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Psychometric properties and factor structure of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women. Results from the Swedish Obese Subjects (SOS) study

Abstract

OBJECTIVE: To evaluate the construct validity of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women.

SUBJECTS: A total of 4377 middle-aged, obese subjects in the Swedish Obese Subjects (SOS) study.

METHODS: The total sample was randomly split into two data subsets and psychometric testing was performed separately in each sample. Multitrait/multi-item analysis was conducted to test scaling assumptions and factor analysis was used to test the factor structure. Measures of mental well-being (MACL, HAD) were used for testing criterion-based validity.

RESULTS: The Cognitive Restraint factor was consistently reproduced and scaling analysis demonstrated strong item-scale discriminant validity, while the item-scale convergent validity was unsatisfactory. The internal structure of the Disinhibition scale was weak. Most Disinhibition and Hunger items grouped in one global factor labeled Uncontrolled Eating. A third cluster containing items on Emotional Eating was also identified. The obtained three-factor structure was cross-validated and replicated across subgroups by gender, age and BMI.

CONCLUSION: The original TFEQ factor structure was not replicated. A short, revised 18-item instrument was constructed, representing the derived factors of Cognitive Restraint, Uncontrolled Eating and Emotional Eating. The most efficient items were used to boost both the convergent and discriminant validity of the scales.

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Acknowledgements

We acknowledge Charles Taft for valuable comments on an earlier draft of this paper. This project was supported by the Swedish Council for Social Research (project 97-0355:2b), the Swedish Foundation for Health Care Sciences and Allergy Research (project V96 065), the Swedish Medical Research Council (project 05239) and the Faculty of Medicine, Göteborg.

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Correspondence to J Karlsson.

Additional information

* Some items are presented with altered response categories. The original dichotomized (true-false) response format was used in the analyses in this study. The four-point response scale shown here is recommended for future applications of the instrument.

Appendix: Item content* of revised scales

Appendix: Item content* of revised scales

Cognitive Restraint

  1. 1

    I deliberately take small helpings as a means of controlling my weight.

    definitely true/mostly true/mostly false/definitely false

  2. 2

    I consciously hold back at meals in order not to gain weight.

    definitely true/mostly true/mostly false/definitely false

  3. 3

    I do not eat some foods because they make me fat.

    definitely true/mostly true/mostly false/definitely false

  4. 4

    How frequently do you avoid ‘stocking up’ on tempting foods?

    almost never/seldom/usually/almost always

  5. 5

    How likely are you to consciously eat less than you want?

    unlikely/slightly likely/moderately likely/very likely

  6. 6

    On a scale of 1 to 8, where 1 means no restraint in eating (eating whatever you want, whenever you want it) and 8 means total restraint (constantly limiting food intake and never ‘giving in’), what number would you give yourself?

    eat whatever I want, whenever I want it/constantly limiting food intake, never ‘giving in’

Uncontrolled eating

  1. 1

    When I smell a sizzling steak or a juicy piece of meat, I find it very difficult to keep from eating, even if I have just finished a meal.

    definitely true/mostly true/mostly false/definitely false

  2. 2

    Sometimes when I start eating, I just can't seem to stop.

    definitely true/mostly true/mostly false/definitely false

  3. 3

    Being with someone who is eating often makes me hungry enough to eat also.

    definitely true/mostly true/mostly false/definitely false

  4. 4

    When I see a real delicacy, I often get so hungry that I have to eat right away.

    definitely true/mostly true/mostly false/definitely false

  5. 5

    I get so hungry that my stomach often seems like a bottomless pit.

    definitely true/mostly true/mostly false/definitely false

  6. 6

    I am always hungry so it is hard for me to stop eating before I finish the food on my plate.

    definitely true/mostly true/mostly false/definitely false

  7. 7

    I am always hungry enough to eat at any time.

    definitely true/mostly true/mostly false/definitely false

  8. 8

    How often do you feel hungry?

    only at mealtimes/sometimes between meals/often between meals/almost always

  9. 9

    Do you go on eating binges though you are not hungry?

    never/rarely/sometimes/at least once a week

Emotional eating

  1. 1

    When I feel anxious, I find myself eating.

    definitely true/mostly true/mostly false/definitely false

  2. 2

    When I feel blue, I often overeat.

    definitely true/mostly true/mostly false/definitely false

  3. 3

    When I feel lonely, I console myself by eating.

    definitely true/mostly true/mostly false/definitely false

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Karlsson, J., Persson, LO., Sjöström, L. et al. Psychometric properties and factor structure of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women. Results from the Swedish Obese Subjects (SOS) study. Int J Obes 24, 1715–1725 (2000). https://doi.org/10.1038/sj.ijo.0801442

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Keywords

  • eating behavior
  • obesity
  • TFEQ
  • dietary restraint
  • emotional eating
  • factor structure

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