Psychometric Evaluation of the Dietary-Adherence Intake and Eating Test (DIET): A Measure for Early Detection of Maladaptive Eating Behaviors after Bariatric Surgery

Background: Poor dietary adherence to post-bariatric eating guidelines and associated maladaptive eating behaviors predict suboptimal post-bariatric weight loss outcomes. Psychometricallyevaluated measures that reliably detect such maladaptive behaviors are lacking. Objectives: To describe the Dietary-adherence Intake and Eating Test (DIET), a brief self-report measure to detect post-bariatric maladaptive eating behaviors that have been previously associated with suboptimal weight loss post-bariatric surgery. Methods:Preliminary psychometrics properties, including temporal stability, were examined in 109 patients within their first year postbariatric surgery. Results: The 13-item measure demonstrated good test-retest reliability (p<0.001), internal consistency (α=0.86), and factor analysis results suggested all items load onto a single component solution. Conclusion: The DIET is a brief, reliable, and internally consistent self-report measure with good psychometric properties that assesses the presence and frequency of a range of maladaptive post-bariatric eating behaviors. The DIET fills an important gap in the literature as it is, to our knowledge, the first psychometrically-valid questionnaire to assess the range of maladaptive eating behaviors shown by previous research to be associated with greater risks of suboptimal post-bariatric weight loss. The DIET, which can be easily administered post-bariatric surgery, possesses valuable clinical utility in that the maladaptive eating behaviors it captures can serve as the target of early, postsurgical intervention, thus potentially improving post-bariatric surgery weight loss outcomes.