Validation of the Weight-Related Eating Questionnaire in pregnancy

The Weight-Related Eating Questionnaire (WREQ), designed for assessing distinct constructs of dietary restraint and disinhibition-related eating behaviors, has not been validated in pregnancy. This secondary data analysis aimed to evaluate the WREQ's psychometrics in a diverse sample of pregnant women from the eMoms randomized controlled trial (N = 1399), randomly split for exploratory (EFA, n = 691) and confirmatory factor analysis (CFA, n = 708). Cronbach's alpha and corrected item-total correlation was used to examine internal consistency reliability. Sequential multiple regression analyses were used to assess criterion validity. EFA revealed three factors – dietary restraint, susceptibility to external cues, and emotional eating – accounting for 65.6 % of total variances. Parallel analysis confirmed a combination of two restraint subtypes (routine restraint and compensatory restraint). CFA showed that item 3 for assessing routine restraint had the lowest squared multiple correlation (0.22). The overall Cronbach's alpha of 0.87 demonstrated good internal consistency. Dietary restraint was negatively associated with the intake of energy (p = .03) and carbohydrates (p = .02), whereas susceptibility to external cues was positively associated with the intake of energy (p < .001), carbohydrates (p < .001), and total fat (p = .003). Additionally, emotional eating was positively associated with early-pregnancy body mass index (BMI) after adjustment for covariates (p < .001). These findings confirmed the reliability of the WREQ, the construct validity for susceptibility to external cues and emotional eating, and demonstrated its criterion validity regarding nutritional intake in pregnant women.