Psychometric development of a multidimensional measure of weightrelated attitudes and behaviors

  • C. F. Smith
  • D. A. Williamson
  • L. G. Womble
  • J. Johnson
  • L. E
Original Research Paper


Most weight control programs facilitate weight loss by encouraging participants to adopt healthy eating patterns and increase physical activity. There is a need for a relatively brief measure of eating habits and physical activity that could be used to evaluate changes in behavior during weight loss treatment. The purpose of this series of four studies was to develop and validate such a measure, which was subsequently named the Weight Loss Behavior Scale (WLBS). Study 1 (n = 533) included item and scale development and examination of the WLBS’s factor structure and internal consistency. Study 2 (n = 226) evaluated the test-retest reliability and convergent validity of its subscales. Study 3 examined their reliability and internal consistency scales in a predominantly overweight sample (n = 36). Study 4 evaluated the WLBS as a treatment outcome measure in a weight loss intervention (n = 50). Study 1 found that the WLBS contained five internally consistent and stable factors: 1) Concern with Dieting and Weight, 2) Exercise, 3) Overeating, 4) Avoidance of Fattening Foods and Sweets, and 5) Emotional Eating. Study 2 found convergent validity for the WLBS by assessing the correlation of its factors/scales with established inventories of comparable constructs, e.g., dietary restraint, disinhibited eating, and physical activity. Test-retest reliability of the five scales was also supported in this second study. In Study 3, support for the internal consistency and test-retest reliability of the WLBS among overweight individuals was found. Study 4 found that all scales significantly changed in the expected directions after a 5-month behavioral weight loss treatment. The findings from this series of studies suggest that the WLBS is a reliable and valid self-report inventory of cognitive and behavioral scales associated with weight control that can be utilized as an outcome measure for weight loss interventions.


