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Universidade Estadual Paulista 

“Júlio de Mesquita Filho” 

Faculdade de Ciências Farmacêuticas 

 

Contribuição para investigação do 

comportamento alimentar em adultos: estudos 

de validação  

 

Priscila Carvalho Santos 

 

Tese apresentada ao Programa de 

Pós-graduação em Alimentos e 

Nutrição para obtenção do título de 

Doutor em Alimentos e Nutrição.  

 

Área de Concentração: Ciências 

Nutricionais  

 

Orientadora: Prof.ª Dr.ª Juliana Alvares 

Duarte Bonini Campos  

Coorientador: Prof. Dr. Wanderson 

Roberto da Silva  

 

Araraquara 

2022 

 



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Universidade Estadual Paulista 

“Júlio 

Faculdade de Ciências Farmacêutica 

Contribuição para investigação do 

comportamento alimentar em adultos: estudos 

de validação  

 

Priscila Carvalho Santos 

 

 

Tese apresentada ao Programa de 

Pós-graduação em Alimentos e 

Nutrição para obtenção do título de 

Doutor em Alimentos e Nutrição.  

 

Área de Concentração: Ciências 

Nutricionais  

 

Orientadora: Prof.ª Dr.ª Juliana Alvares 

Duarte Bonini Campos 

Coorientador: Prof. Dr. Wanderson 

Roberto da Silva 

 

Araraquara 

2022 

 



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Agradecimentos 

À Coordenação de Aperfeiçoamento de Pessoal de Nível Superior 

(CAPES, código 001) e à Fundação de Amparo à Pesquisa do Estado de São 

Paulo (FAPESP – processo no 2019/19590-9) pelo apoio financeiro. 

À minha orientadora Profª Drª Juliana Alvares Duarte Bonini Campos 

pela oportunidade de desenvolver esse trabalho. Agradeço sua 

disponibilidade, orientação, empenho e dedicação em todo o meu processo 

de doutorado. 

Ao meu coorientador Prof. Dr. Wanderson Roberto da Silva por todo 

ensinamento e dedicação. Agradeço ainda por sua solicitude e empenho em 

transmitir seus ensinamentos a mim. 

Ao Prof. Dr. João Marôco por todo auxílio durante o meu processo do 

doutorado. Agradeço por nortear minhas análises e auxiliar com os artigos 

científicos. 

Aos integrantes do grupo de pesquisa do Laboratório de Estatística e 

Validação que me auxiliaram na interpretação dos resultados das análises 

estatísticas. 

Aos técnicos Beatriz Buda Fuller e Arthur Fiorin Ragazzi pelo auxílio na 

coleta e elaboração do banco de dados. 

A todos os participantes do estudo. 

À equipe de docentes, técnicos e discentes do programa de Pós-

graduação em Alimentos e Nutrição da Faculdade de Ciências Farmacêuticas 

(UNESP, Campus de Araraquara).  

 



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Agradecimentos Pessoais 

Agradeço primeiramente à Deus, por demonstrar estar presente em 

minha vida através de oportunidades e pessoas, que permitiram que eu 

continuasse minha jornada com força, fé, esperança e apoio em todos os 

momentos de dificuldade. Em cada momento da minha caminhada foram 

surgindo anjos que deixaram o meu caminho mais leve, e possibilitaram a 

minha chegada até aqui. Sei que isso faz parte de Você. Eu o enxerguei em 

cada detalhe... 

Em seguida, gostaria de dizer que tenho muitas pessoas para 

agradecer, e que acredito que serei injusta em não conseguir expressar minha 

gratidão a cada um que passou pelo meu caminho durante toda minha 

trajetória na área acadêmica. Acredito e sinto que cada um que passou por 

minha vida deixou um pouco de si e me auxiliou para que eu conseguisse 

chegar exatamente onde cheguei. Portanto, gostaria de escrever inúmeros 

nomes nesta tese. Mas, devido à falta de espaço, poderei citar somente 

alguns deles. Todos os outros, saibam que vocês moram no meu coração. 

Meu muito obrigada a cada um!  

Gostaria de agradecer aos meus pais, Dorama e Carlos, pelo amor e 

apoio durante toda a minha vida. Obrigada por acreditarem em mim, por 

compreenderem meu caminho e minhas escolhas. Por me darem as mãos 

nos momentos de dificuldade e me auxiliarem, especialmente, nas últimas 

mudanças de minha vida. 

À minha terapeuta Dra. Helena Lanzillo, por todo amparo psicológico e 

emocional. Obrigada por me auxiliar na ampliação da minha consciência, do 

 



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meu conhecimento e por enxergar minha força e potencial. Sou extremamente 

grata a você.  

