{"paper_id":"2ee5b6e8-29df-4ae1-83de-15b58bc4233f","body_text":"Validation and assessment of psychometric properties of the Greek Eating Behaviors Assessment for Obesity (GR-EBA-O) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Validation and assessment of psychometric properties of the Greek Eating Behaviors Assessment for Obesity (GR-EBA-O) Panagiota Mavrandrea, Matteo Aloi, Matteo Geraci, Fragiskos Gonidakis, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3882043/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 11 May, 2024 Read the published version in Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity → Version 1 posted 7 You are reading this latest preprint version Abstract Introduction With increasing morbidity and risk of death, obesity has become a serious health problem largely attributable to difficulties in finding proper treatments for related diseases. Many studies show how detecting abnormal eating behaviors could be useful in developing effective clinical treatments. This study aims at validating the Greek version of the Eating Behaviors Assessment for Obesity (EBA-O). Method After a double English/Greek forward/backward translation of the EBA-O, 294 participants completed the Greek version (GR-EBA-O), the Eating Disorder Examination Questionnaire, the Binge Eating Scale, and the Yale Food Addiction Scale. Confirmatory factor analysis (CFA) and construct validity were calculated, and Two-way MANOVA was computed with the factors of GR-EBA-O controlling for sex and BMI categories. Results CFA confirmed the second-order five factors (i.e., food addiction, night eating, binge eating, sweet eating, and prandial hyperphagia) structure of the original EBA-O with excellent fit indices. GR-EBA-O factors were highly correlated. The GR-EBA-O subscales were also significantly correlated with the remaining measures, demonstrating good concurrent validity. Conclusion The Greek version of the EBA-O has demonstrated sound psychometric properties and appears a reliable and user-friendly tool to identify pathological eating behaviors in obesity. Level of evidence: Level V, descriptive research. obesity eating behavior assessment Greek validation psychometric properties Figures Figure 1 Figure 2 What is already known on this subject? Pathological eating behaviors could contribute to identify different phenotypes of obesity. The EBA-O is a self-report measure developed to identify emotional-related eating behaviors in persons with obesity. What does this study add? The Greek version of the EBA-O, GR-EBA-O, has been found to be a valuable, reliable and feasible tool to evaluate pathological eating behaviors for clinicians unskilled in the assessment of eating disorders. Introduction Obesity is a complex and multifactorial condition that not only represents a significant health problem with an increasing risk of mortality [ 1 ] but is also frequently associated with comorbidities [ 2 , 3 ] and high rates of treatment dropout among patients [ 4 ]. Increasing evidence indicates that binge eating disorder (BED) impacts a subpopulation of patients dealing with obesity [ 5 ]. In fact, individuals with BED are 3–6 times more likely to be obese compared to those without an eating disorder [ 6 , 7 ]. BED is also linked to an early onset of increased weight and obesity, with around 30% of individuals with binge eating behaviors reporting a history of childhood obesity [ 8 ]. Additionally, family negative influences related to shape, weight, and eating, along with concerns about body shape and weight, have all been associated with a diagnosis of BED [ 9 ]. Binge eating is more prevalent among those pursuing weight loss approaches, with a percentage ranging from 9 to 29% reporting episodes of binge eating [ 10 ]. Clinical practice has revealed that various types of patients with obesity necessitate diversified therapeutic approaches [ 11 ]. Therefore, achieving accurate phenotyping is essential. The requirement to personalize therapeutic interventions has rendered the phenotyping of obesity indispensable [ 12 , 13 ]. Research indicates that pathological eating behaviors can play a role in phenotyping obese individuals [ 14 ]. Recently, a questionnaire has been validated, demonstrating effectiveness in identifying and determining the severity of pathological eating behaviors typical of patients with obesity: the Eating Behavior Assessment for Obesity (EBA-O) [ 15 ]. The EBA-O is an 18-item questionnaire that evaluates the presence and severity, in the last three months, of five pathological eating behaviors typically observed in patients with obesity: night eating, food addiction, sweet eating, hyperphagia, and binge eating. Therefore, its main characteristic is that it can simultaneously evaluate various dysfunctional eating behaviors in patients with obesity. While there are numerous tools in the literature that assess these behaviors separately, using them would require more time for both administration and scoring [ 16 – 18 ]. According to its authors, the primary purpose of the EBA-O suggest is to provide clinicians and researchers an easy tool to administer and score that can be used by health care providers without expertise in the field of EDs [ 15 ] in order to evaluate pathological eating behaviors frequently associated with obesity. Based on the above, the aim of the present study is to validate and assess the psychometric properties of EBA-O questionnaire (i.e. factor structure, internal consistency, construct validity) in a sample of patients with obesity in the Greek population. Methods Participants A convenience sample was recruited from the general population between October 2022 and March 2023 through an online survey. Participants were informed about the study's purpose, procedures, the voluntary nature of participation, anonymity, and data management and storage. They provided consent by clicking on the consent box. Socio-demographic data, including age, gender, education, occupation, height, weight, and lifestyle, were collected. Inclusion criteria comprised men and women, aged between 18 and 65 years, with a BMI ≥ 25 kg/m 2 . A total of 294 individuals, all of Greek nationality, participated by clicking on the consent box, with 260 of them being women (88%). All participants completed the battery of measures. Responses from individuals younger than 18 or older than 65 years and those with a BMI < 25 kg/m 2 were excluded from the analysis. Measures Eating Behaviors Assessment for Obesity (EBA-O) The authors made a double English/Greek forward/backward translation of the EBA-O as follows: once an initial agreement was reached among translators from English to Greek, another researcher, blind to this original version, made the translation back into English. After verifying the similarity with the original test, the newly developed GR-EBA-O was given to a small group of 15 volunteers who evaluated the comprehensibility of the items. All raters considered it to be clear and easy to rate. The GR-EBA-O consists of 18 item rated with an 8-point Likert type scale ranging from 0 (never) to 7 (everyday) in order to assess the presence and severity, in the last three months, of five pathological eating behaviors representative of obesity: night eating, food addiction, sweet eating, hyperphagia, and binge eating (Appendix 1). To assess the convergent validity of the EBA-O, participants were asked to complete the following tests: Binge Eating Scale (BES) [ 16 ]: A 16-item test measuring the severity of binge eating; scores < 17, 17–27, and > 27 indicate that the risk of an individual suffering from BED is unlikely, possible, and probable, respectively. The internal consistency in this study was McDonald’s ω = .88. Yale Food Addiction Scale (YFAS) [ 18 ]: This scale