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  1. 1.
    National Heart, Lung, and Blood Institute (NHLBI): Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. U.S. Department of Health and Human Services, 1998.Google Scholar
  2. 2.
    World Health Organization (WHO): Obesity: Preventing and managing the global epidemic, 1997.Google Scholar
  3. 3.
    Wing R.R.: Behavioral approaches to the treatment of obesity. In: Bray G., Bouchard C., James P.T. (Eds.), Handbook of obesity. New York, Marcel Dekker, 1998, pp. 855–873.Google Scholar
  4. 4.
    Wadden T.A., Foster G.D., Letizia K.A.: Oneyear behavioral treatment of obesity: Comparison of moderate and severe caloric restriction and the effects of weight maintenance therapy. J. Consult. Clin. Psychol., 62, 165–171, 1994.PubMedCrossRefGoogle Scholar
  5. 5.
    Wing R.R., Jeffery R.W., Burton L.R., Thorson C., Sperber Nissinoff K., Baxter J.E.: Food provision vs. structured meal plans in the behavioral treatment of obesity. Int. J. Obesity, 20, 56–62, 1996.Google Scholar
  6. 6.
    Block G., Hartman A.M., Dresser C.M., Carol M.D., Gannon J., Gardner L.: A databased approach to diet questionnaire design and testing. Am. J. Epidemiol., 124, 453–469, 1986.PubMedGoogle Scholar
  7. 7.
    Stunkard A.J., Messick S.: The three factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J. Psychosom. Res., 29, 71–83, 1985.PubMedCrossRefGoogle Scholar
  8. 8.
    Paffenbarger R.S., Hyde R.T., Wing A.L., Hsieh C.C.: Physical activity, all-cause mortality, and longevity of college alumni. N. Engl. J. Med, 314, 605–613, 1986.PubMedCrossRefGoogle Scholar
  9. 9.
    Serdula M.K., Williamson D.F., Anda R.F., Levy A., Heaton A., Byers T.: Weight control practices in adults: Results of a multistate telephone survey. Am. J. Public Health, 84, 1821–1824, 1994.PubMedCrossRefGoogle Scholar
  10. 10.
    Klem M.L., Wing R.R., McGuire M.T., Seagle H.M., Hill J.O.: A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am. J. Clin. Nutr., 66, 239–246, 1997.PubMedGoogle Scholar
  11. 11.
    Marcus M.D., Wing R.R.: Binge eating among the obese. Ann. Behav. Med., 9, 23–27, 1987.CrossRefGoogle Scholar
  12. 12.
    Spitzer R.L., Devlin M.J., Walsh B.T., Hasin D., Wing R., Marcus M.D., Stunkard A., Wadden T., Yanovski S., Agras S., Mitchell J., Nonas C.: Binge eating disorder: A multistate field trial of the diagnostic criteria. Int. J. Eating Disord., 11, 191–203, 1992.CrossRefGoogle Scholar
  13. 13.
    Levy A.S., Heaton A.W.: Weight control practices of US adults trying to lose weight. Ann. Intern. Med., 119, 661–666, 1993.PubMedCrossRefGoogle Scholar
  14. 14.
    Grilo C.M.: Physical activity and obesity. Biomed. Pharmacother., 48, 127–136, 1994.PubMedCrossRefGoogle Scholar
  15. 15.
    Klesges R.C., Klesges L.M., Haddock C.K., Eck L.H.: A longitudinal analysis of the impact of dietary intake and physical activity on weight change in adults. Am. J. Clin. Nutr., 55, 818–822, 1992.PubMedGoogle Scholar
  16. 16.
    Pavlou K.N., Krey S., Steffee W.: Exercise as an adjunct to weight loss and maintenance in moderately obese subjects. Am. J. Clin. Nutr., 49, 1115–1123, 1989.PubMedGoogle Scholar
  17. 17.
    Arnow B., Kenardy J., Agras W.S.: The Emotional Eating Scale: The development of a measure to assess coping with negative affect by eating. Int. J. Eating Disord., 18, 79–90, 1995.CrossRefGoogle Scholar
  18. 18.
    Marcus M.D., Wing R.R., Hopkins J.: Obese binge eaters: Affect, cognitions, and response to behavioral weight control. J. Consult. Clin. Psychol., 56, 433–439, 1988.PubMedCrossRefGoogle Scholar
  19. 19.
    Telch C.F., Agras W.S.: Obesity, binge eating and psychopathology: Are they related? Int. J. Eating Disord., 15, 53–61, 1994.CrossRefGoogle Scholar
  20. 20.
    Heatherton T.R., Baumeister R.F.: Binge-eating as escape from self-awareness. Psychol. Bull., 110, 86–108, 1991.PubMedCrossRefGoogle Scholar
  21. 21.
    Rosen J.C., Jones A., Ramirez E., Waxman S.: Body Shape Questionnaire: Studies of validity and reliability. Int. J. Eating Disord., 20, 315–319, 1996.CrossRefGoogle Scholar
  22. 22.
    Cash T.F.: Binge eating and body images among the obese: A further evaluation. J. Social Behav. Person., 6, 367–376, 1991.Google Scholar
  23. 23.
    Stunkard A.J., Wadden T.A.: Psychological aspects of severe obesity. Am. J. Clin. Nutr., 55, 524S–532S, 1992.PubMedGoogle Scholar
  24. 24.
    Eldredge K.L., Agras W.S.: Weight and shape overconcern and emotional eating in binge eating disorder. Int. J. Eating Disord., 19, 73–82, 1996.CrossRefGoogle Scholar
  25. 25.
    Wadden T.A., Stunkard A.J., Liebschutz J.: Three-year follow-up of the treatment of obesity by very low calorie diet, behavior therapy, and their combination. J. Consult. Clin. Psychol., 56, 925–928, 1988.PubMedCrossRefGoogle Scholar
  26. 26.
    WordPerfect, San Francisco: Reference Software International, 1994.Google Scholar
  27. 27.
    Crowne D.P., Marlowe D.: The approval motive: Studies in evaluative dependence. New York, Wiley, 1964.Google Scholar
  28. 28.