Ao meu irmão André Luiz e minha grande amiga Paula Clemente, por 

me incentivarem a iniciar no caminho acadêmico. Sem vocês provavelmente 

eu não estaria aqui hoje. Por isso, agradeço pelo incentivo, por todo apoio, 

carinho e amor que sempre me deram.  

À minha querida avó Synézia, por me dar tanto amor e carinho. 

Obrigada por me receber com o maior sorriso e orgulho do mundo no 

momento em que fui aprovada para realizar os cursos de mestrado e 

doutorado e por cuidar de mim como sua filha. 

À minha grande amiga Beatriz Aidê Giovinazzo (in memorian), por ter 

me ensinado tanta coisa... Por ter me dado tanto amor, carinho, por acreditar 

em meu potencial e por me dar os melhores abraços e acolhimento que eu 

pudesse receber. Eu não consigo descrever a falta que você faz em minha 

vida. Você foi embora antes que eu concluísse essa etapa que tanto se 

orgulhava, mas tenho certeza que, de onde estiver, estará olhando por mim e 

festejando cada passo que eu der.  

À minha querida orientadora Juliana Alvares Duarte Bonini Campos, 

por me acolher quando pensei em desistir deste caminho. Você inspira ao 

expor seu conhecimento como professora e faz isso com tanto amor e 

naturalidade, que faz com que nós, seus alunos e orientandos, tenhamos 

vontade de seguir seus passos e assim, quem sabe, consigamos também 

inspirar novas pessoas. Obrigada por abrir novos horizontes em minha vida, 

por me proporcionar tantos ensinamentos e pelas grandiosas contribuições. 

 



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Sem dúvida levarei comigo todo carinho e conhecimento compartilhado. Muito 

obrigada por cada detalhe. 

 Ao grande amigo que o doutorado me trouxe, Wanderson Roberto da 

Silva. Obrigada por ter me auxiliado em cada etapa do meu doutorado. Por 

toda sua dedicação e disponibilidade em compartilhar seus valiosos 

conhecimentos comigo e me orientar com tanto carinho.  Além de toda sua 

orientação tive, ainda, a sorte de tê-lo como meu amigo e de dividir meus dias 

com você. Por isso, agradeço por sua amizade, companheirismo e por tornar 

minha caminhada mais leve e colorida. Você é um presente que levarei 

sempre comigo. 

À Adrielly dos Santos, outro presente que ganhei no doutorado e que 

hoje, me acompanha em cada etapa. Obrigada por desenhar meus modelos, 

por aguentar meu mau humor, por cuidar com tanto amor dos meus bebês 

(Preto, Mike e Pandora) e de mim, e por todo suporte emocional durante essa 

etapa da minha vida.  

Aos meus amigos do Grupo de Pesquisa Análise e Validação Métrica 

Bianca Martins, Bianca Nubia e Lucas Arrais de Campos por todo suporte 

científico e técnico e por todos os momentos compartilhados com tanto 

carinho. 

Aos meus antigos mestres, especialmente, Ellen Cristini de Freitas e 

Cleiton Augusto Libardi por terem me orientado no mestrado e por todas as 

oportunidades que tive ao lado de vocês. Seus ensinamentos foram 

primordiais para a minha formação.  

 



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A todos os meus amigos que deixei em Ribeirão Preto e que sempre 

torceram por mim e me deram suporte emocional especialmente nos 

momentos de grande dificuldade desta caminhada. 

  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Sou feita de retalhos 

 

“Sou feita de retalhos. 

Pedacinhos coloridos de cada vida que passa pela minha e que vou 

costurando na alma. 

Nem sempre bonitos, nem sempre felizes, mas me acrescentam e me 

fazem ser quem eu sou. 

Em cada encontro, em cada contato, vou ficando maior… 

Em cada retalho, uma vida, uma lição, um carinho, uma saudade… 

Que me tornam mais pessoa, mais humana, mais completa. 

E penso que é assim mesmo que a vida se faz: de pedaços de outras 

gentes que vão se tornando parte da gente também. 

E a melhor parte é que nunca estaremos prontos, finalizados… 

Haverá sempre um retalho novo para adicionar à alma. 

Portanto, obrigada a cada um de vocês, que fazem parte da minha vida e 

que me permitem engrandecer minha história com os retalhos deixados em 

mim. Que eu também possa deixar pedacinhos de mim pelos caminhos e 

que eles possam ser parte das suas histórias. 

E que assim, de retalho em retalho, possamos nos tornar, um dia, um 

imenso bordado de ‘nós’”. 

