Accepted Manuscript

Research report
The Dutch Eating Behaviour Questionnaire (DEBQ): Assessment of eating be
haviour in an aging French population
Nathalie Bailly, Isabelle Maitre, Marion Amand, Catherine Herv, Daniel
Alaphilippe
PII: S0195-6663(12)00371-6
DOI: http://dx.doi.org/10.1016/j.appet.2012.08.029
Reference: APPET 1627
To appear in: Appetite
Received Date: 29 August 2012
Accepted Date: 31 August 2012
Please cite this article as: Bailly, N., Maitre, I., Amand, M., Herv, C., Alaphilippe, D., The Dutch Eating Behaviour
Questionnaire (DEBQ): Assessment of eating behaviour in an aging French population, Appetite (2012), doi: http://
dx.doi.org/10.1016/j.appet.2012.08.029
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The Dutch Eating Behaviour Questionnaire (DEBQ):
Assessment of eating behaviour in an aging French population



Authors:
Nathalie Bailly*
Isabelle Maitre
Marion Amand
Catherine Herv
Daniel Alaphilippe

Correspondence to: Nathalie Bailly, University Franois Rabelais, E.A. 2114.
Psychologie des Ages de la Vie , Department of Psychology, 3 rue des Tanneurs, 37041
Tours Cedex, France. bailly@univ-tours.fr




2


Abstract:
The aim of the study was to develop a French version of the Dutch Eating
Behaviour Questionnaire (DEBQ) in order to provide a self-report measure for French
people in the field of gerontology. A short version of the DEBQ was administered to
262 participants aged 65 years and older. Single and multigroup confirmatory analyses
were carried out. The fit measures for the three-factor model and the factorial invariance
models with respect to age, sex and BMI status were satisfactory. Three subscales of
DEBQ had satisfactory internal consistency. Regarding age, the results showed
significant differences in emotional eating and restrained eating. Concerning sex,
women had higher mean scores for emotional eating and restrained eating than men.
Finally, the overweight older people had higher scores for emotional eating than the
normal-weight participants. The short version of DEBQ should provide a useful
measure for researchers and clinicians who are interested in exploring eating behaviours
among the elderly.

Keywords:
Dutch Eating Behaviour Questionnaire
Eating behaviour
Elderly
Older people
Validation



3


Introduction
Population aging is now a worldwide phenomenon. In the more developed
regions, the proportion of the population 60 years and older is estimated to increase
from 19 percent to 32 percent between 2000 and 2050, with those 80 years and older
constituting more than one out of four of the elderly in 2050 (United Nations, 2003).
This aging of the population has raised important questions concerning the specific
nutrition of aging systems, changes in food preferences and overall quality of life
(Elsner, 2002). Decreased physical activity and decreased energy expenditure with
ageing predispose to fat accumulation and redistribution. According to several studies in
developed countries, the early phase of aging (55 to 65 years) is often associated with a
positive energy balance and an increase in body fat which is linked to excess morbidity,
mortality, and health care costs (Andreyeva, Sturn & Ringel, 2004; Calle, Teras &
Thun, 2005; Cornoni-Huntley, Harris, Everett, Albanes, Micozzi, Miles, & Feldman,
1991). In the subsequent phase of aging (after 65 to 75 years), body fat and lean body
mass decrease and continue to decline with a negative energy balance (Wilson &
Morley, 2003). Age-related physiological changes contribute to the development of
malnutrition in older adults (Chapman, 2007; Chen, Schilling, & Lyder, 2001).
Eating is not an automatic process but is influenced to a large extent by cultural,
social, and psychological pressures felt by each of us. Over the last 30 years, theories
have been developed to assess various aspects of the motivation to eat which could
impair adequate food intake and body weight control. Based on psychological theories,
Van Strien et al. (Van Strien, Frijters, Bergers & Defares, 1986) defined three different
eating behaviours. The psychosomatic theory

(Bruch, 1973; Kaplan & Kaplan, 1957)
emphasizes the role of emotional eating. It refers to eating in response to negative

4

emotions in order to relieve stress while disregarding internal physiological signals of
hunger. The externality theory (Schachter, Goldman & Gordon, 1968; Rodin, 1981)
refers to eating in response to food-related stimuli (sight or smell of food) regardless of
the internal state of hunger and satiety. The theory of restrained eating (Herman &
Polivy, 1980)

reflects the degree of conscious food restriction (attempts to refrain from
eating in order to lose or maintain a particular weight).
Most studies have indicated that these three eating behaviours are linked to the
body mass index (BMI) (Baos, Cebolla, Etchemendy,