assesses addiction-like eating behavior in the past 12 months through 25 items, scored on an eight-point scale ranging from never (score = 0) to every day (score = 7), representing 11 symptoms. The Kuder–Richardson coefficient of reliability as internal consistency for the YFAS in this study was .83. Eating Disorder Examination-Questionnaire (EDE-Q) [ 19 ]: it is a self-administered questionnaire with 28 questions investigating eating psychopathology in the last four weeks. It allows obtaining scores related to four subscales (restraint, eating concern, weight concern, and shape concern) and a total score. In the present study, we found the following McDonald’s ω internal consistency reliability indexes: Restraint = .75; Eating Concern = .77; Weight Concern = .78; Shape Concern = .83; Global score = .84 Statistical analysis A second-order five factor model, trough confirmatory factor analysis (CFA), was run using the open-source JASP software (JASP, version 0.16.4, University of Amsterdam). This aimed to assess the underlying factor structure of the EBA-O and validate the suitability of a total score. The choice to employ the diagonally weighted least squares (DWLS) estimator, utilizing a polychoric correlation matrix, was made to effectively estimate the parameters, as it stands out as the most suitable method for modeling ordered data. The assessment of model fit utilized several indices: the relative chi-square (χ2/df), Tucker-Lewis index (TLI), comparative fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR). Adequate values were considered as follows: TLI and CFI ≥ 0.90 (adequate) and ≥ 0.95 (very good), RMSEA ≤ 0.08 (adequate) and ≤ 0.05 (very good), and an SRMR close to 0.08. Additionally, good fit was indicated by χ 2 /df values < 3.0 and very good fit by values < 2.0, aligning with the guidelines proposed by Hu and Bentler [ 20 ]. To establish construct validity, correlations between the EBA-O factors and respective questionnaires were examined, emphasizing correlation coefficients (r) greater than .30 as recommended benchmarks. Two-way multivariate analysis of variance (two-way MANOVA) was carried out with the five factors of EBA-O as independent variables, and sex and categorical BMI as dependent variables. Eta-squared (η 2 ) was used as a measure of the effect size of MANOVA considering values of 0.01, 0.06, and 0.14 as indicating small, medium, and large effects, respectively. The Bonferroni correction was used to correct for multiple comparisons (p = 0.05/10 = 0.005). Results Out of the initial 294 participants from whom responses were gathered, 71 were excluded due to having a BMI < 25. Characteristics of the 223 participants are detailed in Table 1 . Table 1 Socio demographic features of the sample. Fr % Sex F 192 86.1 M 31 13.9 Age 35.2 9.1 BMI 31.3 5.8 BMI category 25–30 121 54.3 30–35 53 23.8 35–40 24 10.8 > 40 25 11.2 Education High school 130 58.3 University 23 10.3 PhD/Specialization 68 30.5 Other 2 0.9 Occupation housewife 12 5.4 not working 20 9 working 166 74.4 retired 3 1.3 student 20 9 other 2 0.9 Comorbidity 0 143 64.4 1 79 35.6 Diets 0 17 7.6 1–2 50 22.4 3–4 49 22 > 5 107 48 Confirmatory Factor Analysis The CFA exhibited excellent fit indices: CFI = .99, TLI = .99, RMSEA = .03, relative chi-square (χ 2 /df) = 1.21, p = .06. These results suggest alignment with the tested second-order five factor GR-EBA-O model (Fig. 1). Internal Consistency (McDonald's ω) The internal consistency for the total score, evaluated by McDonald's ω coefficient, was very high (ω = .94), indicating the excellent reliability of the GR-EBA-O. Regarding the McDonald’s coefficient ω of all factors, it was very high indicating very good reliability: food addiction = .92; night eating = .82; binge eating = .87; sweet eating = .91; and hyperphagia = .89. The factors were highly correlated with each other. The highest correlation was between factors 3 and 5 and the lowest between factors 2 and 4 (Table 2 ). Table 2 Correlations between factors of the GR-EBA-O Factor 1 Factor 2 Factor 3 Factor 4 Factor 5 Factor 1 Food addiction - Factor 2 Night eating .389 ** - Factor 3 Binge eating .615 ** .340 ** - Factor 4 Sweet eating .709 ** .309 ** .506 ** - Factor 5 Hyperphagia .557 ** .372 ** .782 ** .500 ** - ** p < .001 Concurrent Validity Correlation analysis (Table 3 ) demonstrates notably significant correlations between the GR-EBA-O subscales and the BES (from .355 to .533), YFAS (from .294 to .451), and EDE-Q total score (from .212 to .616). Table 3 Results of convergent validity Factor 1 Food Addiction Factor 2 Night eating Factor 3 Binge eating Factor 4 Sweet eating Factor 5 Hyperphagia BES .533 ** .355 ** .519 ** .410 ** .455 ** YFAS Symptom count .434 ** .332 ** .451 ** .294 ** .430 ** EDE-Q Total score .562 ** .212 ** .616 ** .430 ** .471 ** BES: Binge Eating Scale, YFAS: Yale Food Addiction Scale **p < .001 Two-way MANOVA There were non-significant differences in GR-EBA-O subscales based on sex (F = 1.127, p = .347; Wilk’s lambda = .974), categorical BMI (F = 1.103, p = .349; Wilk’s lambda = .926) and their interaction (F = 1.477, p = .145; Wilk’s lambda = .934). Means and standard deviation of GR-EBA-O factors and total score in this study are displayed in Fig. 2. Discussion The primary objective of this research was to validate the GR-EBA-O questionnaire. To our knowledge, no prior studies have explored the psychometric properties of the Greek version of this instrument. Regarding its structural composition, the original version suggested a second-order five-factor structure as the best fit. In our research, our findings align consistently with a second-order five-factor model, affirming that the total score effectively reassumes the characteristics of all the five factors. Additionally, our reliability assessments yielded highly satisfactory results, displaying ω coefficients ranging from .87 to .92. These findings indicate commendable levels of omega reliability, valuable for clinical decisions. Segura-Garcia and colleagues also reported sound internal consistency in their results which ranged from .80 to .92 [ 15 ]. Regarding the convergent validity, significant positive correlations were found between the GR-EBA-O factors and the other psychopathological questionnaires in line with the findings of Segura-Garcia and colleagues [ 15 ], so the GR-EBA-O has proved to be appropriate to measure pathological eating behaviors. Further, the investigation of eating behaviors indicated a good discriminant validity of the GR-EBA-O, in fact the MANOVA demonstrated that GR-EBA-O was a reliable instrument as no differences were found by sex and categorical BMI in the five factors of the scale, thus indicating the good reliability of the GR-EBA-O. Finally, in line with the original results [ 15 ], in this study we found the same score within the factors, in particular sweet eating subscale had the highest mean; while, night eating scored the lowest. To date, there is no specific assessment available to intercept pathological eating behaviors associated with obesity. Employing the EBA-O as a self-assessment tool has proven beneficial in uncovering the intricate links between emotions and eating behaviors. Its user-friendly nature ensures accessibility even for those unversed in ED expertise. The robust psychometric properties of the EBA-O establish it as an easily applicable instrument in clinical settings, especially advantageous for professionals less familiar with EDs. In the pursuit of averting relapses into detrimental eating behaviors and drop-out treatment, screening for pathological eating behaviors serves as a valuable guide for physicians treating obesity, aiding in tailor-made interventions. Hence, leveraging the insights gleaned from the EBA-O results allows for the identification