Psychometric properties of the Child Eating Behavior Questionnaire (CEBQ) in school age children with overweight and obesity: A proposed three‐factor structure

Abstract

Background: Obesity in youth is a significant public health concern, with eating behaviors being a major contributor. The Child Eating Behavior Questionnaire (CEBQ) was developed to evaluate the appetitive characteristics of young children, across a myriad of eating domains. Despite the breadth of its use, the psychometric properties of the measure in children with overweight/obesity (OW/OB), particularly treatment seeking youth, remains largely unexplored. Methods:The psychometric properties of the CEBQ were examined in a sample of school age children (8-12) with OW/OB. Parent-child dyads (N = 148) completed assessments prior to beginning a family weight management program. Exploratory factor analysis (EFA) was performed utilizing polychoric correlations, and emerging subscales were assessed to ensure that the range of response scores demonstrated adequate variability. Indices of the number of factors to be retained included acceleration factor (2), optimal coordinates (4), Velicer's MAP (5) and parallel analysis (11). These indices were used in combination with clinical utility to determine the final factor structure.Results: A three-factor structure emerged. The first factor combined many food responsiveness, enjoyment of food, satiety responsiveness and slowness in eating items, with the latter two domains loading negatively. The second factor retained the food fussiness subscale, and the third factor included items from the emotional overand under-eating subscales.Conclusions: These results suggest that in children with OW/OB, eating behaviors may be optimally assessed using three domains: reward-based eating, emotional eating and picky eating. Future research should explore how this structure holds in non-treatment-seeking samples and across wider socio-demographic profiles. | INTRODUCTIONWith current rates of obesity in children reaching 18.5% in the U.S. population, understanding patterns of children's eating behaviors that convey risk and maintenance of "obesogenic" eating behaviors remain an urgent public health goal. 1,2 The Child Eating Behavior Questionnaire

Appetitive traits and food groups consumption in school-aged children: prospective associations from the Generation XXI birth cohort

“…Both data on child's appetitive traits and food consumption was reported by the main caregiver, and this may be biased and potentially lead to an over report of healthy food intake due to social desirability. Nevertheless, the CEBQ showed good psychometric properties in our sample, besides being a validated tool, extensively used in other populations [58][59][60]. In addition, data collected with the FFQ was compared with 3-day food records in a sub-sample of children from Generation XXI at 4 and 7 years and showed acceptable validity [25].…”

Early Feeding Factors and Eating Behaviors among Children Aged 1–3: A Cross-Sectional Study

“…Since then, CEBQ in original or modified versions has been used in multiple studies, involving wide age ranges of study subjects (from 12 months [ 35 ] up to 16 years old [ 20 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]). Originally, the CEBQ included eight subscales, four of them representing “food approach” traits—food responsiveness (FR), enjoyment of food (EF), emotional overeating (EOE), and desire to drink (DD), with the remaining four representing “food avoidance” eating traits—satiety responsiveness (SR), food fussiness (FF), slowness in eating (SE) and emotional undereating (EUE) [ 44 , 45 ]. Appetitive traits can vary with age; nonetheless, some studies showed good continuity/stability of selected eating behaviors over time [ 42 , 46 , 47 ].…”

Metabolic, behavioral health, and disordered eating comorbidities associated with obesity in pediatric patients: An Obesity Medical Association (OMA) Clinical Practice Statement 2022

“…Tools to evaluate for EE include [ 144 , 155 , 156 ]: Dutch Eating Behavior Questionnaire (DEBQ) Child Eating Behavior Questionnaire (CEBQ) Emotional Eating Scale for Children and Adolescents (EES-C) …”