Felipe, Rasal & Botella 2011;
Bozan, Bas & Asci, 2011; Porter & Johnson, 2011; Ricca, Castellini, Lo Sauro Ravaldi,
Lapi, Mannucci, Rotella & Faravelli, 2009; Van strien, Herman & Verheijden, 2009),
nature of food consumption (Baos et al., 2011; Burton, Smit & Lightowler, 2007;
Ouwens, Van Strien, & Van Der Staak, 2003; Porter & Johnson, 2011; Snoek, Van
Strien, Janssens & Engels, 2007) and psychological outcomes such as depression,
anxiety or body-esteem (Flament, Hill, Buchholz, Henderson, Tasca & Goldfield, 2012;
Goossens, Braet, Van Vlierberghe & Mels, 2009; Porter & Johnson, 2011). The three
types of eating behaviour can be reliably and validly measured using the Dutch eating
Behaviour Questionnaire (DEBQ: Van Strien et al., 1986). The DEBQ consists of 33
items with answers on a 5-point Likert scale (ranging from never to very often).
The English version of the original DEBQ (Wardle, 1987) has been translated into
many languages: Portuguese (Viana & Sinde, 2003), Turkish (Bozan et al. 2011),
Spanish (Baos et al., 2011), French (Llutch, Kahn, Stricker-Krongrad, Ziegler, Drouin
& Mjan, 1996) and Swedish (Halvarsson & Sjoden (1998). All these versions show
good factorial validity (reporting a stable factor solution for the total DEBQ and for the
three subscales) and reliability, and also satisfactory internal consistency. The DEBQ

3

has a stable factor structure across genders, weight categories, and random samples
(Allison, Kalinsky & Gorman, 1992; Van Strien & Oosterveld, 2008). Different
versions have been adapted for adults and adolescents (LLutch et al., 1996; Van Strien
et al., 1986; Wardle, 1987) for children (Halvarsson & Sjoden, 1998: 9-10 years old;
Van Strien & Oosterveld, 2008: 7- 12 years old) and for clinical populations (Baos et
al., 2011; LLutch et al., 1996). A version of the questionnaire for parents (DEBQ-P) has
been validated in the Italian population (Caccialanza, Nicholls, Cena, Maccarini,
Rezzani, Anatonioli et al., 2004). However to date, no version adapted for an older and
oldest-old population has been developed. Given the specific nutritional problems
linked to an aging population, it seems important to have a reliable and valid tool to
provide a better understanding of eating behaviours in aging, which can be used by
public health nutrition practitioners and researchers.
The aims of the present study were to test the factorial validity and internal
consistency of a short version of the DEBQ in an older people population. Further aims
were to test the factorial validity and the similarity of the factorial structure for men and
women, older and the oldest-old, and for those who were or were not overweight (BMI-
status). The final purpose was to obtain basic data concerning the DEBQ in an older
population.
Methods
Participants
Data presented in this study were obtained from the Aupalesens project:Improving
pleasure of elderly people for better aging and for fighting against malnutrition

6

(http://www2.dijon.inra.fr/aupalesens/)
1
. A sample of 559 older French adults aged 65 years
and older replied to a multidisciplinary questionnaire on food preferences, social factors and
food context, sensory abilities, medical status and nutritional status of individuals aged
65 years and older (the survey contained a total of more than 400 items). French older adults
were recruited and stratified by age, gender and marital status in four towns in France.
Volunteers were screened for cognitive impairment using the French adaptation of
Folsteins Mini Mental Status Examination (MMSE; Desrosiers & Hbert, 1997) and
were excluded if they scored less than 25. The Aupalesens project was funded by the
French National Research Agency (ANR); the experimental protocols were approved by
the local research ethics committee (CPP).
The present study concerns only older people living independently (the first
category of the Aupalesens Project). The total sample included 262 French adults aged
65 and older living in their own homes. The mean age of the participants was 73.49
years (SD = 5.46, 65-90) with 178 women (67.9%, M age = 73.75, SD = 5.4) and 84
men (32.1%, M age = 72.95, SD = 5.4). Regarding marital situation, 51 % (n = 134)
were married or had a partner and 49 % (n = 128) lived alone. Regarding previous
occupational status, the main categories were office workers (42.74%, n = 112),
executives (33.6%, n = 88) and middle managers (21%, n = 55).
BMI was calculated from height and weight measurements. International cut-off
scores were used to determine whether a participant was overweight or obese.
Participants with scores above 25 were considered overweight or obese. There were no

1
The Aupalesens project aims to investigate food preferences and behaviour associated with the desire to
eat and the pleasure of eating in older people during aging. Four categories were identified: 1) people
living at home without any assistance, 2) people living at home with assistance, except for meal
preparation, 3) people living at home with assistance for meal preparation or meal delivery and 4) people
living in a nursing home



7

underweight participants (BMI < 18.50) in our sample. A total of 34.44% (n=90) of the
participants had a normal weight status and 65.56 % (n=172) were overweight or obese.
The distribution of BMI obtained for our sample was close to the percentages for the
French population. In 2009, in France, 1.9% of people over 65 years of age were
underweight and 60.2% were overweight or obese (Obpi, 2009).

