores in restrictive eating disorder presentations should be interpreted with care.

Subject of Research: Validation of the Italian version of the Food Addiction Symptom Inventory in patients with eating disorders

Article Title: Italian validation and exploratory measurement invariance of the food addiction symptom inventory (FASI)

Article References: Carbone, E. A., Rotella, L., Garofalo, S. M., Vizza, G. F., Quirino, D., de Filippis, R., Rania, M., D’Onofrio, E., Gearhardt, A. N., LaFata, E. M., Segura-Garcia, C., & Aloi, M. (2026). Italian validation and exploratory measurement invariance of the food addiction symptom inventory (FASI). Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity. https://doi.org/10.1007/s40519-026-01917-6

Image Credits: AI Generated

DOI: 10.1007/s40519-026-01917-6

Keywords: food addiction, FASI, Italian validation, eating disorders, anorexia nervosa, binge-eating disorder, psychometrics, confirmatory factor analysis, measurement invariance, YFAS 2.0, convergent validity, ultra-processed food