of patients at heightened risk of EDs, facilitating their referral to specialized ED units. This study has some limits. Firstly, the data were obtained through self-reporting, potentially introducing biases. Secondly, the reliance on Internet-based data collection may have led to a sample of participants who self-selected [ 21 ]. Lastly, the absence of a re-test makes it challenging to determine the stability of the EBA-O as a measure of eating behavior but it is important to note that the EBA-O is intended as a state measure rather than a trait one. Conclusions Summing up, the GR-EBA-O has demonstrated sound psychometric properties such as good model fit indexes and internal consistency. Thus, this study has shown that the Greek version of the EBA-o can be an easy-to-use and valid tool for clinicians and researchers in the self-report measurement of most present eating behaviors in patients with obesity. Declarations Acknowledgements. We thank all participants and patients who agreed to participate in our study. Funding. No funding was received for this research. Availability of data and material. Data are available from the corresponding author upon request. Compliance with ethical standards Conflict of interest. On behalf of all authors, the corresponding author states that there is no conflict of interest. Ethical approval. All procedures performed in studies involving human participants were in accordance with the ethical standards of institutional and/or national research committees and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent. Informed consent was obtained from all individual participants included in the study. Author Contribution Panagiota Mavrandrea, carried out the research In the greek population; Matteo Aloi assisted with the research and prepared the draft of the manuscript ; Matteo Geraci conducted the statistical analysis and assisted with the preparation of the manuscript; Fragiskos Gonidakis* co-ordinated the greek team, contributed with the study's methodology and reviewed the manuscript; Cristina Segura-Garcia designed the study's methodology, co-ordinated the Italian team and reviewed the manuscript References Marcus MD, Wildes JE (2009) Obesity: Is it a mental disorder? 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Appetite 52:430–436 . doi: 10.1016/j.appet.2008.12.003 Fairburn C, Beglin S (2008) Eating disorder examination questionnaire (EDE-Q 6.0). In: Cognitive behavior therapy and eating disorders. Guiford Press, New York Hu L, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model A Multidiscip J 6:1–55 . doi: 10.1080/10705519909540118 Mayr A, Gefeller O, Prokosch HU, et al (2012) Web-based data collection yielded an additional response bias - But had no direct effect on outcome scales. J Clin Epidemiol 65:970–977 . doi: 10.1016/j.jclinepi.2012.03.005 Appendix Appendix 1 is not available with this version. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 11 May, 2024 Read the published version in Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity → Version 1 posted Editorial decision: Revision requested 07 Apr, 2024 Reviews received at journal 10 Mar, 2024 Reviewers agreed at journal 05 Mar, 2024 Reviewers invited by journal 05 Mar, 2024 Editor assigned by journal 25 Jan, 2024 Submission checks completed at journal 21 Jan, 2024 First submitted to journal 20 Jan, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-3882043\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":false,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":268465116,\"identity\":\"7a9ecc07-7190-4301-bac6-e8fc794f8fce\",\"order_by\":0,\"name\":\"Panagiota Mavrandrea\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"National and Kappodistrian University of Athens\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Panagiota\",\"middleName\":\"\",\"lastName\":\"Mavrandrea\",\"suffix\":\"\"},{\"id\":268465117,\"identity\":\"a3633f37-2972-4dac-800a-f8e48fe346c1\",\"order_by\":1,\"name\":\"Matteo Aloi\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"University of Messina\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Matteo\",\"middleName\":\"\",\"lastName\":\"Aloi\",\"suffix\":\"\"},{\"id\":268465118,\"identity\":\"2e7d96f1-6de1-4f6f-8a00-401107d11749\",\"order_by\":2,\"name\":\"Matteo Geraci\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"University “Magna Graecia” of Catanzaro\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Matteo\",\"middleName\":\"\",\"lastName\":\"Geraci\",\"suffix\":\"\"},{\"id\":268465119,\"identity\":\"51eec0d7-43e8-46e3-93be-0d875ea89ad1\",\"order_by\":3,\"name\":\"Fragiskos Gonidakis\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAzElEQVRIiWNgGAWjYBAC9gYQacAsByKJ08JzAKLFmFQtDMyJDcRrkT5+8XFBgXX62vbmDcw8FXYM8tEHCGjhyyk2nmGQnrvtzLECZp4zyQyG5xLwa7Hn4UmT5jE4nLvtRo4BM28bM4NhDyGHQbWkm91/A9JST4wW9mMgLQlmN3hAWg4zyPMQtoXZmMcg3XDbmbSCg3POHOcxIKyF/eFjnj/W8mbHD2988KaiWk6ekMOAmhDRcQDMPUBQC/sDVL58A0Eto2AUjIJRMMIAAESROWuBbCPgAAAAAElFTkSuQmCC\",\"orcid\":\"\",\"institution\":\"National and Kappodistrian University of Athens\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Fragiskos\",\"middleName\":\"\",\"lastName\":\"Gonidakis\",\"suffix\":\"\"},{\"id\":268465120,\"identity\":\"95b17311-9e84-43fd-94f5-53b5b1110900\",\"order_by\":4,\"name\":\"Cristina Segura-Garcia\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"University “Magna Graecia” of Catanzaro\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Cristina\",\"middleName\":\"\",\"lastName\":\"Segura-Garcia\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2024-01-20 16:45:00\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-3882043/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-3882043/v1\",\"draftVersion\":[],\"editorialEvents\":[{\"content\":\"https://doi.org/10.1007/s40519-024-01664-6\",\"type\":\"published\",\"date\":\"2024-05-11T21:18:08+00:00\"}],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":50120612,\"identity\":\"d5f4ce14-e4d5-4bdc-8d44-51af49c1b180\",\"added_by\":\"auto\",\"created_at\":\"2024-01-24 19:36:31\",\"extension\":\"jpg\",\"order_by\":1,\"title\":\"Figure 1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":64178,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003ePath diagram of the second-order five-factor model of the GR-EBA-O with reported standardized coefficients of first- and second-order loadings. All values are significant for p\\u0026lt;0.001.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"fig.1.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-3882043/v1/5316aa0db5e32b2e09938941.jpg\"},{\"id\":50119547,\"identity\":\"87d2b434-bb47-42ce-85bd-9c8d99ae8857\",\"added_by\":\"auto\",\"created_at\":\"2024-01-24 19:28:31\",\"extension\":\"jpg\",\"order_by\":2,\"title\":\"Figure 2\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":61050,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eMeans and standard deviation of GR-EBA-O factors and total score.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"fig.2.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-3882043/v1/1a8ca11fa05dd7d3f62abeb3.jpg\"},{\"id\":56488224,\"identity\":\"3bc91da0-191a-4685-b476-5647017f91d0\",\"added_by\":\"auto\",\"created_at\":\"2024-05-14 21:30:04\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":611595,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-3882043/v1/fec0c05e-027a-4ae3-a807-67010b9a27aa.pdf\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Validation and assessment of psychometric properties of the Greek Eating Behaviors Assessment for Obesity (GR-EBA-O)\",\"fulltext\":[{\"header\":\"What is already known on this subject? \",\"content\":\"\\u003cp\\u003ePathological eating behaviors could contribute to identify different phenotypes of obesity. The EBA-O is a self-report measure developed to identify emotional-related eating behaviors in persons with obesity.