Instrument: the DEBQ
The DEBQ was assessed using the French version of Van Striens scale (LLutch
et al., 1996). The DEBQ consists of 33 items answered on a 5-point Likert scale
(ranging from never to very often). Considering the aims of the Aupalesens project,
the DEBQ could be for used on less autonomous populations including those loosing
physical autonomy living in nursing homes. However, due to the fatigue and annoyance
effect specific to this older population (oldest-old) and further comparison with them,
we decided to shorten the DEBQ scale. To this end, a group of experts in gerontology
and eating behaviours met to identify strategies for selecting items. Attention was
focused both on the results of the French validation study (Llutch et al, 1996) and on the
validation of the questionnaire in an adult population.
Firstly, we examined the factorial loadings of the 33 items from previous
research. Items such as Eat less if you have put on weightor Desire to eat when
bored or restless were removed because of their lower factorial loadings when
validated in French adults (Llutch et al., 1996). Secondly, the pertinence of the items in
relation to an aging population was examined. For example items such as Tempted
when food is being prepared and Tempted by snack bar/fast food store were
removed due to their lack of relevance for an aging population. Indeed, older adults may
have difficulty performing basic activities of daily living, such as eating or preparing

8

meals. Some of them require personal assistance services, assistive technology, help
from others or all three to perform activities of daily living, and receive home delivery
of meal trays (Davin, Paraponaris & Verger, 2009). As a result of this review, 16 items
(Table 1) were selected to represent the three eating behaviour patterns: restrained
eating (5 items), external eating (5 items) and emotional eating (6 items). This adapted
scale was then pilot-tested with ten older people. All the participants stated that they had
no difficulty understanding the items and expressed their willingness to complete all the
items.
Data analysis
First we carried out a factor and item analysis on the DEBQ. A Kaiser-Meyer-
Olkin (KMO) value of .82 indicated a good sampling adequacy for the factor analysis.
Bartletts test of sphericity yielded a chi-square value of 1752 (p = .000), indicating that
the model is appropriate.
The factor analysis was performed by means of a principal component factor
analysis with varimax rotation. Criteria for item selection were 1) a factor loadings
above .40 on the appropriate factors and 2) factor loadings not exceeding .20 on non-
appropriate factors.
To test whether the three-factor structure was an adequate representation of the
older adult responses, a confirmatory factor analysis (CFA - Joreskog & Sorbom, 1998)
was performed on the total sample of participants. CFA was chosen over exploratory
factor analysis (EFA) because it can be used (1) to test first whether the hypothesized
factor structure for the set of measures fits the data and, if this is the case, (2) to
examine how similarly the model fits across the different sub-samples (Bryant &

9

Yarnold, 1995). Firstly, we investigated whether the three-factor model was an adequate
representation of the relationship between the items. Secondly, we investigated whether
this model was appropriate for several subsamples by fitting multigroup models. Hence,
a number of models were fitted for which equality constraints on parameters over the
groups were gradually imposed, i.e., first the three-factor model was fitted for each
group (Model 0), then equality constraints were imposed on the factor correlations
(Model 1), then additional equality restrictions were imposed on the factor loadings
(Model 2) and, finally, equality restrictions were imposed on the unique variances
(Model 3). Model fit was examined using the ratio of 2 and degree of freedom (2/df),
and the root mean square error of approximation (RMSEA). The ratio should not exceed
2; the RMSEA should not exceed the .05 level. The RMSEA is accompanied by the test
of close fit, which should not reach significance. For multigroup models, a 2 difference
test can be used to test whether imposing additional restrictions leads to a significant
drop in fit. Multigroup tests were performed for age, sex and BMI-status. The test on
factorial invariance for age was conducted on two age groups (based on the median):
65- 73 years-old (n=141) and 73 years-old and older (n= 121).
Finally, scores for each of the three scales were obtained by dividing the sum of
the item-scores by the total number of items on that scale. For each scale, means and
standard deviations (SD) were calculated and compared according to sex, BMI-status
and age.
All analyses were conducted with AMOS-SPSS.
Results

10

The factorial structure of the shorter form was examined using exploratory factor
analysis on the 262 older people of 65 years and older. The scree-test suggested that a
three-factor solution was the best fit for the data (Table 1).

The three factors explained 54% of the variance among the scale items (30.27%,
13.39%, and 10.37%). Factor 1 included the six emotional eating items (eigenvalue =
4.8). Factor 2 included the five restrained eating items (eigenvalue = 2.1). Factor 3
included the five externality eating items (eigenvalue = 1.66). In line with the results of
Van strien et al., our findings thus support a three-factor model in an older population.
Cronbachs alpha value was .90 for emotional eating, .71 for restrained eating and .70
for externality eating, indicating satisfactory internal consistencies in our study.
Factor structure and factorial invariance
Table 2 shows the fit measures of the three-factor model in the total sample and
the multigroup models for the test of factorial invariance. First, a baseline model was
examined involving three correlated latent factors (emotion, restriction and externality)
with six items loading for emotion, five items each loading for restriction and
externality. The 2/df was just above 2 and the RMSEA was higher than .05. The
indices were acceptable but not good. If the initial model to be tested did not provide an
adequate representation of the data, the modification indices (MIs) and standardized
expected parameter changes (SEPCs) were used to modify the model, as recommended
by Kaplan (1989). MIs and SEPCs suggested error covariances between 1) items 13
and 15 (external dimension), 2) items 1 and 8 (emotion dimension) and 3) items 9 and
16. The model was modified to incorporate these additional parameters; the fit indices

