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Pediatrics

Evaluating psychometric properties of the Emotional Eating Scale Adapted for Children and Adolescents (EES-C) in a clinical sample of children seeking treatment for obesity: a case for the unidimensional model

International Journal of Obesity volume 43, pages 2565–2572 (2019)Cite this article

Subjects

Abstract

Background

The Emotional Eating Scale - Adapted for Children and Adolescents (EES-C) assesses children’s urge to eat in response to experiences of negative affect. Prior psychometric studies have demonstrated the high reliability, concurrent validity, and test–retest reliability of theoretically defined subconstructs among non-clinical samples of children and adolescents who were primarily healthy weight; however, no psychometric studies exist investigating the EES-C among clinical samples of children with overweight/obesity (OW/OB). Furthermore, studies conducted in different contexts have suggested a discordant number of subconstructs of emotions related to eating. The purpose of this study was to evaluate the validity of the EES-C in a clinical sample of children seeking weight-loss treatment.

Method

Using a hierarchical bi-factor approach, we evaluated the validity of the EES-C to measure a single general construct, a set of two separate correlated subconstructs, or a hierarchical arrangement of two constructs, and determined reliability in a clinical sample of treatment-seeking children with OW/OB aged 8–12 years (N = 147, mean age = 10.4 years.; mean BMI z = 2.0; female = 66%; Hispanic = 32%, White and other = 68%).

Results

Comparison of factor-extraction methods suggested a single primary construct underlying EES-C in this clinical sample. The bi-factor indices provided clear evidence that most of the reliable variance in the total score (90.8 for bi-factor model with three grouping factors and 95.2 for bi-factor model with five grouping factors) was attributed to the general construct. After adjusting for relationships with the primary construct, remaining correlations among sets of items did not suggest additional reliable constructs.

Conclusion

Results suggest that the primary interpretive emphasis of the EES-C among treatment-seeking children with overweight or obesity should be placed on a single general construct, not on the 3- or 5- subconstructs as was previously suggested.

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Acknowledgements

This work was supported by the National Institute of Health [grant numbers R01DK075861 and K02HL1120242, PI: Boutelle, K23DK114480, PI: Eichen]. The opinions and assertions expressed herein are those of the authors and are not to be construed as reflecting the views of the National Institute of Health, Uniformed Services University or the U.S. Department of Defense.

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Authors and Affiliations

  1. Department of Pediatrics, UC San Diego, 9500 Gilman Drive, MC 0874, La Jolla, CA, 92093, USA

    D. Eastern Kang Sim, Michael Manzano, Dawn M. Eichen, Kyung E. Rhee & Kerri N. Boutelle

  2. Department of Family Medicine and Public Health, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA

    David R. Strong & Kerri N. Boutelle

  3. San Diego State University/ University of California, San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120, USA

    Michael Manzano

  4. Department of Medical and Clinical Psychology, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA

    Marian Tanofsky-Kraff

  5. Department of Psychiatry, UC San Diego, 9500 GiIman Drive, MC 0874, La Jolla, CA, 92093, USA

    Kerri N. Boutelle

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  1. D. Eastern Kang Sim
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Correspondence to D. Eastern Kang Sim.

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Kang Sim, D.E., Strong, D.R., Manzano, M. et al. Evaluating psychometric properties of the Emotional Eating Scale Adapted for Children and Adolescents (EES-C) in a clinical sample of children seeking treatment for obesity: a case for the unidimensional model. Int J Obes 43, 2565–2572 (2019). https://doi.org/10.1038/s41366-019-0427-8

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