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eWhat does this study add?\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe Greek version of the EBA-O, GR-EBA-O, has been found to be a valuable, reliable and feasible tool to evaluate pathological eating behaviors for clinicians unskilled in the assessment of eating disorders.\\u003c/p\\u003e\"},{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003eObesity is a complex and multifactorial condition that not only represents a significant health problem with an increasing risk of mortality [\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e] but is also frequently associated with comorbidities [\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e] and high rates of treatment dropout among patients [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eIncreasing evidence indicates that binge eating disorder (BED) impacts a subpopulation of patients dealing with obesity [\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e]. In fact, individuals with BED are 3\\u0026ndash;6 times more likely to be obese compared to those without an eating disorder [\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e]. BED is also linked to an early onset of increased weight and obesity, with around 30% of individuals with binge eating behaviors reporting a history of childhood obesity [\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e]. Additionally, family negative influences related to shape, weight, and eating, along with concerns about body shape and weight, have all been associated with a diagnosis of BED [\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e]. Binge eating is more prevalent among those pursuing weight loss approaches, with a percentage ranging from 9 to 29% reporting episodes of binge eating [\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eClinical practice has revealed that various types of patients with obesity necessitate diversified therapeutic approaches [\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e]. Therefore, achieving accurate phenotyping is essential.\\u003c/p\\u003e \\u003cp\\u003eThe requirement to personalize therapeutic interventions has rendered the phenotyping of obesity indispensable [\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e]. Research indicates that pathological eating behaviors can play a role in phenotyping obese individuals [\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e]. Recently, a questionnaire has been validated, demonstrating effectiveness in identifying and determining the severity of pathological eating behaviors typical of patients with obesity: the Eating Behavior Assessment for Obesity (EBA-O) [\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e]. The EBA-O is an 18-item questionnaire that evaluates the presence and severity, in the last three months, of five pathological eating behaviors typically observed in patients with obesity: night eating, food addiction, sweet eating, hyperphagia, and binge eating. Therefore, its main characteristic is that it can simultaneously evaluate various dysfunctional eating behaviors in patients with obesity. While there are numerous tools in the literature that assess these behaviors separately, using them would require more time for both administration and scoring [\\u003cspan additionalcitationids=\\\"CR17\\\" citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e]. According to its authors, the primary purpose of the EBA-O suggest is to provide clinicians and researchers an easy tool to administer and score that can be used by health care providers without expertise in the field of EDs [\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e] in order to evaluate pathological eating behaviors frequently associated with obesity.\\u003c/p\\u003e \\u003cp\\u003eBased on the above, the aim of the present study is to validate and assess the psychometric properties of EBA-O questionnaire (i.e. factor structure, internal consistency, construct validity) in a sample of patients with obesity in the Greek population.\\u003c/p\\u003e\"},{\"header\":\"Methods\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eParticipants\\u003c/h2\\u003e \\u003cp\\u003eA convenience sample was recruited from the general population between October 2022 and March 2023 through an online survey. Participants were informed about the study's purpose, procedures, the voluntary nature of participation, anonymity, and data management and storage. They provided consent by clicking on the consent box. Socio-demographic data, including age, gender, education, occupation, height, weight, and lifestyle, were collected.\\u003c/p\\u003e \\u003cp\\u003eInclusion criteria comprised men and women, aged between 18 and 65 years, with a BMI\\u0026thinsp;\\u0026ge;\\u0026thinsp;25 kg/m\\u003csup\\u003e2\\u003c/sup\\u003e. A total of 294 individuals, all of Greek nationality, participated by clicking on the consent box, with 260 of them being women (88%). All participants completed the battery of measures. Responses from individuals younger than 18 or older than 65 years and those with a BMI\\u0026thinsp;\\u0026lt;\\u0026thinsp;25 kg/m\\u003csup\\u003e2\\u003c/sup\\u003e were excluded from the analysis.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec4\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eMeasures\\u003c/h2\\u003e \\u003cdiv id=\\\"Sec5\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003eEating Behaviors Assessment for Obesity (EBA-O)\\u003c/h2\\u003e \\u003cp\\u003eThe authors made a double English/Greek forward/backward translation of the EBA-O as follows: once an initial agreement was reached among translators from English to Greek, another researcher, blind to this original version, made the translation back into English. After verifying the similarity with the original test, the newly developed GR-EBA-O was given to a small group of 15 volunteers who evaluated the comprehensibility of the items. All raters considered it to be clear and easy to rate.\\u003c/p\\u003e \\u003cp\\u003eThe GR-EBA-O consists of 18 item rated with an 8-point Likert type scale ranging from 0 (never) to 7 (everyday) in order to assess the presence and severity, in the last three months, of five pathological eating behaviors representative of obesity: night eating, food addiction, sweet eating, hyperphagia, and binge eating (Appendix 1).\\u003c/p\\u003e \\u003cp\\u003eTo assess the convergent validity of the EBA-O, participants were asked to complete the following tests:\\u003c/p\\u003e \\u003cp\\u003e \\u003cul\\u003e \\u003cli\\u003e \\u003cp\\u003eBinge Eating Scale (BES) [\\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e]: A 16-item test measuring the severity of binge eating; scores\\u0026thinsp;\\u0026lt;\\u0026thinsp;17, 17\\u0026ndash;27, and \\u0026gt;\\u0026thinsp;27 indicate that the risk of an individual suffering from BED is unlikely, possible, and probable, respectively. The internal consistency in this study was McDonald\\u0026rsquo;s ω\\u0026thinsp;=\\u0026thinsp;.88.\\u003c/p\\u003e \\u003c/li\\u003e \\u003cli\\u003e \\u003cp\\u003eYale Food Addiction Scale (YFAS) [\\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e]: This scale assesses addiction-like eating behavior in the past 12 months through 25 items, scored on an eight-point scale ranging from never (score\\u0026thinsp;=\\u0026thinsp;0) to every day (score\\u0026thinsp;=\\u0026thinsp;7), representing 11 symptoms. The Kuder\\u0026ndash;Richardson coefficient of reliability as internal consistency for the YFAS in this study was .83.