11

associated with this model are presented in Table 2 as Model (a). Analysis revealed that
the model now provided a better fit to the data as evidenced by the low RMSEA and
higher 2/df.
The second section of Table 2 contains the fit measures of the multigroup
models for testing factorial invariance for age. Model 0 - the model specifying that the
three-factor model is adequate for both groups with varying parameter values for the
groups - had adequate fit measures. Thus, the three-factor model was applicable for
older and the oldest-old participants. The results were basically the same for Model 1
and the 2 difference test showed that the difference in fit for Model 0 and 1 is not
significant. The results were the same for Model 1 and Model 2. This was not the case
for Model 3: the 2 difference test showed that adding equality restrictions on the unique
variance led to a significant difference in fit. The third section of Table 2 contains the fit
measures of the multigroup model for testing factorial invariance for sex. All the
models had acceptable fit measures and the differences between the models are not
significant indicating that the three-factor model was applicable for the older men and
women. However, in Model 3, the 2 difference test showed that adding equality
restrictions on the unique variances led to a significant difference in fit. The fourth
section of Table 2 contains the results for the factorial invariance test in relation to BMI
status. The results indicate that the three-factor structure was applicable for normal
weight status and overweight status, while Model 3, the most restricted model, led to
a significant difference in fit.
Eating behaviours in relation to age, sex and BMI-status

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Table 3 shows the means and standard deviations of the scales obtained in the
total sample and sub-sample (younger-old/older-old, men/women, and normal weight/
overweight). In all the samples, restrained eating was the most prevalent type of eating
behaviour, followed by external eating and emotional eating. Regarding age, results
show significant differences in emotional eating (t(260) = 2.14 , p =.033) and restrained
eating (t(260) = 2.12 , p =.035). The younger-old had higher mean scores for restriction
and emotion than the older-old. Similarly, regarding sex, women had higher mean
scores for emotional eating (t(260) = 5.31 , p =.000) and restrained eating (t(260) =
2.80 , p =.006) than men. The DEBQ responses showed no significant age and gender
interactions (restrained eating: F(1,257) = 0.04; NS emotional eating: F(1,257)=0.19;
NS and external eating: F(1.257) = 0.23; NS). Finally, regarding BMI status,
overweight older people had higher scores for emotional eating than normal-weight
participants (t(260) =2.24 , p =.026). No differences for external eating were observed
between groups in the subsamples.

Discussion
The aim of this study was to validate a short version of the DEBQ to measure
restrained, emotional and external eating in an older adult population. A confirmatory
factor analysis was performed to assess 1) the construct validity for the measure of
eating behaviour dimensions, and 2) whether the factorial structure is invariant for age,
sex and BMI-status. An additional objective was to provide some basic data for this first
validation study among people aged 65 years and older.
A tool of 16 items (6 for emotional eating, 5 for external eating and 5 for
restrained eating) was drawn up which selected items according to their appropriateness

13

for older people and their previous factor loadings in adults. A three-factor model
showed acceptable fit indicating that this short version represents three dimensional
factors. These three factors correspond to those of the original work of Van Strein et al.
(1986) and the different language adult versions (LLutch et al., 1996; Wardle, 1987). To
our knowledge, the CFA method has been used in only two previous studies (Baos et
al., 2011; Van Strien & Oosterveld, 2007). The CFA was chosen in preference to
exploratory factor analysis (EFA) because it can be used on models which have a well-
developed underlying theory and to examine how similarly a model fits across diverse
sub samples. In this study, the tests for factorial invariance showed that the three-factor
model was applicable for the younger-old and oldest-old, men and women and the two
groups of BMI status. Adding equality constraints on the factor correlations (Model 1)
and on the factor loadings (Model 2) did not lead to a significant increase in 2 values.
Nonetheless, the more restrictive model (Model 3), where equality restrictions were
imposed on the unique variances, led to a significant difference in fit.
Although the internal consistency values of DEBQ are good, they are lower than
those reported in the original version of DEBQ (Van Strien et al., 1986 - alpha between
.80 an.95) and those reported in an adult French population (Llutch et al., 1996 alpha
between .82 and .91). The absence of previous data on an older population makes
comparison difficult (the maximum age was 41 years in Llutchs French validation). For
a better understanding of these first results a larger sample of older people needs to be
investigated. Nonetheless, regarding the structure and the psychometric properties of the
DEBQ, this shorten scale appears to be a good self-report screening instrument that
measures eating behaviours and attitudes to eating in an older adult population.

