Re-evaluation and revision of Eating Habits Questionnaire

Abstract

ABSTRACTBackground and aimsThe Eating Habits Questionnaire (EHQ) serves as the second most widely used measurement tool for assessing orthorexia nervosa. EHQ has undergone multiple translation and re-evaluations, leading to notable variations in factor structure and the final number of items. This study aimed to reassess the English version of the EHQ, utilizing the original 35 items from its second-stage of the validation process, on two diverse populations with English predominantly as a second language.MethodsAn online survey was conducted with 163 female models and 243 female non-models, participants completed the EHQ, the Eating Disorder Inventory (EDI), and the SCOFF questionnaire. Confirmatory factor analysis was used to test the factorial validity of EHQ subscales, and items not fitting the factor structure were eliminated. The reliability was further assessed through Cronbach’s alpha, while convergent validity was checked by correlation with EDI. Mean differences between groups based on SCOFF threshold were also examined.ResultsAfter eliminating 17 items from the original 35-item questionnaire, the model fit for the EHQ was acceptable. Cronbach’s alpha values indicated acceptable reliability. EHQ Problems subscale displayed significant positive correlations with all EDI subscales, while all EHQ subscales demonstrated significant positive correlations with the EDI Drive for Thinness subscale. Comparing groups based on SCOFF threshold revealed positive and significant differences across all subscales.Discussion and conclusionsOur analysis supports the factorial and convergent validity, as well as the reliability of the EHQ-18. Furthermore, the findings suggest potential discriminant validity of the EHQ-18 among diverse population mostly with English as second language.