Cris Pizziment 
 

 

 

 

 

 

 

 

 

 



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Resumo 
 

Introdução: O comportamento alimentar pode ser influenciado por diferentes 
aspectos e por esse motivo a compreensão biopsicossociocultural desse 
conceito faz-se necessária. Diante da influência que fatores psicológicos, 
sociais e culturais podem ter sobre a alimentação das pessoas, a utilização 
de instrumentos capazes de capturar conceitos latentes e produzir dados 
válidos e confiáveis torna-se importante. Objetivos: O presente estudo foi 
desenvolvido com três objetivos: 1. apresentar a versão em português do 
Eating and Appraisal Due to Emotions and Stress Questionnaire (EADES), da 
Salzburg Estress Eating Scale (SSES) e da Palatable Eating Motives Scale 
(PEMS); 2. estimar as propriedades psicométricas do EADES, SSES, PEMS 
e do Mindful Eating Questionnaire (MEQ) quando aplicados a adultos jovens 
brasileiros e 3. verificar a influência de características demográficas nos 
conceitos avaliados pelos instrumentos. Métodos: Participaram do estudo 
indivíduos com idade entre 18 e 35 anos. As versões em português do 
EADES, da SSES e da PEMS foram elaboradas. As propriedades 
psicométricas de todos os instrumentos foram estimadas utilizando análise 
fatorial exploratória e/ou confirmatória. A validade e a confiabilidade dos 
dados foram avaliadas. Modelos estruturais foram construídos a fim de avaliar 
a influência de características amostrais nos conceitos avaliados por cada 
instrumento. As trajetórias (B) foram estimadas e avaliadas com o teste z 
(α=5%). Resultados: As versões em português do EADES, da SSES e da 
PEMS foram bem compreendidas pelos participantes. Após diferentes 
refinamentos, os modelos fatoriais de cada instrumento foram ajustados para 
as amostras (EADES mulheres: CFI=0,90; TLI=0,90; RMESA=0,08; 
IC90%RMSEA=0,075-0,080; α=0,89-0,93); homens: CFI=0,91; TLI=0,91; 
RMSEA=0,07; IC90%RMSEA=0,071-0,078; α=0,90-0,93/ SSES mulheres: 
CFI=0,95; TLI=0,93; SRMR=0,06; α=0,94; homens: CFI=0,94; TLI=0,92; 
SRMR=0,07; α=0,93/ PEMS amostra total: CFI=0,96; TLI=0,96; SRMR=0,062; 
RMSEA=0,088; IC90%RMSEA=0,084-0,095; α=0,76-0,94/ MEQ mulheres: 
CFI=0,93; TLI=0,92; SRMR=0,07; α=0,72-0,85; homens: CFI=0,93; TLI=0,91; 
SRMR=0,08; α=0,73-0,86). Em relação aos diferentes modelos estruturais, 
em geral, observou-se que sexo, índice de massa corporal e idade 
influenciaram significativamente nos diferentes conceitos avaliados pelos 
instrumentos sendo que mulheres, indivíduos classificados com 
sobrepeso/obesidade e aqueles mais jovens podem ser considerados grupos 
suscetíveis ao desenvolvimento de comportamentos alimentares 
disfuncionais. Conclusão: As versões em português do EADES, da SSES e 
da PEMS foram apresentados na literatura e podem integrar a investigação 
do comportamento alimentar de adultos jovens brasileiros. Os dados obtidos 
com o EADES, SSES, PEMS e MEQ foram válidos e confiáveis e as 
características demográficas são importantes quando da investigação do 
comportamento alimentar dos indivíduos. 
Palavras-chave: Comportamento Alimentar; Validade; Confiabilidade; 
Emoções; Consciência. 

 
 