14

Examination of the subsample scores on restrained, emotional and external
eating reveals that restrained eating was the most prevalent type of reported eating
behaviour, followed by emotional and external eating. The importance of restrained
eating behaviour in the older people suggests that this population is particularly aware
of food intake. In response to the prevalence of malnutrition in the older people, France
has developed health awareness campaigns directed towards seniors and set up specific
controlling bodies (PNNS: National Nutritional Health Programme; HAS: French
National Authority for Health). These health recommendations can discourage older
people from eating food considered unhealthy by social medical science. In addition,
diabetes, cholesterol and other common diseases in older people can also lead to
restrained food intake, for example reducing the consumption of cured meats and high-
sugar content foods. This observed restrained eating behaviour would therefore be
linked to a desire to remain healthy. Concerning age, our results indicate that restrained
eating is higher in the younger-old group (65-73 years old) than in the oldest-old (over
73 years old). According to the restrained theory, restrained eaters attempt to control
their eating but with age, uncontrollable and irreversible events occur (bereavement,
death of close friends, role loss, etc.) which put considerable strain on one's perceived
control (Infurna, Gerstorf & Zarit, 2011; Skaff, 2007). This perceived loss of control
can explain the difference on restrained eating between younger-old and the oldest-old.
It could also be postulated that the sensorial, physical and social losses among the
oldest-old would lead individuals to put the pleasure of eating before health
recommendations. This is clearly summarised by one of the interviewees in the
Aupalesens project who said eating is the only pleasure left! (Sulmont-Ross, Matre
& Issanchou, 2010). Thus, this loss of control on restrained eating may be a deliberate

13

choice. In addition, our results indicate higher scores for emotional eating in the
younger-old than for the oldest-old. Younger-old are more prone to eat in response to
negative emotions to relieve stress. Gerontological research suggests a decline in
negative emotions with age (Carstensen, Fung & Charles, 2003). In particular, socio-
emotional selectivity theory (Carstensen, et al., 2003) suggests that elders improve in
affect optimization, i.e., the ability to maximize positive emotion and dampen negative
emotion. The oldest-old would thus have less need for emotion eating. However, to
investigate this further it would be interesting to introduce a positive emotion item (e.g.,
Desire to eat when happy) in the DEBQ scale to understand better the role of both
positive and negative emotions on eating behaviour.
Our study indicates that women scored higher in restrained and emotion eating
than men. Regarding restrained eating, our results are similar to those observed in
previous studies in young adult and adult populations (Wardle, 1987). It has been
suggested that higher scores for dietary restraint in women could be explained by the
fact that women are more likely to diet than men. Therefore, women express restrained
behaviours in response to greater awareness and concern about food and fear of gaining
weight (de Castro, 1995). In addition, current societal standards for female beauty
emphasize the desirability of thinness (Wiseman, Gray, Mosimann, Ahrens, 1992)
leading women to be more concerned than men about the effects of aging on their
appearance (Gupta & Schork, 1993). Several authors highlight a standard of aging
whereby older women are judged much more harshly than older men (Tiggemann,
2004; Wilcox, 1997). With regard to emotional eating, older women are more prone to
this than older men. Gerontological literature indicates that older women experience
depression and anxiety more often than older men (Schoevers, Beekman, Deeg, Janker

16

& van Tilburg, 2003). This suggests emotion-oriented coping among older women is
used to alleviate negative emotional states (Konttinen, Mnnist, Sarlio-Lhteenkorva,
Silventoinen, & Haukkala, 2010; Spoor, Bekker, Van Strien & van Heck, 2007).
Finally, concerning the BMI status, our study indicates that emotional eating is
more important for the overweight participants. Our results are in line with previous
studies (Greeno & Wing, 1994; Van Strien, Frijters, Roosen, Knuiman-Hijl & Defares,
1985) which support the idea that overweight individuals are more likely to use food as
an emotional defence to cope with a negative event, which causes overconsumption
which, in turn, leads to obesity (Kaplan & Kaplan, 1957). However, contrary to
previous results (Baos et al., 2011; Snoek et al., 2007; Wardle, 1987), BMI status did
not influence restrained eating in the older group. This could be related to the body
mass index (BMI) used to measure body fat. Many authors consider BMI to be
unsuitable and not to take into account the age-related changes in body fat distribution.
Some claim that the BMI thresholds for overweight and obesity are overly restrictive
for older people (Flicker, McCaul, Hankey, Jamrozik, Brown, Byles, & Almeida,
2010). Recent evidence indicates that in older people, obesity is paradoxically
associated with a lower rather than higher, mortality risk (Chapman, 2010). Evidence
from practice, in addition to literature reviews, does not support the use of BMI when
assessing nutritional issues in individual older subjects. Furthermore, this could also
explain the high rate of overweight participants in our sample (65.56%).
Our study has several limitations. Given the characteristics of our sample (younger-old,
living independently with no cognitive impairment, previously have high-level
professional occupations, etc.), we can assume that our participants have not yet had to
deal with major health or social problems. The high functioning level of our sample

17

could have biased certain results. A study involving a more representative sample of the
older French population would improve understanding of eating behaviour in old age.
Further research should involve less autonomous and older people. These first results
among younger-old should be compared with those for the oldest-old. Indeed, the loss
of control in preparing meals and food choice for people with assistance for meal
preparation or meal delivery will change eating behavior in terms of restrained,
emotional and external eating. The DEBQ scale also needs to be tested for its
concurrent, discriminant and predictive validity. To improve prevention and treatment
strategies, factors that influence eating behaviours among older people need to be
investigated. In particularly, social eating networks, body self-esteem, general eating
habits, health status (misfitting or unclean dentures, lack of dentition) and mental health
(anxiety, depression) undoubtedly impact on the motivation to eat among older people.
Nonetheless, this first study shows that the French adaptation of the shorten
scale has satisfactory psychometric properties and may therefore be a valuable
instrument for researchers and clinicians who are interested in exploring the motivation
to eat in older people.







