Re-evaluation and revision of Eating Habits Questionnaire

The Eating Habits Questionnaire (EHQ) is a key tool in evaluating orthorexia nervosa, but its evaluation process has witnessed considerable variation, with one item notably excluded from the last phase of its development. This study undertakes a thorough re-evaluation of the English version of the EHQ, focusing on its original 35 items, within two diverse populations where English serves predominantly as a second language. Through an online survey involving 163 female models and 243 non-models, participants completed the EHQ along with the Eating Disorder Inventory (EDI) and SCOFF questionnaire. Using Confirmatory Factor Analysis, we scrutinised the factorial validity of EHQ subscales, eliminating items that did not align with the factor structure. After eliminating 17 items from the original 35-item questionnaire, the fit of the model for EHQ was acceptable. Cronbachs alpha values indicated acceptable reliability. The EHQ problem subscale showed significant positive correlations with all EDI subscales, while all EHQ subscales demonstrated significant positive correlations with the EDI drive for thinness subscale. Comparison of the groups based on the SCOFF threshold revealed positive and significant differences across all subscales. The study examined the impact of replacing an item in the EHQ-21 during its development process, finding that it potentially influenced the resulting factor structure. A new version of EHQ (EHQ-18) was introduced supported by the analysis of the factorial and convergent validity, as well as the reliability. Furthermore, the findings suggest a potential discriminant validity of EHQ-18 in a diverse population, mostly speaking English as a second language.