\\u003c/p\\u003e \\u003c/li\\u003e \\u003cli\\u003e \\u003cp\\u003eEating Disorder Examination-Questionnaire (EDE-Q) [\\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e]: it is a self-administered questionnaire with 28 questions investigating eating psychopathology in the last four weeks. It allows obtaining scores related to four subscales (restraint, eating concern, weight concern, and shape concern) and a total score. In the present study, we found the following McDonald\\u0026rsquo;s ω internal consistency reliability indexes: Restraint\\u0026thinsp;=\\u0026thinsp;.75; Eating Concern\\u0026thinsp;=\\u0026thinsp;.77; Weight Concern\\u0026thinsp;=\\u0026thinsp;.78; Shape Concern\\u0026thinsp;=\\u0026thinsp;.83; Global score\\u0026thinsp;=\\u0026thinsp;.84\\u003c/p\\u003e \\u003c/li\\u003e \\u003c/ul\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec6\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eStatistical analysis\\u003c/h2\\u003e \\u003cp\\u003eA second-order five factor model, trough confirmatory factor analysis (CFA), was run using the open-source JASP software (JASP, version 0.16.4, University of Amsterdam). This aimed to assess the underlying factor structure of the EBA-O and validate the suitability of a total score. The choice to employ the diagonally weighted least squares (DWLS) estimator, utilizing a polychoric correlation matrix, was made to effectively estimate the parameters, as it stands out as the most suitable method for modeling ordered data. The assessment of model fit utilized several indices: the relative chi-square (χ2/df), Tucker-Lewis index (TLI), comparative fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR). Adequate values were considered as follows: TLI and CFI\\u0026thinsp;\\u0026ge;\\u0026thinsp;0.90 (adequate) and \\u0026ge;\\u0026thinsp;0.95 (very good), RMSEA\\u0026thinsp;\\u0026le;\\u0026thinsp;0.08 (adequate) and \\u0026le;\\u0026thinsp;0.05 (very good), and an SRMR close to 0.08. Additionally, good fit was indicated by χ\\u003csup\\u003e2\\u003c/sup\\u003e/df values\\u0026thinsp;\\u0026lt;\\u0026thinsp;3.0 and very good fit by values\\u0026thinsp;\\u0026lt;\\u0026thinsp;2.0, aligning with the guidelines proposed by Hu and Bentler [\\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e]. To establish construct validity, correlations between the EBA-O factors and respective questionnaires were examined, emphasizing correlation coefficients (r) greater than .30 as recommended benchmarks.\\u003c/p\\u003e \\u003cp\\u003eTwo-way multivariate analysis of variance (two-way MANOVA) was carried out with the five factors of EBA-O as independent variables, and sex and categorical BMI as dependent variables. Eta-squared (η\\u003csup\\u003e2\\u003c/sup\\u003e) was used as a measure of the effect size of MANOVA considering values of 0.01, 0.06, and 0.14 as indicating small, medium, and large effects, respectively. The Bonferroni correction was used to correct for multiple comparisons (p\\u0026thinsp;=\\u0026thinsp;0.05/10\\u0026thinsp;=\\u0026thinsp;0.005).\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003eOut of the initial 294 participants from whom responses were gathered, 71 were excluded due to having a BMI\\u0026thinsp;\\u0026lt;\\u0026thinsp;25. Characteristics of the 223 participants are detailed in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eSocio demographic features of the sample.\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"4\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eFr\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e%\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eSex\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eF\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e192\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e86.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eM\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e31\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e13.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eAge\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e35.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e9.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eBMI\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e31.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e5.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eBMI category\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e25\\u0026ndash;30\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e121\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e54.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e30\\u0026ndash;35\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e53\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e23.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e35\\u0026ndash;40\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e24\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e10.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u0026gt;\\u0026thinsp;40\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e25\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e11.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eEducation\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eHigh school\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e130\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e58.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eUniversity\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e23\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e10.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003ePhD/Specialization\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e68\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e30.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eOther\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eOccupation\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003ehousewife\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e12\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e5.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003enot working\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e20\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e9\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eworking\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e166\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e74.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eretired\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003estudent\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e20\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e9\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eother\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eComorbidity\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e143\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e64.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e79\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e35.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eDiets\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e17\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e7.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1\\u0026ndash;2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e50\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e22.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e3\\u0026ndash;4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e49\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e22\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u0026gt;\\u0026thinsp;5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e107\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e48\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cdiv id=\\\"Sec8\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eConfirmatory Factor Analysis\\u003c/h2\\u003e \\u003cp\\u003eThe CFA exhibited excellent fit indices: CFI\\u0026thinsp;=\\u0026thinsp;.99, TLI\\u0026thinsp;=\\u0026thinsp;.99, RMSEA\\u0026thinsp;=\\u0026thinsp;.03, relative chi-square (χ\\u003csup\\u003e2\\u003c/sup\\u003e/df)\\u0026thinsp;=\\u0026thinsp;1.21, p\\u0026thinsp;=\\u0026thinsp;.06. These results suggest alignment with the tested second-order five factor GR-EBA-O model (Fig.