Rfrences

18


Allison, D. B., Kalinsky, L. B., & Gorman, B. S. (1992). The comparative
psychometric properties of three measures of dietary restraint. Psychological
Assessment, 4, 391398.
Andreyeva, T, Sturm, R, & Ringel, J.S. (2004). Moderate and severe obesity have
large differences in health care costs. Obesity Research, 12:193643.
Baos, R.M., Cebolla, A., Etchemendy,

E., Felipe, S., Rasal, P., & Botella, C. (2011).
Validation of the Dutch eating behavior questionnaire for children (DEBQ-C) for use
with Spanish children. Nutricin Hospitalaria, 26(4), 890-898.
Bozan, N., Bas, M., & Hulya Asci, F. (2011). Psychometric properties of Turkish
version of Dutch Eating Behaviour Questionnaire (DEBQ). A preliminary results.
Appetite, 56(3), 564-566.
Bruch, H. (1973). Eating Disorders: Obesity, Anorexia Nervosa, and the Person
Within. New York: Basic Books, pp. 4465.
Bryant, F.B., & Yarnold, P.R. (1995). Principal-components analysis and exploratory
and confirmatory factor analysis. In L.G. Grimm, P.R. Yarnold (dir.), Reading and
Understanding Multivariate Statistics (p. 99-136). Washington, DC : American
Psychological Association.
Burton, P., Smit, H.J., & Lightowler H.J. (2007). The influence of external eating
behavior on overeating: mediation by food cravings. Appetite, 49, 191-197.
Caccialanza, R., Nicholls, D., Cena, H., Maccarini, L., Rezzani, C., Antonioli, L., et al.
(2004). Validation of the Dutch Eating Behaviour Questionnaire parent version
(DEBQ-P) in the Italian population. European Journal of Clinical Nutrition, 58, 1217
1222.
Calle, E.E., Teras, L.R., & Thun, MJ. (2005) Obesity and mortality. The New England
Journal Medicine, 353, 21972199.
Carstensen, L.L., Fung, H.H., & Charles, S.T. (2003). Socioemotional Selectivity
Theory and the Regulation of Emotion in the Second Half of Life . Motivation and
Emotion, 27(2), 103-123.
Chapman, I.M. (2010). Obesity paradox during aging. Interdiscilinary Topics in
Gerontology, 37, 2023.
Chen, C.C., Schilling, L.S., & Lyder, H. (2001) A concept analysis of malnutrition in
the elderly. Journal of Advanced Nursing, 36(1), 131142.
Cornoni-Huntley, J.C., Harris, T.B., Everett, D.F., Albanes, D., Micozzi, M.S., Miles,
T.P., & Feldman, J.J. (1991). An overview of body weight of older persons, including
the impact on mortality. The National Health and Nutrition Examination Survey I
Epidemiologic Follow-up Study. Journal of Clinical Epidemiology, 44(8), 743-753.

19

Davin, B., Paraponaris A., & Verger, P. (2009). Socioeconomic determinants of the
need for personal assistance reported by community-dwelling elderly: Empirical
evidence from a French national health survey. Journal of Socio-Economics. 38(1),
138-146.
De Castro, J.M. (1995) The relationship of cognitive restraint to the spontaneous food
and fluid intake of free-living humans. Physiology and Behavior, 57, 287295.
Desrosiers , J. , & Hbert , R. ( 1997 ). Principaux outils dvaluation en clinique et en
recherche . In M. Arcand & R. Hbert (Eds.), Prcis Pratique de Griatrie (pp. 77
107). Edisem .
Elsner, R.J. (2002). Changes in eating behavior during the aging process. Eating
Behaviours, 3, 15-43.
Flament, M.F., Hill, E.M., Buchholz, A., Henderson, K., Tasca, G.A., & Goldfield, G.
(2012). Internalization of the thin and muscular body ideal and disordered eating in
adolescence: the mediation effects of body esteem. Body image, 9(1), 68-75.
Flicker, L., McCaul, K.A., Hankey, G.J., Jamrozik, K., Brown, W.J., Byles, J.E., &
Almeida, O.P. (2010). Body Mass Index and Survival in Men and Women Aged 70 to
75. Journal of the American Geriatrics Society, 58(2), 234-241.
Goossens, L., Braet, C., Van Vlierberghe, L. & Mels, S. (2009). Loss of control over
eating in overweight youngsters: the role of anxiety, depression and emotional eating.
European Eating Disorders Review, 17(1), 68-78.
Greeno, C., & Wing, R. (1994). Stress-induced eating. Psychological Bulletin, 115(3),
444-464.
Gupta, M. A., & Schork, N. J. (1993). Aging-related concerns and body
image: Possible future implications for eating disorders. International Journal of
Eating Disorders, 14, 481-486.
Halvarsson, K., & Sjoden, P.O. (1998). Psychometric properties of the Dutch eating
behaviour questionnaire (DEBQ) among 9-10-year-old Swedish girls. European
Eating Disorders Review, 6, 115-125.
Herman, C.P., & Polivy, J. (1975). Anxiety, restrained and eating behavior. Journal of
Abnormal Psychology, 84(6), 666-672.
Infurna, F.J., Gerstorf, D., & Zarit, S.H. (2011). Examining Dynamic Links between
Perceived Control and Health: Longitudinal Evidence for Differential Effects in
Midlife and Old Age. Developmental Psychology, 47(1), 9-18.
Joreskog, K., & Sorbom, J.(1998). LISREL 8: Users Reference Guide. Hillsdale, NJ:
Lawrence Erlbaum, 1998.