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Abstract 
 

Introduction: Eating behavior can be influenced by different aspects and for 
this reason the biopsychosociocultural understanding of this concept is 
necessary. Given the influence that psychological, social and cultural factors 
can have on people's eating, the use of instruments capable of capturing latent 
concepts and producing valid and reliable data becomes important. Aims: The 
present study was developed with three aims: 1. to present the Portuguese 
version of the Eating and Appraisal Due to Emotions and Stress Questionnaire 
(EADES), the Salzburg Stress Eating Scale (SSES) and the Palatable Eating 
Motives Scale (PEMS); 2. estimate the psychometric properties of the EADES, 
SSES, PEMS and the Mindful Eating Questionnaire (MEQ) when applied to 
Brazilian young adults and 3. verify the influence of demographic 
characteristics on the concepts assessed by the instruments. Methods: 
Individuals aged between 18 and 35 years participated in the study. 
Portuguese versions of EADES, SSES and PEMS were developed. The 
psychometric properties of all instruments were estimated using exploratory 
and/or confirmatory factor analysis. The validity and reliability of the data were 
evaluated. Structural models were built in order to assess the influence of 
sample characteristics on the concepts evaluated by each instrument. The 
trajectories (β) were estimated and evaluated with the z test (α=5%). Results: 
The Portuguese versions of EADES, SSES and PEMS were well understood 
by the participants. After different refinements, the factor models of each 
instrument were adjusted for the samples (EADES female: CFI=0.90; 
TLI=0.90; RMESA=0.08; IC90%RMSEA=0.075-0.080; α=0.89 -0.93); male: 
CFI=0.91; TLI=0.91; RMSEA=0.07; IC90%RMSEA=0.071-0.078; α=0.90-
0.93/ SSES female: CFI=0.95; TLI=0.93; SRMR=0.06; α=0.94; male: 
CFI=0.94; TLI=0.92; SRMR=0.07; α=0.93/ PEMS total sample: CFI=0.96; 
TLI=0.96; SRMR=0.062; RMSEA=0.088; IC90%RMSEA=0.084-0.095; 
α=0.76-0.94/ MEQ female: CFI=0.93; TLI=0.92; SRMR=0.07; α=0.72-0.85; 
male: CFI=0.93; TLI=0.91; SRMR=0.08; α=0.73-0.86). Regarding the different 
structural models, in general, it was observed that sex, body mass index and 
age significantly influenced the different concepts evaluated by the 
instruments, with women, individuals classified as overweight/obesity and 
younger individuals being considered susceptible groups to development of 
dysfunctional eating behaviors. Conclusion: The Portuguese versions of the 
EADES, SSES and PEMS were presented in the literature and can contribute 
to the investigation of part of the eating behavior of Brazilian young adults. The 
data obtained with the EADES, SSES, PEMS and MEQ were valid and reliable 
and demographic characteristics are important when investigating the eating 
behavior of individuals. 
Key-words: Eating Behavior; Validity; Reliability; Emotions; Awareness. 
 
 
 

 

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Lista de Tabelas e Quadros 

 Página 

Capítulo 1  

  

Table 1. Descriptive statistics of the Eating and Appraisal due to 
Emotions and Stress (EADES) Questionnaire for sample of 
Brazilian adults (Total sample: n=1,240; Female sample: n=815; 
Male sample: n=425) 

63 

Table 2. Standardized factorial loadings (λ) of items the Eating and 
Appraisal due to Emotions and Stress (EADES) Questionnaire of 
the original and Mexican models to the sample of Brazilian adults 
(Total sample: n=1,240; Female sample: n=815; Male sample: 
n=425) 

65 

Table 3. Psychometric properties of the Eating and Appraisal due 
to Emotions and Stress (EADES) Questionnaire fitted to the sample 
of Brazilian adults 

67 

Table 4. Influence of demographic variables on eating related to 
emotions and stress 
 

68 

  

Capítulo 2  

Tabela 1. Versões em inglês e em português da Escala de 
Estresse na Alimentação de Salzburg (SSES). 

96 

Tabela 2. Caracterização da amostra (n=1.047). 97 

Tabela 3. Análise descritiva das respostas dadas aos itens e pesos 
fatoriais da Escala de Estresse na Alimentação de Salzburg 
(SSES) para as amostras de adultos brasileiros. 

98 

Tabela 4. Indicadores psicométricos da Escala de Estresse na 
Alimentação de Salzburg (SSES) para as amostras de adultos 
brasileiros. 

99 

  

Capítulo 3  

Tabela 1. Versão em Português (e em inglês proposta por 
Boggiano 2016) da Palatable Eating Motives Scale (PEMS) e 
análise descritiva das respostas dadas pelos participantes aos 
itens 

127 

Tabela 2. Caracterização da amostra (n=1.031) 129 

Tabela 3. Indicadores psicométricos da Palatable Eating Motives 
Scale (PEMS) para amostra de adultos brasileiros (n=1.031). 

130 

Tabela 4. Influência de variáveis demográficas nos motivos para 
alimentação palatável. 

131 

  

 
Capítulo 4 

 

Tabela 1. Versão em português (e em inglês proposta por Framson 
et al. 2009) do Questionário de Alimentação Consciente (Mindful 

165 

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Eating Questionnaire) e análise descritiva das respostas dadas 
pelos participantes aos itens 
Tabela 2. Tabela 2 Caracterização da amostra 168 

Tabela.3..Indicadores psicométricos do Questionário de 

Alimentação Consciente (Mindful Eating Questionnaire) para a 
amostra de adultos brasileiros 

169 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Lista de Figuras  

 Página 

Capítulo 1  

Figure 1. Original and Mexican factorial models of the Eating and 
Appraisal due to Emotions and Stress (EADES) Questionnaire 

61 

Figure 2. Mexican factorial model of the Eating and Appraisal due 
to Emotions and Stress (EADES) Questionnaire fitted for the 
Brazilian sample 

62 

  

Capítulo 4  

Figura 1. Modelo fatorial do Mindful Eating Questionnaire ajustado 
para amostra feminina (n=551) e masculina (n=313). 

