Broader Validation of New Zealand Eating Behavior Questionnaire as Clinical Assessment Tool to Identify Actionable...

Background/Objectives: The New Zealand Eating Behavior Questionnaire (NZ-EBQ) is a validated questionnaire that comprises three distinct scales that measure satiation at mealtimes, satiety in the post-eating period, and emotional eating behavior. This study evaluated the model validity of the NZ-EBQ across two additional samples of demographically diverse participants using confirmatory factor analysis. Methods: We compared the classification of the eating behavior (EB) type with that of the initial cohort used to develop the three-factor model. Two cohorts of 81 and 214 participants provided complete data sets for analysis. Cohort 1 was characterized by the use of more weight management medications, and participants in Cohort 2 were significantly heavier. Confirmatory factor analysis was performed using combined data from both cohorts to maximize the sample size. Results: Except for one item, all items demonstrated a factor loading consistent with the established three-factor model. After removing one item from the emotional eating scale, the model fit statistics did not change significantly. Participants were assigned to one of the three EB types based on their highest median score, and most could be classified into one of the three EB types, with only a few who could not be classified (Cohort 1:12.3%; Cohort 2:13.0%). The test-retest reliability performed in a subset of participants was comparable to that of the initial validation cohort. A significant positive correlation was found between BMI and the individual EB scores. Conclusions: The NZ-EBQ may serve as a screening tool for identifying actionable EB traits that help select targeted interventions based on EB, supporting precision medicine-based approaches.