Abstract
Background
Assessment of eating disorder psychopathology during preoperative psychological evaluations
could be facilitated with psychometrically valid measures. One of the most commonly
used measures, the Eating Disorder Examination Questionnaire (EDE-Q), is lengthy and
has been found to have psychometric limitations. Research has identified a shorter
version that has received reliable support across diverse samples but requires further
validation for use with patients being evaluated for bariatric surgery.
Objectives
To cross-validate the factor structure of the EDE-Q: Brief Form (EDE-Q-BF, standalone,
nonnested version) with patients being evaluated for bariatric surgery across English-
and Spanish-language versions and establish measurement invariance for gender and
language.
Setting
Northeastern hospital in the United States.
Methods
Participants (n = 618) undergoing evaluations prior to bariatric surgery who identified
as Hispanic/Latino/a/x and consented to participate in this research study (which
did not influence eligibility for bariatric surgery) completed self-reports. Of the
618 participants, 92 were male and 526 were female, 318 preferred English and were
administered English versions of the measures, and 300 preferred Spanish and were
administered Spanish versions of the measures.
Results
The 3-factor structure (“Restraint,” “Weight/Shape Concerns,” and “Body Dissatisfaction”)
of the EDE-Q-BF fit the data well (χ2 [11] = 18.47; P = .071; root mean square error of approximation [RMSEA] = .033; comparative fit index
[CFI] > .99; standardized root mean squared residual [SRMR] = .02). Scaler invariance
was met for both gender and language. Correlations with external criteria further
supported its validity.
Conclusion
The EDE-Q-BF can easily be administered as part of a preoperative psychological assessment
battery to screen for eating disorder psychopathology and is valid for Hispanic/Latino/a/x
men and women who speak either English or Spanish.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Surgery for Obesity and Related DiseasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Long-term outcomes after bariatric surgery: a systematic review and meta-analysis of weight loss at 10 or more years for all bariatric procedures and a single-centre review of 20-year outcomes after adjustable gastric banding.Obes Surg. 2019; 29: 3-14
- Weight regain and insufficient weight loss after bariatric surgery: definitions, prevalence, mechanisms, predictors, prevention and management strategies, and knowledge gaps—a scoping review.Obes Surg. 2021; 31: 1755-1766
- Recommendations for the presurgical psychosocial evaluation of bariatric surgery patients.Surg Obes Relat Dis. 2016; 12: 731-749
- A review of the psychosocial aspects of clinically severe obesity and bariatric surgery.Am Psychol. 2020; 75: 252-264
- Six-year bariatric surgery outcomes: the predictive and incremental validity of presurgical psychological testing.Surg Obes Relat Dis. 2021; 17: 1008-1016
- What is “grazing”? Reviewing its definition, frequency, clinical characteristics, and impact on bariatric surgery outcomes, and proposing a standardized definition.Surg Obes Relat Dis. 2014; 10: 973-982
- Loss of control over eating predicts outcomes in bariatric surgery patients: a prospective, 24-month follow-up study.J Clin Psychiatry. 2010; 71: 175-184
- Binge eating, binge eating disorder and loss of control eating: effects on weight outcomes after bariatric surgery.Eur Eat Disord Rev. 2014; 22: 87-91
- Understanding the role of psychopathology in bariatric surgery outcomes.Obes Rev. 2016; 17: 126-141
- Postoperative behavioral variables and weight change 3 years after bariatric surgery.JAMA Surg. 2016; 151: 752-757
- Eating disorders and problematic eating behaviours before and after bariatric surgery: characterization, assessment and association with treatment outcomes.Eur Eat Disord Rev. 2015; 23: 417-425
- Loss-of-control eating following sleeve gastrectomy surgery.Surg Obes Relat Dis. 2017; 13: 392-398
- Loss of control eating and binge eating in the 7 years following bariatric surgery.Obes Surg. 2019; 29: 1773-1780
- Interrater reliability and internal consistency of the eating disorder examination in the longitudinal assessment of bariatric surgery study.Surg Obes Relat Dis. 2022; 18: 1015-1022
- Interrater reliability of the Eating Disorder Examination among postbariatric patients.Surg Obes Relat Dis. 2020; 16: 1988-1993
- Disordered eating following bariatric surgery: a review of measurement and conceptual considerations.Surg Obes Relat Dis. 2021; 17: 1510-1520
- Assessment of eating disorders: interview or self-report questionnaire?.Int J Eat Disord. 1994; 16: 363-370
- A review of psychological assessment instruments for use in bariatric surgery evaluations.Psychol Assess. 2016; 28: 1142-1157
- Factor structure of the eating disorder examination interview in patients with binge-eating disorder.Obesity. 2010; 18: 977-981
- Eating Disorder Examination Questionnaire factor structure and construct validity in bariatric surgery candidates.Obes Surg. 2013; 23: 657-662
- The factor structure of the Eating Disorder Examination in clinical and community samples.Int J Eat Disord. 2010; 43: 260-265
- The Eating Disorder Examination: norms and construct validity with young and middle adolescent girls.Int J Eat Disord. 2008; 41: 551-558
- Factor structure and construct validity of the Eating Disorder Examination–Questionnaire in college students: further support for a modified brief version.Int J Eat Disord. 2015; 48: 284-289
- Replication of a modified factor structure for the Eating Disorder Examination–Questionnaire: extension to clinical eating disorder and non-clinical samples in Portugal.Eur Eat Disord Rev. 2018; 26: 75-80
- Psychometric evaluation of the Eating Disorder Examination–Questionnaire for bariatric surgery candidates.Obesity. 2008; 16: 763-769
Shen MR, Jiang S, Millis MA, et al. Racial variation in baseline characteristics and wait times among patients undergoing bariatric surgery. Surg Endosc. Epub 2022 May 4.
