Development and validation of the Maladaptive Eating Behavior Questionnaire for Chinese patients after bariatric surgery

Introduction: It was challenging to accurately measure the maladaptive eating behavior after bariatric surgery. Our study was aimed to develop and validate the Maladaptive Eating Behavior Questionnaire after Bariatric Surgery (MEBQBS). Methods: The initial questionnaire was developed through concept clarification, literature review, focus group discussion, and pilot study. Its reliability and validity were also examined in 457 patients after bariatric surgery. Results: The final 53-item MEBQBS comprised 8 factors, including emotional eating (negative emotion, positive emotion sub-domain), grazing behavior, food craving (positive outcome expectancy, emotional craving, preoccupation with food sub-domain), uncontrolled eating (cognition, behavior sub-domain). Exploratory factor analysis revealed a cumulative variance contribution rate of 69.54%. Confirmatory factor analysis revealed that the indices of c ² /df, goodness-of fit index, normed fit index, incremental fit index, Tucker-Lewis index, confirmatory fit index and root mean-square error of approximation were 1.868, 0.804, 0.884, 0.943, 0.934, 0.942, and 0.050, indicating the model fit well. Additionally, significant correlations were observed between the total score of MEBQBS and the Three-Factor Eating Questionnaire-R21 ( P <0.05). The Cronbach's α and Guttman split-half coefficient of MEBQBS were 0.966 and 0.790, respectively. Conclusion: The MEBQBS is a valid and reliable instrument for identifying unhealthy eating behavior of patients after bariatric surgery, offering potential utility in evaluating the effect of tailored interventions.