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Updated: Oct 12, 2025
Concept Development and Use of an Automated Food Intake and Eating Behavior Assessment Method
Published on: February 19, 2021
How do young children eat after an obesity intervention? Validation of the Child Eating Behaviour Questionnaire using
M Somaraki1, A Ek2, P Sandvik1
1Department of Food Studies, Nutrition and Dietetics, Uppsala University, Sweden.
Insights
This study refined the Child Eating Behaviour Questionnaire (CEBQ) using Rasch analysis. The validated CEBQ showed no treatment differences but revealed decreases in food approach behaviors and increases in fussy eating in children undergoing obesity treatment.
Area of Science:
- Pediatric Obesity
- Behavioral Science
- Psychometrics
Background:
- Child eating behaviors are linked to weight status, but changes during obesity treatment are understudied.
- Existing Child Eating Behaviour Questionnaire (CEBQ) evaluations are sample-dependent, potentially missing key behavioral traits.
- Rasch analysis offers a robust method for psychometric evaluation, overcoming sample dependency and trait capture limitations.
Purpose of the Study:
- To validate the Child Eating Behaviour Questionnaire (CEBQ) using Rasch analysis in children undergoing obesity treatment.
- To assess changes in child eating behaviors over 12 months of obesity intervention.
- To evaluate the effectiveness of a parenting program compared to standard treatment on child eating behaviors.
Main Methods:
- Applied Rasch analysis to validate the CEBQ using data from Australian and Swedish children (n=1724).
- Utilized linear mixed models to analyze changes in eating behaviors from the refined CEBQ in a randomized controlled trial (RCT) (n=177).
- Parents completed the CEBQ at four time points over a 12-month period.
Main Results:
- CEBQ validity was confirmed after removing 4 items based on Rasch fit statistics.
- No significant differences in reported eating behavior changes were found between the parenting program and standard treatment groups (p > 0.05).
- Across the total sample, food approach behaviors decreased, while fussy eating behaviors increased (p < 0.05).
Conclusions:
- The Rasch-refined CEBQ is a valid tool for assessing parent-reported child eating behaviors.
- Early obesity interventions may reduce eating behaviors associated with higher child weight.
- Further research is needed to explore the relationship between changes in child weight status and eating behaviors.
Abstract:
Child eating behaviours have consistently been linked to child weight status. Yet, changes in child eating behaviours during early obesity treatment are rarely evaluated. Psychometric evaluation of the Child Eating Behaviour Questionnaire (CEBQ) is common, but results are sample-dependent and included items may not capture the full range of the underlying traits. Rasch analysis can overcome these disadvantages. The aim of this paper was to assess child eating behaviours measured by the CEBQ after a 12-month obesity intervention applying the Rasch model for the validation of the CEBQ. The Rasch-based fit statistics were applied in children from two samples, Australian and Swedish (n = 1724). Changes in eating behaviours amongst children aged 4-6 years were examined in the More and Less RCT for obesity treatment (n = 177), which compared a parenting programme (with and without boosters) against standard treatment. Parents completed the CEBQ at four time points over 12-months. Linear mixed models were applied to estimate treatment effects on the CEBQ, refined according to Rasch, over time. We found that the validity of CEBQ was confirmed after removing 4 items (item fit statistics outside range 0.5-1.5). When the refined CEBQ was used in the assessment of the RCT, there were no differences in parental reports of changes in children's eating behaviours between the parenting programme and standard treatment (group-by-time interactions p > 0.05). However, in the total sample food approach behaviours decreased while fussy eating behaviours increased (p < 0.05). In conclusion, the refined CEBQ proved to be a valid tool for examining parent-reported child eating behaviours. Early obesity treatment may decrease eating behaviours associated with higher child weight. Future research should address the associations between changes in child weight status and eating behaviours.
