Psychometric Validation of the Eating Behavior and Appetite Questionnaire (EBAQ) for Individuals with Obesity or...

Obesity management medications influence eating behavior and promote substantial weight reduction in individuals with obesity or overweight. Existing patient-reported outcome measures do not adequately measure appetite and eating behavior concepts relevant to individuals with these conditions. This study presents psychometric properties of the Eating Behavior and Appetite Questionnaire (EBAQ), a new patient-reported outcome measure to assess appetite and eating behaviors in adults with obesity or overweight.

Participants (n = 120) completed two web-based surveys (baseline, week 2). Survey 1 included the 21-item EBAQ, Control of Eating Questionnaire, Food Cravings Questionnaire-Trait-reduced, Impact of Weight on Quality of Life-Lite Clinical Trials Version, and Patient Global Impression of Severity (PGIS) items for appetite, eating control, cravings, and overall eating behavior. Survey 2 included the EBAQ and PGIS items. Factor structure, reliability, and validity of the EBAQ were assessed.

Exploratory factor analysis of the EBAQ supported a 2-factor structure. Items loaded moderately to strongly (≥ 0.48) on factors corresponding to appetite control or eating behavior (inter-factor correlation 0.57). Four items with factor loadings ≤ 0.43 were dropped. Internal consistency for the 17-item EBAQ was good/excellent for the domain scores (0.84-0.91) and excellent for the total score (0.92). Test-retest reliability was good (intraclass correlation coefficients ≥ 0.84). Convergent validity was demonstrated via large correlations with the Control of Eating Questionnaire craving subscales, Food Cravings Questionnaire-Trait-reduced total score, and PGIS items, and smaller correlations with less similar PRO measures. EBAQ domain and total scores demonstrated known-groups validity, with higher EBAQ scores in participants who reported a well-controlled appetite, feeling in control of their eating, fewer food cravings, and better eating habits (i.e., higher PGIS scores).

Results support the 2-factor structure, reliability, and validity of the final 17-item EBAQ. The EBAQ can be used in observational studies, clinical trials, and clinical practice to comprehensively assess appetite and eating behaviors in individuals with obesity or overweight.