163 

Figura 2. Escores médios e intervalo de confiança de 95% (IC 95%) 
para cada fator do Mindful Eating Questionnaire considerando a 
estrutura trifatorial ajustada para cada sexo. 

164 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Lista de Apêndice  

 Página 

Capítulo 1  

Appendix 1. English (original) and Portuguese versions of the 
Eating and Appraisal due to Emotions and Stress (EADES) 
Questionnaire 
 
 

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Sumário 

 Página 

Resumo xi 

Abstract xii 

Lista de Tabelas e Quadros xiii 

Lista de Figuras xv 

Lista de Apêndice xvi 

Introdução 19 

  
Capítulo.1. Cross-cultural adaptation and psychometric 
assessment of the Portuguese language version of the Eating and 
Appraisal due to Emotions and Stress (EADES) Questionnaire in 
Brazilian adults 

29 

Abstract 30 

Introduction 31 

Methods 34 

Results 40 

Discussion 43 

Conclusion 49 

References 50 

  
Capítulo 2. Adaptação transcultural e investigação psicométrica 
da Escala de Estresse na Alimentação de Salzburg (SSES) para 
uma amostra de adultos brasileiros 

69 

Resumo 70 

Introdução 71 

Métodos 74 

Resultados 82 

Discussão 84 

Conclusão 90 

Referências 91 
 
Capítulo 3. Adaptação transcultural e investigação psicométrica 
da Palatable Eating Motives Scale (PEMS) para uma amostra de 
adultos brasileiros 

100 

Resumo 101 

Intrudução 102 

Métodos 106 

Resultados 112 

Discussão 114 

Conclusão 120 

Referências 122 
 
Capítulo..4. Avaliação Psicométrica do Mindful Eating 
Questionnaire (MEQ) em amostra de adultos brasileiros 

132 

Resumo 133 

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Intrudução 134 

Métodos 138 

Resultados 145 

Discussão 148 

Conclusão 156 

Referências 157 

  

Considerações Finais 170 

Referências 174 
 

 

  

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Introdução 

A alimentação é um processo complexo que envolve uma série de 

fatores e pode sofrer influência não somente de aspectos biológicos, como 

também de psicológicos e socioculturais (1-3). Apesar desse fato ser 

reconhecido pela literatura especializada, a maior parte dos estudos da área 

da nutrição ainda centraliza as pesquisas na identificação de nutrientes e seu 

papel no organismo, enquanto poucos abrangem outros aspectos. Diante 

disso e de outras questões, os profissionais da área tendem a implementar 

protocolos nutricionais reducionistas considerando apenas o papel biológico 

dos alimentos para a prevenção e tratamento de doenças e enfermidades. 

Neste caminho, fatores psicológicos e socioculturais são delegados a um 

segundo plano e a alimentação passa a ser vista unicamente como fonte de 

saúde. Porém, apesar de tangenciarem sua formação de base é importante 

que profissionais/pesquisadores da área Nutrição ultrapassem os limites da 

compreensão da alimentação para além do olhar biomédico. 

Neste sentido, para compreender de maneira holística o processo da 

alimentação, é necessário ampliar o entendimento acerca do papel dos 

alimentos na vida das pessoas (4). Para tanto, alguns pesquisadores da área 

da Nutrição têm despendido esforços para a compreensão e investigação do 

comportamento alimentar dos indivíduos por meio de uma visão 

biopsicossociocultural (1, 2, 5). Segundo Taragano e Alvarenga (6) o 

comportamento alimentar pode ser definido pelas ações dos indivíduos em 

relação ao ato de se alimentar, as quais envolvem não somente o consumo, 

como também a forma que comemos. O comportamento é influenciado por 



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crenças, pensamentos e sentimentos e esses, por sua vez, pelas experiências 

dos indivíduos com o alimento, a cultura e a sociedade (3). Assim, uma visão 

biopsicossociocultural é aquela que considera a função biológica do alimento, 

além de aspectos psicológicos e socioculturais como parte de todo o processo 

alimentar (1, 5).  