- Impact of racial disparities in preoperative cardiovascular evaluation and surgical outcomes in patients undergoing metabolic and bariatric surgery: a retrospective cohort analysis.J Am Heart Assoc. 2022; 11e024499
- Diabetes prevalence among diverse Hispanic populations: considering nativity, ethnic discrimination, acculturation, and BMI.Eat Weight Disord. 2021; 26: 2673-2682
- Rates of help-seeking in US adults with lifetime DSM-5 eating disorders: prevalence across diagnoses and differences by sex and ethnicity/race.Elsevier, Amsterdam2019: 1415-1426
- Application of cultural constructs in the care of first generation Latino clients in a community mental health setting.J Psychiatr Pract. 2005; 11: 221-230
- Distinctiveness and significance of body dissatisfaction and overvaluation among Latinx/Hispanic and White men and women.Int J Eat Disord. 2021; 54: 354-364
- The Spanish language version of the Eating Disorder Examination Questionnaire: comparison with the Spanish language version of the Eating Disorder Examination and test–retest reliability.Behav Res Ther. 2007; 45: 1369-1377
- Eating Disorder Examination–Questionnaire short forms: a comparison.Int J Eat Disord. 2020; 53: 937-944
- Inter-rater and test-retest reliability of the Spanish language version of the Eating Disorder Examination interview: clinical and research implications.J Psychiatr Pract. 2005; 11: 231-240
- Comparative research methodology: cross-cultural studies.Int J Psychol. 1976; 11: 215-229
- Loss of control over eating is associated with eating disorder psychopathology in a community sample of Latinas.Eat Behav. 2008; 9: 501-503
- Orlistat with behavioral weight loss for obesity with versus without binge eating disorder: randomized placebo-controlled trial at a community mental health center serving educationally and economically disadvantaged Latino/as.Behav Res Ther. 2013; 51: 167-175
- Development and validation of the eating loss of control scale.Psychol Assess. 2014; 26: 77
- Psychometric properties of the eating loss of control scale among postbariatric patients.Surg Obes Relat Dis. 2019; 15: 1829-1835
Muthén LK, Muthén BO. Mplus user’s guide, 8th ed. Los Angeles: Muthén & Muthén; 1998–2017.
- IBM SPSS statistics for Windows (Version 27).IBM Corp, Armonk, NY2020
- Accuracy in parameter estimation for the root mean square error of approximation: sample size planning for narrow confidence intervals.Multivariate Behav Res. 2011; 46: 1-32
- Comparative fit indexes in structural models.Psychol Bull. 1990; 107: 238-246
- The relationship between the standardized root mean square residual and model misspecification in factor analysis models.Multivariate Behav Res. 2018; 53: 676-694
- An empirical evaluation of the use of fixed cutoff points in RMSEA test statistic in structural equation models.Sociol Methods Res. 2008; 36: 462-494
- Sensitivity of fit indexes to misspecified structural or measurement model components: rationale of two-index strategy revisited.Struct Equ Modeling. 2005; 12: 343-367
- Fit indices versus test statistics.Multivariate Behav Res. 2005; 40: 115-148
- A review and synthesis of the measurement invariance literature: suggestions, practices, and recommendations for organizational research.Organizat Res Meth. 2016; 3: 4-70
- Eating Disorder Examination Questionnaire (EDE-Q): norms for undergraduate women.Int J Eat Disord. 2008; 41: 273-276
- Psychosocial functioning of bariatric surgery patients 6-years postoperative.Obes Surg. 2021; 31: 712-724
- Toward an understanding of racial and ethnic diversity in body image among women.Social Work Res. 2019; 43: 69-80
- Images of thin and plus-size models produce opposite effects on women’s body image, body dissatisfaction, and anxiety.Sex Roles. 2019; 80: 607-616
- Sociocultural and identity predictors of body dissatisfaction in ethnically diverse college women.Body Image. 2016; 16: 32-40
- Congruence between clinical and research-based psychiatric assessment in bariatric surgical candidates.Surg Obes Relat Dis. 2010; 6: 628-634
Article info
Publication history
Published online: December 09, 2022
Accepted:
December 1,
2022
Received:
July 6,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