\\u0026nbsp;1).\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec9\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eInternal Consistency (McDonald's ω)\\u003c/h2\\u003e \\u003cp\\u003eThe internal consistency for the total score, evaluated by McDonald's ω coefficient, was very high (ω\\u0026thinsp;=\\u0026thinsp;.94), indicating the excellent reliability of the GR-EBA-O.\\u003c/p\\u003e \\u003cp\\u003eRegarding the McDonald\\u0026rsquo;s coefficient ω of all factors, it was very high indicating very good reliability: food addiction\\u0026thinsp;=\\u0026thinsp;.92; night eating\\u0026thinsp;=\\u0026thinsp;.82; binge eating\\u0026thinsp;=\\u0026thinsp;.87; sweet eating\\u0026thinsp;=\\u0026thinsp;.91; and hyperphagia\\u0026thinsp;=\\u0026thinsp;.89.\\u003c/p\\u003e \\u003cp\\u003eThe factors were highly correlated with each other. The highest correlation was between factors 3 and 5 and the lowest between factors 2 and 4 (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eCorrelations between factors of the GR-EBA-O\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"6\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFactor 1\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eFactor 2\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eFactor 3\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eFactor 4\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eFactor 5\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFactor 1 Food addiction\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFactor 2 Night eating\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e.389\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFactor 3 Binge eating\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e.615\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e.340\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFactor 4 Sweet eating\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e.709\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e.309\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e.506\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFactor 5 Hyperphagia\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e.557\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e.372\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e.782\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e.500\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003ctfoot\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"6\\\"\\u003e** p\\u0026thinsp;\\u0026lt;\\u0026thinsp;.001\\u003c/td\\u003e\\u003c/tr\\u003e \\u003c/tfoot\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec10\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eConcurrent Validity\\u003c/h2\\u003e \\u003cp\\u003eCorrelation analysis (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab3\\\" class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e) demonstrates notably significant correlations between the GR-EBA-O subscales and the BES (from .355 to .533), YFAS (from .294 to .451), and EDE-Q total score (from .212 to .616).\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab3\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 3\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eResults of convergent validity\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"6\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFactor 1\\u003c/p\\u003e \\u003cp\\u003eFood Addiction\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eFactor 2 Night eating\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eFactor 3 Binge eating\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eFactor 4 Sweet eating\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eFactor 5 Hyperphagia\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eBES\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e.533\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e.355\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e.519\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e.410\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e.455\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eYFAS Symptom count\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e.434\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e.332\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e.451\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e.294\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e.430\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eEDE-Q Total score\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e.562\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e.212\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e.616\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e.430\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e.471\\u003csup\\u003e**\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003ctfoot\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"6\\\"\\u003eBES: Binge Eating Scale, YFAS: Yale Food Addiction Scale\\u003c/td\\u003e\\u003c/tr\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"6\\\"\\u003e**p\\u0026thinsp;\\u0026lt;\\u0026thinsp;.001\\u003c/td\\u003e\\u003c/tr\\u003e \\u003c/tfoot\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec11\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eTwo-way MANOVA\\u003c/h2\\u003e \\u003cp\\u003eThere were non-significant differences in GR-EBA-O subscales based on sex (F\\u0026thinsp;=\\u0026thinsp;1.127, p\\u0026thinsp;=\\u0026thinsp;.347; Wilk\\u0026rsquo;s lambda\\u0026thinsp;=\\u0026thinsp;.974), categorical BMI (F\\u0026thinsp;=\\u0026thinsp;1.103, p\\u0026thinsp;=\\u0026thinsp;.349; Wilk\\u0026rsquo;s lambda\\u0026thinsp;=\\u0026thinsp;.926) and their interaction (F\\u0026thinsp;=\\u0026thinsp;1.477, p\\u0026thinsp;=\\u0026thinsp;.145; Wilk\\u0026rsquo;s lambda\\u0026thinsp;=\\u0026thinsp;.934).\\u003c/p\\u003e \\u003cp\\u003eMeans and standard deviation of GR-EBA-O factors and total score in this study are displayed in Fig.\\u0026nbsp;2.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eThe primary objective of this research was to validate the GR-EBA-O questionnaire. To our knowledge, no prior studies have explored the psychometric properties of the Greek version of this instrument. Regarding its structural composition, the original version suggested a second-order five-factor structure as the best fit. In our research, our findings align consistently with a second-order five-factor model, affirming that the total score effectively reassumes the characteristics of all the five factors.\\u003c/p\\u003e \\u003cp\\u003eAdditionally, our reliability assessments yielded highly satisfactory results, displaying ω coefficients ranging from .87 to .92. These findings indicate commendable levels of omega reliability, valuable for clinical decisions. Segura-Garcia and colleagues also reported sound internal consistency in their results which ranged from .80 to .92 [\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eRegarding the convergent validity, significant positive correlations were found between the GR-EBA-O factors and the other psychopathological questionnaires in line with the findings of Segura-Garcia and colleagues [\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e], so the GR-EBA-O has proved to be appropriate to measure pathological eating behaviors.