No que se refere aos aspectos psicológicos, sabe-se que a alimentação 

é um processo que será sempre acompanhado por um contorno emocional, 

onde a comida é carregada por representações, significados, bem como de 

lembranças e memórias (3). A partir das interações e estímulos ao longo da 

vida, cada indivíduo aprenderá diferentes maneiras de lidar com os alimentos, 

que podem estar relacionadas, por exemplo, ao enfrentamento e mecanismos 

de regulação de emoções e situações (7-9). Neste sentido, destaca-se a 

alimentação emocional, que se trata da busca e consumo de alimentos na 

tentativa de modificar, aliviar ou reforçar uma emoção, seja ela de valência 

positiva ou negativa (10). Evers et al. (11) sugerem que as emoções de 

valência positiva podem influenciar no processo da alimentação 

especialmente em momentos de celebração ou socialização. Por outro lado, 

as emoções de valência negativa tendem a guiar a alimentação a fim de 

reduzir desconforto emocional (9, 12).  

Nesse contexto, a literatura tem destacado que a alteração da 

alimentação pode ocorrer frente ao estresse (13-15). Na presença de uma 

situação estressora, os indivíduos podem apresentar esgotamento de 

recursos para enfrentar e resolver o estressor, o que pode levá-lo a utilizar a 

comida como forma de lidar com essa situação (13). Tanto na alimentação 



21 
 

emocional (especialmente de valência negativa), quanto na alimentação 

influenciada pelo  estresse, fatores como intensidade, duração, fonte ou tipo 

de emoção ou estressor têm sido apontados como importantes para 

compreender e promover mudanças, quando necessário, no comportamento 

alimentar das pessoas (9, 10). Essas mudanças podem estar relacionadas, 

especialmente, à escolha, consumo (aumento ou redução) de alimentos e 

apetite (10, 14, 16).  

 O apetite é caracterizado pelo desejo de consumir um alimento ou 

grupo de alimentos específicos onde espera-se obter satisfação e prazer (3). 

Entre os fatores que podem exercer influência sobre o apetite, alguns autores 

tem relatado que as emoções (de valência negativa), situações estressoras 

(3, 17), bem como características dos alimentos se destacam (3, 18). Segundo 

Baik (19), os alimentos hiperpalatáveis, ou seja, aqueles ricos em gordura, 

açúcar e densos em energia, tendem a ser os que mais estimulam o apetite, 

uma vez que são capazes de liberar, de forma mais acentuada, hormônios e 

neurotransmissores relacionados ao valor de recompensa dos alimentos, os 

quais são capazes de aumentar a sensação de prazer despertada. Além 

disso, é importante mencionar que os alimentos hiperpalatáveis tendem a ser 

reconhecidos como recompensadores, especialmente, por serem 

frequentemente oferecidos como motivação ou prêmio em comportamentos 

considerados adequados no âmbito familiar, desde as primeiras experiências 

de vida, o que pode impulsionar ainda mais o consumo (20).  Vale destacar 

que, o apetite dos indivíduos, assim como outros fatores envolvidos no 



22 
 

processo da alimentação, poderá ser influenciado por fatores individuais, 

ambientais e organizacionais (3, 21). 

A sociedade, cultura e ambiente podem exercer influência no processo 

da alimentação dos indivíduos a partir da interação desses com o meio em 

que vivem. Essa relação se dá a partir de experiências e conhecimentos 

compartilhados, os quais poderão moldar os gostos, preferências, crenças, 

atitudes, motivações, escolhas e o consumo de alimentos (4, 5). Além disso, 

dentro do âmbito familiar, da sociedade e da cultura, diferentes valores são 

transmitidos por meio da comida, e esses serão responsáveis por participar 

de forma direta na maneira como os indivíduos irão se relacionar com os 

alimentos, podendo afetar positiva ou negativamente o comportamento 

alimentar (3, 4). Deve-se ainda mencionar que, os alimentos são, muitas 

vezes, escolhidos e consumidos com o intuito de pertencimento, na busca por 

identificação ou aceitação por parte de pessoas ou grupos sociais. Esse 

comportamento pode ser denominado conformidade (22). Portanto, o meio 

em que o indivíduo vive e as experiências compartilhadas durante sua vida 

são fundamentais para a formulação das representações simbólicas dos 

alimentos as quais poderão levar a diferentes comportamentos alimentares 

(3, 4). 

Ainda no que se refere ao ambiente, a literatura tem destacado que 

características do ambiente como estímulos sonoros, intensidade de luz, 

temperatura, número de pessoas, companhia (conhecidos ou desconhecidos) 

e odor também podem exercer influência sobre o comportamento alimentar 

das pessoas (3, 23). Essas características, juntamente à disponibilidade de 



23 
 

alimentos e aos aspectos psicológicos, podem ser responsáveis por promover 

uma alimentação baseada em fatores externos, onde os sinais internos 

(especialmente fome e saciedade) passam a não ser reconhecidos e dão 

espaço aos diversos estímulos relacionados ao ambiente e à comida (23, 24). 

