Thoughts, worries, and fears about food: a preliminary analysis of the psychometric properties of the Worries about Eating Scale (WaES)

Introduction: According to scientific literature, eating disorders (EDs) and disordered eating behaviors (DEB) are characterized by cognitive distortions and maladaptive schemas. These include excessive preoccupation with food, body image, and control over food consumption (Fairburn et al., 2003; Siep et al., 2011). Cognitive components, in particular recurring thoughts and worries about food, are fundamental both in the development and in the maintenance of EDs (Sapuppo et al., 2018). Repetitive negative thinking, particularly worry and rumination, has been found to be significantly associated with various EDs (Palmieri et al., 2021). Currently, the Eating Attitudes Test-26 (EAT-26; Garner et al., 1982) is one of the most widely used psychometric tools to evaluate food preoccupation and symptoms of EDs. However, EAT-26 does not focus exclusively on the construct of food preoccupation, being more oriented to detect specific aspects of bulimia and anorexia nervosa (Garner et al., 1982). Therefore, existing literature has limitations regarding instruments designed specifically to evaluate food related worries, thus leaving an important gap in research. To fill this gap, the current study proposes to develop and preliminarily validate the Worries About Eating Scale (WAES), a new psychometric tool designed to specifically measure the construct of worries related to food and their influence on the psychopathology of EDs. Method: The sample consisted of 268 Italian adults (204 women and 64 men) aged between 18 and 82 (M = 33.64, SD = 14.40). Participants were recruited online and completed a battery of self-report questionnaires, which included: the newly developed Worries about Eating Scale (WAES), the Eating Attitudes Test-26 (EAT-26), the Orthorexia Nervosa Inventory (ONI), the Three-Factor Eating Questionnaire (TFEQ-R-18), the Perseverative Thinking Questionnaire (PTQ), the Intolerance of Uncertainty Scale (IUS-12) and the Brief Perfectionism Scale 9 (BPS9). Results: The exploratory factor analysis (EFA) revealed a two-factor structure for the Worries About Eating Scale (WAES), explaining 61.2% of the variance. Factor 1 reflects general food-related worries, while Factor 2 captures specific concerns, including caloric intake, aligning with emerging constructs like orthorexia nervosa (ON). Correlational analyses confirmed its convergent validity, showing strong associations with the EAT-26 and ONI, while also correlating with cognitive restraint, emotional eating and uncontrolled eating, perfectionism, repetitive negative thinking, and intolerance of uncertainty. Discussion: These findings suggest that the WAES captures distinct yet interconnected dimensions of food-related worries. The WAES demonstrated robust psychometric properties, with significant factor loadings and internal consistency. These results highlight the scale's ability to capture the multidimensional nature of food preoccupation effectively. The WAES is a valid and reliable tool for measuring food-related worries, distinguishing between general cognitive patterns and ones more specific to behavioral dimensions. Its innovative focus bridges a critical gap in the psychometric literature by addressing food-related worries that are not adequately captured by existing tools like the EAT-26. Clinically, the WAES has the potential to aid in early identification of risk factors for EDs and emerging conditions like ON, supporting more tailored preventive and therapeutic interventions. However, limitations such as sample homogeneity and item redundancy suggest the need for future studies to refine the scale and validate it across diverse populations and cultural contexts. Longitudinal research is also recommended to assess the WAES' predictive utility and temporal stability. Despite these limitations, the WAES makes a significant contribution to the understanding of food-related psychopathology.