\\u003c/p\\u003e \\u003cp\\u003eFurther, the investigation of eating behaviors indicated a good discriminant validity of the GR-EBA-O, in fact the MANOVA demonstrated that GR-EBA-O was a reliable instrument as no differences were found by sex and categorical BMI in the five factors of the scale, thus indicating the good reliability of the GR-EBA-O. Finally, in line with the original results [\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e], in this study we found the same score within the factors, in particular sweet eating subscale had the highest mean; while, night eating scored the lowest.\\u003c/p\\u003e \\u003cp\\u003eTo date, there is no specific assessment available to intercept pathological eating behaviors associated with obesity. Employing the EBA-O as a self-assessment tool has proven beneficial in uncovering the intricate links between emotions and eating behaviors. Its user-friendly nature ensures accessibility even for those unversed in ED expertise. The robust psychometric properties of the EBA-O establish it as an easily applicable instrument in clinical settings, especially advantageous for professionals less familiar with EDs. In the pursuit of averting relapses into detrimental eating behaviors and drop-out treatment, screening for pathological eating behaviors serves as a valuable guide for physicians treating obesity, aiding in tailor-made interventions. Hence, leveraging the insights gleaned from the EBA-O results allows for the identification of patients at heightened risk of EDs, facilitating their referral to specialized ED units.\\u003c/p\\u003e \\u003cp\\u003eThis study has some limits. Firstly, the data were obtained through self-reporting, potentially introducing biases. Secondly, the reliance on Internet-based data collection may have led to a sample of participants who self-selected [\\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e21\\u003c/span\\u003e]. Lastly, the absence of a re-test makes it challenging to determine the stability of the EBA-O as a measure of eating behavior but it is important to note that the EBA-O is intended as a state measure rather than a trait one.\\u003c/p\\u003e\"},{\"header\":\"Conclusions\",\"content\":\"\\u003cp\\u003eSumming up, the GR-EBA-O has demonstrated sound psychometric properties such as good model fit indexes and internal consistency. Thus, this study has shown that the Greek version of the EBA-o can be an easy-to-use and valid tool for clinicians and researchers in the self-report measurement of most present eating behaviors in patients with obesity.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eAcknowledgements.\\u0026nbsp;\\u003c/strong\\u003eWe thank all participants and patients who agreed to participate in our study.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eFunding.\\u0026nbsp;\\u003c/strong\\u003eNo funding was received for this research.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAvailability of data and material.\\u003c/strong\\u003e Data are available from the corresponding author upon request.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eCompliance with ethical standards\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConflict of interest.\\u0026nbsp;\\u003c/strong\\u003eOn behalf of all authors, the corresponding author states that there is no conflict of interest.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eEthical approval.\\u0026nbsp;\\u003c/strong\\u003eAll procedures performed in studies involving human participants were in accordance with the ethical standards of institutional and/or national research committees and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eInformed consent.\\u0026nbsp;\\u003c/strong\\u003eInformed consent was obtained from all individual participants included in the study.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthor Contribution\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003ePanagiota Mavrandrea, carried out the research In the greek population; Matteo Aloi assisted with the research and prepared the draft of the manuscript ; Matteo Geraci conducted the statistical analysis and assisted with the preparation of the manuscript; Fragiskos Gonidakis* co-ordinated the greek team, contributed with the study\\u0026apos;s methodology and reviewed the manuscript; Cristina Segura-Garcia designed the study\\u0026apos;s methodology, co-ordinated the Italian team and reviewed the manuscript\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\n\\u003cli\\u003eMarcus MD, Wildes JE (2009) Obesity: Is it a mental disorder? Int J Eat Disord 42:739\\u0026ndash;753 . doi: 10.1002/eat.20725\\u003c/li\\u003e\\n\\u003cli\\u003eChouinard V-A, Pingali SM, Chouinard G, et al (2016) Factors associated with overweight and obesity in schizophrenia, schizoaffective and bipolar disorders. Psychiatry Res 237:304\\u0026ndash;310 . doi: 10.1016/j.psychres.2016.01.024\\u003c/li\\u003e\\n\\u003cli\\u003eSegura-Garcia C, Caroleo M, Rania M, et al (2017) Binge Eating Disorder and Bipolar Spectrum disorders in obesity: Psychopathological and eating behaviors differences according to comorbidities. J Affect Disord 208:424\\u0026ndash;430 . doi: 10.1016/j.jad.2016.11.005\\u003c/li\\u003e\\n\\u003cli\\u003eEveritt JD, Battista‐Dowds EM, Heggs D, et al (2023) Determinants of completion and early dropout in an adult weight management service: a prospective observational study. J Hum Nutr Diet 36:1931\\u0026ndash;1941 . doi: 10.1111/jhn.13196\\u003c/li\\u003e\\n\\u003cli\\u003eForman EM, Evans BC, Berry MP, et al (2023) Behavioral weight loss outcomes in individuals with binge‐eating disorder: A meta‐analysis. Obesity 31:1981\\u0026ndash;1995 . doi: 10.1002/oby.23790\\u003c/li\\u003e\\n\\u003cli\\u003eHudson JI, Hiripi E, Pope HG, Kessler RC (2007) The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry 61:348\\u0026ndash;58 . doi: 10.1016/j.biopsych.2006.03.040\\u003c/li\\u003e\\n\\u003cli\\u003eKessler RC, Berglund PA, Chiu WT, et al (2013) The Prevalence and Correlates of Binge Eating Disorder in the World Health Organization World Mental Health Surveys. Biol Psychiatry 73:904\\u0026ndash;914 . doi: 10.1016/j.biopsych.2012.11.020\\u003c/li\\u003e\\n\\u003cli\\u003eJacobi C, Hayward C, de Zwaan M, et al (2004) Coming to Terms With Risk Factors for Eating Disorders: Application of Risk Terminology and Suggestions for a General Taxonomy. Psychol Bull 130:19\\u0026ndash;65 . doi: 10.1037/0033-2909.130.1.19\\u003c/li\\u003e\\n\\u003cli\\u003eGrogan K, MacGarry D, Bramham J, et al (2020) Family-related non-abuse adverse life experiences occurring for adults diagnosed with eating disorders: a systematic review. J Eat Disord 8:36 . doi: 10.1186/s40337-020-00311-6\\u003c/li\\u003e\\n\\u003cli\\u003eDecaluw\\u0026eacute; V, Braet C (2003) Prevalence of binge-eating disorder in obese children and adolescents seeking weight-loss treatment. Int J Obes 27:404\\u0026ndash;409 . doi: 10.1038/sj.ijo.0802233\\u003c/li\\u003e\\n\\u003cli\\u003eTahrani AA, Panova-Noeva M, Schloot NC, et al (2023) Stratification of obesity phenotypes to optimize future therapy (SOPHIA). Expert Rev Gastroenterol Hepatol 17:1031\\u0026ndash;1039 . doi: 10.1080/17474124.2023.2264783\\u003c/li\\u003e\\n\\u003cli\\u003eAgius R, Pace NP, Fava S (2023) Phenotyping obesity: A focus on metabolically healthy obesity and metabolically unhealthy normal weight. Diabetes Metab Res Rev. doi: 10.1002/dmrr.3725\\u003c/li\\u003e\\n\\u003cli\\u003eSt Fleur RG, Tanofsky‐Kraff M, Yanovski JA, et al (2023) Phenotyping children and adolescents with obesity using behavioral, psychological, and familial data. Obesity 31:3016\\u0026ndash;3024 . doi: 10.1002/oby.23893\\u003c/li\\u003e\\n\\u003cli\\u003eCaroleo M, Primerano A, Rania M, et al (2018) A real world study on the genetic, cognitive