    Spector P.E.: Summated rating scale construction. California, Sage Publication Inc., 1992.Google Scholar
  29. 29.
    Garrow J.S.: Indices of adiposity. Rev. Clin. Nutr., 53, 697–708, 1983.Google Scholar
  30. 30.
    Jeffery R.W.: Bias in reported body weight as a function of education, occupation, health and weight concern. Addict. Behav., 21, 217–222, 1996.PubMedCrossRefGoogle Scholar
  31. 31.
    Stunkard A.J., Albaum J.M.: The accuracy of self-reported weights. Am. J. Clin. Nutr., 34, 1593–1599, 1981.PubMedGoogle Scholar
  32. 32.
    Norusis M.: SPSS-PC+ Base Manual V2.0., Chicago, Ill, SPSS, Inc., 1988.Google Scholar
  33. 33.
    Tabachnick B.G., Fidell L.S.: Using multi- variate statistics. Northridge, CA, Harper Collins Publishers, 1989.Google Scholar
  34. 34.
    Allison D.A., Kalinsky L.B., Gorman B.S.: A comparison of the psychometric properties of three measures of dietary restraint, Psychol. Assess., 4, 391–398, 1992.Google Scholar
  35. 35.
    Laessle R.G., Tuschl R.J., Kotthaus B.C., Pirke K.M.: A comparison of the validity of three scales for the assessment of dietary restraint. J. Abnorm. Psychol., 98, 504–507, 1989.PubMedCrossRefGoogle Scholar
  36. 36.
    Heatherton T.R., Herman C.P., Polivy J., King G.A., McGree S.T.: The (mis) measurement of restraint: An analysis of conceptual and psychometric issues. J. Abnorm. Psychol., 98, 89–92, 1988.CrossRefGoogle Scholar
  37. 37.
    Williamson D.A., Lawson O.J., Brooks E.R., Wozniak P.J., Ryan D.H., Bray G.A., Duchmann E.G.: Association of body mass with dietary restraint and overeating. Appetite, 25, 31–41, 1995.PubMedCrossRefGoogle Scholar
  38. 38.
    Gorman B.S., Allison D.B.: Measures of restrained eating. In: Allison D.B. (Ed.), Handbook of assessment methods for eating behavior and weight-related problems. California, Sage, 1995, pp. 149–184.Google Scholar
  39. 39.
    Thelen M.H., Farmer J., Wonderlich S., Smith M.: A revision of the Bulimia Test: The BULIT-R. Psychol. Assess., 3, 119–124, 1991.CrossRefGoogle Scholar
  40. 40.
    Baecke J.A.H., Burema J., Frijters J.E.R.: A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am. J. Clin. Nutr., 36, 936–942, 1982.PubMedGoogle Scholar
  41. 41.
    Cooper P.J., Taylor M.J., Cooper Z., Fairburn C.G.: The development and validation of the Body Shape Questionnaire. Int. J. Eating Disord., 6, 485–494, 1987.CrossRefGoogle Scholar
  42. 42.
    Garner D.M., Garfinkel P.E.: The Eating Attitudes Test: An index of the symptoms of anorexia nervosa. Psychol. Med., 9, 273–279, 1979.PubMedCrossRefGoogle Scholar
  43. 43.
    Anderson A.A., Williamson D.A., Duchmann E.G., Gleaves D.H., Barbin J.M.: Development and validation of a multifactorial treatment outcome measure for eating disorder. Assessment, 6, 7–20, 1999.PubMedCrossRefGoogle Scholar
  44. 44.
    Herman C.P., Mack D.: Restrained and unrestrained eating. J. Pers., 43, 647–660, 1975.PubMedCrossRefGoogle Scholar
  45. 45.
    Herman C.P., Polivy J.: Anxiety, restraint, and eating behavior. J. Abnorm. Psychol., 84, 666–672, 1975.CrossRefGoogle Scholar
  46. 46.
    Williamson D.A., Barker S.E., Bertman L.J., Gleaves D.H.: Body image, body dysphoria, and dietary restraint: Factor structure in nonclinical subjects. Behav. Res. Ther., 33, 85–93, 1995.PubMedCrossRefGoogle Scholar
  47. 47.
    Arnow B., Kenardy J., Agras W.S.: Binge eating among the obese: A descriptive study. J. Behav. Med., 15, 155–170, 1992.PubMedCrossRefGoogle Scholar
  48. 48.
    Westenhoefer J., Broeckmann P., Munch A.K., Pudel V.: Cognitive control of eating behaviour and the disinhibition effect. Appetite, 23, 27–41, 1994.PubMedCrossRefGoogle Scholar
  49. 49.
    Smith C.F., Williamson D.A., Bray G.A., Ryan D.H.: Flexible vs. rigid dieting strategies: Relationship with adverse behavioral outcomes. Appetite, 32, 295–305, 1999.PubMedCrossRefGoogle Scholar
  50. 50.
    French S.A., Jeffery R.W., Wing R.R.: Sex differences among participants in a weightcontrol program. Addict. Behav., 19, 147–158, 1994.PubMedCrossRefGoogle Scholar
  51. 51.
    Hsu G.L.K.: The gender gap in eating disorders: Why are the eating disorders more common among women? Clin. Psychol. Rev., 9, 393–407, 1989.CrossRefGoogle Scholar
  52. 52.
    Klesges R.C., DeBon M., Meyers A.: Obesity in African American women: Epidemiology, determinants, and treatment issues. In: Thompson, K. Body Image, Eating Disorders, and Obesity: An integrative guide for assessment and treatment. Washington, D.C., American Psychological Association, 1996.Google Scholar
  53. 53.
    Kazdin A.E.: Preparing and evaluating research reports, Psychological Assessment, 7, 228–237, 1995.CrossRefGoogle Scholar

Copyright information

© Editrice Kurtis 2000

Authors and Affiliations

  • C. F. Smith
    • 1
  • D. A. Williamson
    • 2
  • L. G. Womble
    • 2
  • J. Johnson
    • 2
  • L. E
    • 1
  1. 1.Western Psychiatric Institute and ClinicUniversity of PittsburghPittsburghUSA
  2. 2.Deparment of PsychologyLouisiana State UniversityBaton RougeUSA

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