Assessing disordered eating behaviours and attitudes: Factor structure and measurement invariance of the Arabic version of the eating attitudes test (EAT-26) in Saudi Arabia

BackgroundThe factorial structure of the Eating Attitudes Test (EAT-26) has been found to be inconsistent across studies and samples. This study aimed to resolve inconsistencies in the factorial structure of the Arabic version of the EAT-26 by identifying the best-fitting model and test its measurement invariance across sexes and BMI categories in a large non-clinical Saudi sample.Methods1,734 Saudi adults (Mage 26.88 and SD 9.13), predominantly female, completed an online survey. Several existing models were tested (e.g., original 26-item three-factor model, second order 26-item three-factor model, 20-item four-factor model, and 16-item four-factor model) using confirmatory factor analysis (CFA). Fit indices including the CFI, SRMR, and RMSEA were used to identify the best-fitting model for Arabic version of the EAT-26. Multi-group confirmatory factor analysis (MGCFA) was used to test measurement invariance.ResultsThe original three-factor model and two other common models demonstrated poor fit (e.g., CFI = 0.727; SRMR = 0.0911; RMSEA = 0.085 [90% CI 0.082-0.087] for the original three-factor model). Instead, a 16-item, four-factor structure [(Self-Perceptions of Body Weight), (Dieting), (Awareness of Food Contents), and (Food Preoccupation)] showed acceptable fit ([CFI = 0.904; SRMR = 0.0554; RMSEA = 0.073 [90% CI 0.068- 0.077]). Internal consistency was good (alpha and omega = 0.88), and measurement invariance was supported across sex (male and female) and BMI categories (underweight, normal weight, overweight, and obese).ConclusionsThese findings underscore the need for culturally relevant validation of the EAT-26 among Arabic-speaking populations, as the revised factorial structure diverged from previously established models. Future research should further examine this revised 16-item, four-factor structure in clinical settings. Disordered eating behaviours and attitudes are unhealthy behaviours and attitudes toward food and weight, which may include restrictive dieting, purging, excessive exercise, abuse of laxatives, distorted body image, and body dissatisfaction, all of which have been linked to eating disorders. This study investigated the reliability and validity of the Arabic version of the Eating Attitudes Test (EAT-26) among Saudi adults. Contrary to the original factor structure, findings showed that the EAT-26 Arabic version has a four-factor structure with 16 items. This revised 16-items version showed good fit indices and reliability. Researchers and clinicians should avoid using the original EAT-26 and instead use this newly proposed 16-item version in this demographic.