20

Kaplan, D. (1989). Model modification in covariance structure analysis: Application of
the expected parameter change statistic. Multivariate Behavioral Research, 24: 285
305.
Kaplan, H.L., & Kaplan, H.S. (1957). The psychosomatic concept of obesity. Journal
of Nervous and Mental Diseases, 125(2), 181-201.
Konttinen, H., Mnnist, S., Sarlio-Lhteenkorva, S., Silventoinen, K., & Haukkala, A.
(2010). Emotional eating, depressive symptoms and self-reported food consumption. A
population-based study. Appetite, 54(3), 473-479.
Lluch, A., Kahn, J. P., Stricker-Krongrad, A., Ziegler, O., Drouin, P., & Mjean, L.
(1996). Internal validation of a French version of the Dutch Eating Behaviour
Questionnaire. European Psychiatry, 11, 198220.
ObEpi (2009). Enqute pidmiologique nationale sur le surpoids et lobsit. Inserm,
TNS HealthCare Sofres / Roche.
Ouwens, M.A., Van Strien, T., & Van Der Staak, C.P.F. (2003). Tendency toward
overeating and restraint as predictors of food consumption. Appetite, 403, 291-298.
Porter, K.N., & Johnson, M.A. (2011). Obesity is more strongly associated with
inappropriate eating behaviors than with mental health in older adults receiving
congregate meals. Journal of Nutrition in Gerontology and Geriatrics, 30(4), 403-415.
Ricca, V., Castellini, G., Lo Sauro, C., Ravaldi, C., Lapi, F., Mannucci, E., Rotella,
C.M., & Faravelli, C. (2009). Correlations between binge eating and emotional eating
in a sample of overweight subjects. Appetite, 53, 418-421.
Rodin, J. (1981). Current status of the internal-external hypothesis for obesity: What
went wrong? American Psychologist, 36, 361372.
Schachter, S., Goldman, R., & Gordon, A. (1968). Effects of fear, food deprivation,
and obesity on eating. Journal of Personality and Social, Psychology, 10, 91-97.
Schoevers, R.A., Beekman, .A.T, Deeg, D.J., Jonker, C., & van Tilburg, W. (2003).
Comorbidity and risk-patterns of depression, generalised anxiety disorder and mixed
anxiety-depression in later life: results from the AMSTEL study. International journal
of geriatrics , 18(11), 994-1001.
Skaff, M. M. (2007). Sense of control and health: A dynamic duo in the aging process.
In Adlwin CM, Park CL, Spiro R (Eds.), Handbook of health psychology and aging,
New York: Guilford, p. 186209.
Snoek, H. M., Van Strien, T., Janssens, J.M.A.M., & Engels, M.C.M.E. (2007).
Emotional, external, restrained eating and overweight in Dutch adolescents.
Scandinavian Journal of Psychology, 48(1), 2332.
Spoor, S.T.P, Bekker, M.H.J., Van Strien, T., & van Heck, G.L. (2007). Relations
between negative affect, coping, and emotional eating, Appetite, 48, 368376.

21

Sulmont-Ross C, Matre I & Issanchou S (2010). ge, perception chimiosensorielle et
prfrences alimentaires. Grontologie et Socit : Cahiers de la Fondation Nationale
de Grontologie, 134, 87-106.
Tiggemann, M. (2004). Body image across the adult life span: stability and change,
Body Image, 1, 2941.
United Nations (2003). World Population Prospects: The 2002 Revision, United
Nations, New York.
Van Strien, T., & Oosterveld, P. (2008). The childrens DEBQ for assessment of
restrained, emotional and external eating in 7 to 12-year-old children. International
Journal of Eating Disorders, 41(1), 72-81.
Van Strien, T., Frijters, J.E.R., Bergers, G.P.A., & Defares, P.B. (1986). The Dutch
Eating Behaviour Questionnaire (DEBQ) for assessment of restrained, emotional and
external eating behaviour. International Journal of Eating Disorders, 5, 747-755.
Van Strien, T., Frijters, J.E.R., Roosen, R.G., Knuiman-Hijl, W.J., & Defares, P.B.
(1985). Eating behavior, personality traits and body mass in women. Addictive
Behavior, 10, 333343.
Van Strien, T., Herman, C.P., & Verheijden, M.W. (2009). Eating style, overeating,
and overweight in a representative Dutch sample. Does external eating play a role?
Appetite, 52(2), 380-387.
Viana, V., & Sinde, S. (2003). Estilo Alimentar. Adaptaceo e validacao do
quuestionario Holandes do comportamento alimentar (Eating style. A validation study
of the Dutch Eating Behavior Questionnaire for the Portugese population).
PsicologiaTeoria-Investigaca-e-Practica, 8, 5971.
Wardle, J. (1987). Eating style. A validation study of the Dutch Eating Behaviour
Questionnaire in normal weight subjects and women with eating disorders. Journal of
Psychosomatic Research, 31, 161169.
Wilcox, S. (1997). Age and gender in relation to body attitudes: Is there a double
standard of aging? Psychology of Women Quarterly, 21, 549565.
Wilson MMG, & Morley JE. (2003). Aging and energy balance. Journal of Applied
Physiology, 95, 17281736.
Wiseman, C.V., Gray, J.J., Mosimann, .J.E, & Ahrens, A.H. (1992). Cultural
expectations of thinnessin women: An update. International Journal of Eating
Disorders, 11, 8589.




