Intuitive eating Scale-2: Factor structure and associations with disordered eating, impulsivity and quality of life in adolescents with overweight/obesity

Objective: The Intuitive Eating Scale-2 (IES-2) has been shown to be a valid tool to assess the capability of eating in reaction to natural hunger/satiety cues. However, its factor structure seems to differ in function of cultural/socioeconomic backgrounds, and its psychometric properties among the adolescents with overweight/obesity (BMI-for-age percentile >85th) have not been examined yet. Thus, this study aims to 1) investigating the factorial structure/psychometric properties of IES-2 in adolescents with overweight/obesity; and 2) exploring the associations between impulsivity, quality of life disordered and intuitive eating. Methods: A total of 202 Portuguese adolescents (124 girls; 78 boys; 12–19 years) under weight-loss treatment with a mean BMI z-score of 2.41 (SD = 0.75) participated in this study. The IES-2 factor structure was explored by confirmatory factor analysis and bifactor models. Test-retest reliability analyses were performed over 6 months (n = 41) and associations between the variables under study were explored. Results: Confirmatory factor analyses with posthoc modifications resulted in a bifactor model with acceptable fit supporting one general factor (intuitive eating) and three specific factors (IES-2 subscales). The “Unconditional Permission to Eat” subscale could not be replicated in this sample. Test-retest reliability analyses suggested good temporal stability. Intuitive eating scores were negatively associated with grazing eating behavior and impulsivity (negative urgency) and positively linked to quality of life. Conclusions: An adjusted version of IES-2 can be an appropriate measure for assessing intuitive eating levels in adolescents with overweight/obesity. Research on intuitive eating has the potential to enhance pediatric weight-loss interventions.This research was partially conducted at Psychology Research Centre (PSI/01662), University of Minho, through support from the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education (UIDB/01662/2020), through the national funds (PIDDAC), and by grants to Eva Conceição (2020.01538.CEECIND and POCI-01-0145-FEDER-028209), Sílvia Félix (2020.07384.BD), and Sofia Ramalho (SFRH/BD/104182/2014). The funding body had no role in the design, collection, analysis, and interpretation of the data nor in the writing of the manuscript or the decision to submit the manuscript for publication