and psychopathological differences of obese patients clustered according to eating behaviours. Eur Psychiatry 48:58\\u0026ndash;64 . doi: 10.1016/j.eurpsy.2017.11.009\\u003c/li\\u003e\\n\\u003cli\\u003eSegura-Garcia C, Aloi M, Rania M, et al (2022) Development, validation and clinical use of the Eating Behaviors Assessment for Obesity (EBA-O). Eat Weight Disord - Stud Anorexia, Bulim Obes 27:2143\\u0026ndash;2154 . doi: 10.1007/s40519-022-01363-0\\u003c/li\\u003e\\n\\u003cli\\u003eGormally J, Black S, Daston S, Rardin D (1982) The assessment of binge eating severity among obese persons. Addict Behav 7:47\\u0026ndash;55\\u003c/li\\u003e\\n\\u003cli\\u003eAllison KC, Lundgren JD, O\\u0026rsquo;Reardon JP, et al (2008) The Night Eating Questionnaire (NEQ): Psychometric properties of a measure of severity of the Night Eating Syndrome. Eat Behav 9:62\\u0026ndash;72 . doi: 10.1016/j.eatbeh.2007.03.007\\u003c/li\\u003e\\n\\u003cli\\u003eGearhardt AN, Corbin WR, Brownell KD (2009) Preliminary validation of the Yale Food Addiction Scale. Appetite 52:430\\u0026ndash;436 . doi: 10.1016/j.appet.2008.12.003\\u003c/li\\u003e\\n\\u003cli\\u003eFairburn C, Beglin S (2008) Eating disorder examination questionnaire (EDE-Q 6.0). In: Cognitive behavior therapy and eating disorders. Guiford Press, New York\\u003c/li\\u003e\\n\\u003cli\\u003eHu L, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model A Multidiscip J 6:1\\u0026ndash;55 . doi: 10.1080/10705519909540118\\u003c/li\\u003e\\n\\u003cli\\u003eMayr A, Gefeller O, Prokosch HU, et al (2012) Web-based data collection yielded an additional response bias - But had no direct effect on outcome scales. J Clin Epidemiol 65:970\\u0026ndash;977 . doi: 10.1016/j.jclinepi.2012.03.005\\u003c/li\\u003e\\n\\u003c/ol\\u003e\"},{\"header\":\"Appendix\",\"content\":\"\\u003cp\\u003eAppendix 1 is not available with this version.\\u003c/p\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":false,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":true,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"eating-and-weight-disorders-studies-on-anorexia-bulimia-and-obesity\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"eawd\",\"sideBox\":\"Learn more about [Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity](https://www.springer.com/journal/40519)\",\"snPcode\":\"40519\",\"submissionUrl\":\"https://submission.nature.com/new-submission/40519/3\",\"title\":\"Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity\",\"twitterHandle\":\"\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"Springer Hybrid\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":false},\"keywords\":\"obesity, eating behavior, assessment, Greek validation, psychometric properties\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-3882043/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-3882043/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003e\\u003cstrong\\u003eIntroduction\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eWith increasing morbidity and risk of death, obesity has become a serious health problem largely attributable to difficulties in finding proper treatments for related diseases. Many studies show how detecting abnormal eating behaviors could be useful in developing effective clinical treatments. This study aims at validating the Greek version of the Eating Behaviors Assessment for Obesity (EBA-O).\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eMethod\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eAfter a double English/Greek forward/backward translation of the EBA-O, 294 participants completed the Greek version (GR-EBA-O), the Eating Disorder Examination Questionnaire, the Binge Eating Scale, and the Yale Food Addiction Scale. Confirmatory factor analysis (CFA) and construct validity were calculated, and Two-way MANOVA was computed with the factors of GR-EBA-O controlling for sex and BMI categories.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eResults\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eCFA confirmed the second-order five factors (i.e., food addiction, night eating, binge eating, sweet eating, and prandial hyperphagia) structure of the original EBA-O with excellent fit indices. GR-EBA-O factors were highly correlated. The GR-EBA-O subscales were also significantly correlated with the remaining measures, demonstrating good concurrent validity.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConclusion\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe Greek version of the EBA-O has demonstrated sound psychometric properties and appears a reliable and user-friendly tool to identify pathological eating behaviors in obesity.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eLevel of evidence:\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eLevel V, descriptive research.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Validation and assessment of psychometric properties of the Greek Eating Behaviors Assessment for Obesity (GR-EBA-O)\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2024-01-24 19:28:26\",\"doi\":\"10.21203/rs.3.rs-3882043/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0},{\"type\":\"decision\",\"content\":\"Revision requested\",\"date\":\"2024-04-07T08:19:06+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorInvitedReview\",\"content\":\"\",\"date\":\"2024-03-10T10:28:01+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"dd5f7f23-6f65-488d-9fa7-3d8ff4a05c73\",\"date\":\"2024-03-05T18:34:33+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewersInvited\",\"content\":\"\",\"date\":\"2024-03-05T18:30:53+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorAssigned\",\"content\":\"\",\"date\":\"2024-01-25T08:48:33+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"checksComplete\",\"content\":\"\",\"date\":\"2024-01-22T04:43:43+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"submitted\",\"content\":\"Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity\",\"date\":\"2024-01-20T16:43:28+00:00\",\"index\":\"\",\"fulltext\":\"\"}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"eating-and-weight-disorders-studies-on-anorexia-bulimia-and-obesity\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"eawd\",\"sideBox\":\"Learn more about [Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity](https://www.springer.com/journal/40519)\",\"snPcode\":\"40519\",\"submissionUrl\":\"https://submission.nature.com/new-submission/40519/3\",\"title\":\"Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity\",\"twitterHandle\":\"\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"Springer Hybrid\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":false}}],\"origin\":\"\",\"ownerIdentity\":\"39bd76f4-91ad-437e-9921-500374ba20af\",\"owner\":[],\"postedDate\":\"January 24th, 2024\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"published-in-journal\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2024-05-14T21:24:17+00:00\",\"versionOfRecord\":{\"articleIdentity\":\"rs-3882043\",\"link\":\"https://doi.org/10.1007/s40519-024-01664-6\",\"journal\":{\"identity\":\"eating-and-weight-disorders-studies-on-anorexia-bulimia-and-obesity\",\"isVorOnly\":false,\"title\":\"Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity\"},\"publishedOn\":\"2024-05-11 21:18:08\",\"publishedOnDateReadable\":\"May 11th, 2024\"},\"versionCreatedAt\":\"2024-01-24 19:28:26\",\"video\":\"\",\"vorDoi\":\"10.1007/s40519-024-01664-6\",\"vorDoiUrl\":\"https://doi.org/10.1007/s40519-024-01664-6\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-3882043\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-3882043\",\"identity\":\"rs-3882043\",\"version\":[\"v1\"]},\"buildId\":\"qtupq5eGEP_6zYnWcrvyt\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}