Psychometric properties of a new questionnaire to assess eating in the absence of hunger in children and adolescents

Background Eating in the absence of hunger (EAH), studied in the context of laboratory paradigms, has been associated with obesity and is predictive of excess weight gain in children. However, no easily administered questionnaire exists to assess for EAH in children. Objective We developed an Eating in the Absence of Hunger Questionnaire to be administered to children and adolescents (EAH-C) and examined psychometric properties of the measure. Design Two-hundred and twenty-six obese (BMI ≥ 95th percentile for age and sex, n = 73) and non-obese (BMI < 95th percentile, n = 153) youth (mean age ± S.D., 14.4 ± 2.5 y) completed the EAH-C and measures of loss of control and emotional eating, and general psychopathology. Temporal stability was assessed in a subset of participants. Results Factor analysis generated three subscales for the EAH-C: Negative Affect, External Eating, and Fatigue/Boredom. Internal consistency for all subscales was established (Cronbachʹs alphas: 0.80–0.88). The EAH-C subscales had good convergent validity with emotional eating and loss of control episodes (pʹs < 0.01). Obese children reported higher Negative Affect subscale scores than non-obese children (p ≤ 0.05). All three subscales were positively correlated with measures of general psychopathology. Intra-class correlation coefficients revealed temporal stability for all subscales (ranging from 0.65 to 0.70, pʹs < 0.01). We conclude that the EAH-C had internally consistent subscales with good convergent validity and temporal stability, but may have limited discriminant validity. Further investigations examining the EAH-C in relation to laboratory feeding studies are required to determine whether reported EAH is related to actual energy intake or to the development of excess weight gain.