Além de promover distração, a alimentação baseada em fatores ou sinais 

externos pode levar à desinibição alimentar, que se refere à inabilidade de 

parar de comer mesmo na ausência de fome (25, 26). Neste sentido, alguns 

estudos têm apontado para a relevância da atenção durante o ato de se 

alimentar como forma de reduzir a desinibição e o comportamento alimentar 

baseado em emoções e sinais externos, uma vez que esses podem influenciar 

negativamente o consumo alimentar das pessoas (25, 27, 28).  

A atenção ou consciência durante o ato de se alimentar envolve a 

capacidade perceptiva do indivíduo de seus sentimentos, pensamentos e 

sensações corporais frente ao alimento ou ambiente alimentar. Esse conceito, 

denominado “comer com atenção plena” (Mindful Eating) tem ganhado espaço 

em contexto acadêmico e clínico, uma vez que pode promover a redução de 

distrações externas e auxiliar na percepção dos indivíduos frente aos seus 

sinais de fome e saciedade. Outra característica dessa prática ou habilidade 

se refere à capacidade de atentar-se a todos os aspectos do alimento como, 

por exemplo, cor, sabor, textura, aroma bem como às sensações físicas e 

emocionais que ocorrem durante o ato de comer. Geralmente, os indivíduos 

que comem com atenção plena conseguem reduzir o impacto das emoções, 

do estresse e das distrações no processo de alimentação e apresentam uma 

relação mais parcimoniosa com a comida.  



24 
 

Assim, considerando que a alimentação pode estar relacionada às 

emoções, ao estresse, às características que tornam o alimento atrativo em 

termos de palatabilidade, bem como à atenção despendida durante o ato de 

consumir alimentos, torna-se relevante promover estudos que vão além do 

olhar biológico incluindo também esses aspectos psicológicos e 

socioculturais. Esse tipo de estudo abre espaço para ampliar o conhecimento 

acerca do comportamento alimentar das pessoas possibilitando a formulação 

de estratégias mais assertivas e consistentes que promovam, quando 

necessário, uma mudança real de comportamento. Para investigar a 

alimentação a partir das emoções, estresse, palatabilidade percebida e 

atenção, faz-se necessário o uso de instrumentos específicos que sejam 

capazes de capturar conceitos latentes. Tais ferramentas, denominados 

instrumentos ou escalas psicométrico(a)s (29, 30), auxiliam na investigação 

de conceitos que não podem ser medidos diretamente.  

Diversos instrumentos (31-34) foram propostos com o objetivo de 

avaliar comportamentos relacionados à alimentação emocional, no entanto, 

destaca-se o Eating and Appraisal Due to Emotions and Stress (EADES) 

Questionnaire (12, 34), pois ele é capaz de avaliar não somente as emoções 

e o estresse na alimentação, como também a forma de enfrentamento dos 

indivíduos frente a diferentes situações. O EADES foi proposto na língua 

inglesa por Ozier et al. (34) e sua estrutura fatorial foi composta por 49 itens 

e três fatores (“Alimentação Relacionada a Emoção e Estresse”; “Avaliação 

da Capacidade e Recursos para Lidar com Emoções e Estresse”; “Avaliação 

de Estressores/Influências Externas). Posteriormente, Lazarevich et al. (12) 



25 
 

adaptaram o instrumento para língua espanhola e testaram em amostra 

mexicana. No momento que apresentamos nosso projeto de pesquisa à pós-

graduação, apenas uma versão em inglês e outra em espanhol do EADES 

encontravam-se disponíveis na literatura e, portanto, a elaboração de uma 

versão em português representava uma lacuna que merecia ser preenchida. 

Com relação a alimentação baseada no estresse, apesar da existência 

de alguns instrumentos (32, 34) a Salzburg Stress Eating Scale (SSES) se 

destaca por ser o único instrumento presente na literatura capaz de medir 

unicamente o estresse na alimentação dos indivíduos (15). A SSES foi 

desenvolvida em 2018 por Meule et al. (15), nas línguas inglesa e alemã, e 

tem como objetivo avaliar se os indivíduos reduzem, mantêm ou aumentam 

seu consumo alimentar quando estão estressados. O instrumento é composto 

por 10 itens e um único fator (15). A SSES também possuí uma versão em 

holandês e outra em árabe, as quais encontram-se disponíveis em ambiente 

virtual (35) mas, não apresentava até o momento versão disponível em 

português. 

Para a avaliação das motivações para o consumo de alimentos/bebidas 

hiperpalatáveis destaca-se a Palatable Eating Motives Scale (PEMS) (22, 36). 

