Nutrients, Vol. 18, Pages 454: Translation, Cultural Adaptation, and Psychometric Validation of the Iranian Version of the Eating Behavior Assessment Questionnaire for Obesity (EBA-O) in Adults with Obesity and Overweight
Nutrients doi: 10.3390/nu18030454
Authors:
Maryam Mohamadinarab
Atoosa Saidpour
Pegah Rahbarinejad
Parisa Amiri
Mir Saeed Yekaninejad
Fereshteh Sadat Hossseinian Ghamsari
Marianna Rania
Cristina Segura-Garcia
Abdolreza Norouzy
Mohammad Safarian
Background: Research has shown that disordered eating behaviors—including binge eating, night eating syndrome, and food addiction—contribute to the heterogeneity of obesity and assist in phenotyping patients for more tailored interventions. The Eating Behavior Assessment for Obesity (EBA-O) is a recently developed 18-item questionnaire that assesses five pathological eating-behavior domains among individuals with obesity (night eating, food addiction, sweet eating, hyperphagia, and binge eating). The present study aimed to translate, culturally adapt, and validate the Persian (Farsi) version of the EBA-O. Methods: The original English EBA-O was translated into Persian following a standardized forward–backward translation procedure, with cultural adaptations implemented to ensure linguistic accuracy and conceptual clarity. A cross-sectional sample of 278 Iranian adults with overweight or obesity (body mass index [BMI] ≥ 25 kg/m2) completed the Persian EBA-O. Confirmatory factor analysis (CFA) was conducted to verify the five-factor model in the Persian sample. Internal consistency was evaluated using Cronbach’s alpha and composite reliability (CR). Convergent validity was assessed using the average variance extracted (AVE), and discriminant validity was examined with the Heterotrait–Monotrait ratio (HTMT). Model fit indices, including the Comparative Fit Index [CFI], Tucker–Lewis Index [TLI], Normed Fit Index [NFI], Goodness-of-Fit Index [GFI], the Standardized Root Mean Square Residual [SRMR] and relative chi-square value [χ2/df] were used to determine the adequacy of the factor structure. Results: The Persian EBA-O demonstrated a clear and stable five-factor structure consistent with the original instrument. CFA indicated good model fit (CFI = 0.95, TLI = 0.94, NFI = 0.91, GFI = 0.92, SRMR = 0.05, χ2/df = 1.94), confirming the presence of the intended domains. Internal consistency was acceptable to high across all subscales (Cronbach’s α = 0.78–0.86; CR > 0.70), and the total scale showed strong reliability. Three of the five factors demonstrated acceptable convergent validity (AVE = 0.54–0.68), while Food Addiction (AVE = 0.46) and Night Eating (AVE = 0.43) fell slightly below the 0.50 threshold; however, their adequate CR and α values indicate that these constructs remain coherent and psychometrically sound. All inter-factor correlations satisfied discriminant validity criteria (HTMT < 0.90), with the highest association observed between the Binge Eating and Hyperphagia factors. Overall, the psychometric properties of the Persian EBA-O were comparable to those reported in the original validation and subsequent translations. Conclusions: The Persian version of the EBA-O is a valid and reliable instrument for assessing pathological eating behaviors among individuals with obesity. It preserves the original questionnaire’s five-factor structure and demonstrates acceptable internal consistency and construct validity in a Persian-speaking population. This validated tool will support both clinical assessment and research on eating-behavior phenotypes and may contribute to the development of more personalized and effective obesity-management strategies among Persian-speaking individuals.
Background: Research has shown that disordered eating behaviors—including binge eating, night eating syndrome, and food addiction—contribute to the heterogeneity of obesity and assist in phenotyping patients for more tailored interventions. The Eating Behavior Assessment for Obesity (EBA-O) is a recently developed 18-item questionnaire that assesses five pathological eating-behavior domains among individuals with obesity (night eating, food addiction, sweet eating, hyperphagia, and binge eating). The present study aimed to translate, culturally adapt, and validate the Persian (Farsi) version of the EBA-O. Methods: The original English EBA-O was translated into Persian following a standardized forward–backward translation procedure, with cultural adaptations implemented to ensure linguistic accuracy and conceptual clarity. A cross-sectional sample of 278 Iranian adults with overweight or obesity (body mass index [BMI] ≥ 25 kg/m2) completed the Persian EBA-O. Confirmatory factor analysis (CFA) was conducted to verify the five-factor model in the Persian sample. Internal consistency was evaluated using Cronbach’s alpha and composite reliability (CR). Convergent validity was assessed using the average variance extracted (AVE), and discriminant validity was examined with the Heterotrait–Monotrait ratio (HTMT). Model fit indices, including the Comparative Fit Index [CFI], Tucker–Lewis Index [TLI], Normed Fit Index [NFI], Goodness-of-Fit Index [GFI], the Standardized Root Mean Square Residual [SRMR] and relative chi-square value [χ2/df] were used to determine the adequacy of the factor structure. Results: The Persian EBA-O demonstrated a clear and stable five-factor structure consistent with the original instrument. CFA indicated good model fit (CFI = 0.95, TLI = 0.94, NFI = 0.91, GFI = 0.92, SRMR = 0.05, χ2/df = 1.94), confirming the presence of the intended domains. Internal consistency was acceptable to high across all subscales (Cronbach’s α = 0.78–0.86; CR > 0.70), and the total scale showed strong reliability. Three of the five factors demonstrated acceptable convergent validity (AVE = 0.54–0.68), while Food Addiction (AVE = 0.46) and Night Eating (AVE = 0.43) fell slightly below the 0.50 threshold; however, their adequate CR and α values indicate that these constructs remain coherent and psychometrically sound. All inter-factor correlations satisfied discriminant validity criteria (HTMT < 0.90), with the highest association observed between the Binge Eating and Hyperphagia factors. Overall, the psychometric properties of the Persian EBA-O were comparable to those reported in the original validation and subsequent translations. Conclusions: The Persian version of the EBA-O is a valid and reliable instrument for assessing pathological eating behaviors among individuals with obesity. It preserves the original questionnaire’s five-factor structure and demonstrates acceptable internal consistency and construct validity in a Persian-speaking population. This validated tool will support both clinical assessment and research on eating-behavior phenotypes and may contribute to the development of more personalized and effective obesity-management strategies among Persian-speaking individuals. Read More