23


Table 1: Varimax rotated 3-factor solution of the DEBQ (16 items) for older subjects.


Emotional
Eating
30.27%

Restrained Eating
13.39%

External Eating
10.37%

1 - Desire to eat when irritated
.675 .100 .187
2 Eat more when see others eat .131 .061 .499
3 Desire to eat when watch others eat .345 .048 .684
4 Eat less after eating too much -.133 .510 .077
5 Eat less than you would like .118 .634 .152
6 Desire to eat when walk past the baker .239 .047 .461
7 Eat less to avoid weight gain become heavier .137 .793 .033
8 Desire to eat when something unpleasant is about
to happen
.872 .011 .078
9 Desire to eat when feeling lonely .707 .167 .199
10 Watch what you eat .051 .646 -.103
11 Desire to eat when depressed or discouraged .791 .101 .215
12 Desire to eat when things go wrong .892 .037 .100
13 Desire to eat when see or smell food .003 .049 .738
14 Eat slimming foods .187 .724 -.048
15 Eat more if food tastes good .021 -.096 .696
16 Desire to eat when emotionally upset .881 .015 .085
Cronbachs Alpha .90
(6 items)
.71
(5 items)
.70
(5 items)

As the DEBQ is protected by copyright (Berne convention), only abbreviated items are given.



Table 2 : Fit measures for the DEBQ three-factor models and the multigroup models for
age, sex and BMI status.
Fit Measures

2 difference test

2
df p
2/df
RMSEA p
2
df p

Three-factor Model

210

101

.000

2.07

.064

.031

Three-factor Model(a) 157 98 .000 1.63 .049 .52



Test for age (multigroup model)

24

Model 0 281 192 .000 1.47 .043 .89
Model 1 291 205 .000 1.42 .040 .94 9.5 13 .73
Model 2 297 211 .000 1.41 .04 .95 6.3 6 .39
Model 3 332 232 .000 1.43 .04 .94 34.4 21 .03

Test for sex (multigroup model)
Model 0 266 192 .000 1.39 .039 .96
Model 1 283 205 .000 1.38 .038 .96 17.6 13 .17
Model 2 291 211 .000 1.38 .038 .97 7.6 6 .27
Model 3 352 232 .000 1.51 .045 .82 60.7 21 .00

Test for BMI (multigroup model)
Model 0 282 192 .000 1,40 ,039 ,95
Model 1 291 205 .000 1,41 ,040 ,95 19.6 13 ,11
Model 2 298 211 .000 1,38 ,038 ,97 2,71 6 .84
Model 3 332 232 .000 1,58 ,047 ,68 74,49 21 .00


Table 3 - Means, Standard deviations (SD) for restrained, emotional and external eating
in the total sample and the sub-sample of younger-old and older-older, women and men,
normal weight and overweight participants.

Restrained Eating Emotional eating External eating

All sample (n=262) 2.87 (.92)
2.02 (.97)
2.48 (.73)
Age
Younger-old (141)
2.98 (.92) 2.14 (1.09) 2.54 (.73)
Older-old (121)
2.74 (.90) 1.88 (.90) 2.42 (.74)
Sex
Women (178)
2.98 (.88) 2.23 (1.01) 2.50 (.74)
Men (84)
2.64 (.96) 1.58 (.71) 2.44 (.73)
BMI-status
Normal weight (90)
2.82 (.97) 1.83 (.90) 2.49 (.64)
Overweight (172)
2.90 (.90) 2.12 (1) 2.48 (.76)


23

The Dutch Eating Behaviour Questionnaire (DEBQ):
Assessment of eating behaviour in an aging French population

Research highlights
We test a short version of the DEBQ in an aging population
Single and multigroup confirmatory analyses were carried out
Women scored higher in restrained and emotion eating
Younger-old group scored higher in restrained and emotion eating
French version of DEBQ may be a valuable instrument in exploring the
motivation to eat in older people.