Essa escala foi desenvolvida por Burgess et al. (22) e revisada por Boggiano 

(36), na língua inglesa, com o objetivo de identificar os motivos pelos quais 

alimentos e bebidas, potencialmente considerados saborosos, são 

consumidos na ausência da fome. Além da versão em inglês, o instrumento 

foi adaptado para uso na Turquia (37). A PEMS é composta por 20 itens 

distribuídos em quatro fatores (Enfrentamento; Recompensa; Social; 



26 
 

Conformidade) (22, 36, 37). Vale destacar que, até onde se tem 

conhecimento, a PEMS é o único instrumento proposto na literatura com o 

objetivo de avaliar os motivos para a escolha e consumo de alimentos 

considerados exclusivamente saborosos e ainda não apresentava uma versão 

disponível em português.  

No que se refere à investigação do comer com atenção plena, o Mindful 

Eating Questionnaire (MEQ) parecer ser o instrumento mais utilizado por 

pesquisadores (25). O MEQ foi proposto com o objetivo de avaliar a 

Desinibição, Consciência. Sinais Externos, Resposta Emocional e Distração 

durante o ato de se alimentar, a partir de um conjunto de 28 itens. O MEQ foi 

desenvolvido em 2019 por Framson et al. (25), na língua inglesa, e foi 

adaptado culturalmente para população italiana (28) e iraniana (27). No Brasil, 

tem sido utilizada uma versão desenvolvida preliminarmente e que encontra-

se disponível em ambiente virtual (38).    

Nota-se, portanto, que o EADES, a SSES e a PEMS ainda não 

possuem versões disponíveis na língua portuguesa e, considerando os 

recentes trabalhos que têm apontado altos índices de alimentação emocional 

e transtornada na população jovem brasileira (39), bem como redução de 

comportamentos alimentares saudáveis desses indivíduos frente sintomas 

psicológicos (40), destaca-se a importância de adaptar transculturalmente os 

instrumentos visando fornecer a comunidade brasileira ferramentas que 

possam ser úteis para utilização em futuros estudos e/ou protocolos clínicos. 

Tendo em vista que não basta apenas adaptar culturalmente um instrumento 

para que ele seja considerado adequado para uso em uma população distinta 



27 
 

da que foi proposta, destaca-se a necessidade de verificar a validade e a 

confiabilidade dos dados obtidos. Essas são etapas preliminares e 

imprescindíveis no que se refere a utilização de instrumentos psicométricos a 

fim de garantir o levantamento de evidências válidas e confiáveis (30, 41).  

Além da investigação psicométrica, a construção de modelos 

estruturais também pode ser uma estratégia interessante, uma vez que 

poderá identificar a relação entre diferentes características amostrais e os 

construtos avaliados pelos instrumentos de medida (30, 41). Nesse sentido, 

alguns estudos (12, 15, 42) conduzidos no âmbito da alimentação sugerem 

que características como sexo, índice de massa corporal (IMC) e idade podem 

exercer influência sobre diferentes aspectos do comportamento alimentar. No 

que se refere ao sexo e ao IMC, as mulheres e os indivíduos com maior IMC 

têm relatado utilizar de maneira mais frequente a comida como forma de 

enfrentamento das emoções (12, 15, 36). Essas características também 

parecem exercer influência sobre o consumo de alimentos hiperpalatáveis 

(36). Com relação à idade, os indivíduos mais jovens parecem apresentar 

maior tendência para comportamentos relacionados à alimentação 

descontrolada, emocional e pela busca de alimentos ricos em açúcar e 

gordura em comparação aos mais velhos (42). Além disso, o nível econômico, 

apesar de pouco investigado, também pode exercer influência a partir do 

conhecimento dos indivíduos acerca dos alimentos e nutrição, da variedade e 

acessibilidade aos alimentos (3). Portanto, tendo em vista todas as possíveis 

influências expostas anteriormente, a construção de modelos hipotéticos para 

verificar a influência de tais características no comportamento alimentar dos 



28 
 

indivíduos pode ser relevante para uma abordagem mais direcionada e 

inclusiva, possibilitando rastreamento, auxílio e/ou acompanhamento clínico 

mais acurado. 

Frente ao exposto, o presente trabalho foi proposto com três objetivos 

distintos, a saber: 

1. Realizar a adaptação transcultural das versões em inglês do 

EADES, da SSES e da PEMS para a língua portuguesa a fim de 

que possam ser utilizados em contexto brasileiro;  

2. Estimar as propriedades psicométricas do EADES, da SSES, da 

PEMS e do MEQ quando aplicados a uma amostra de adultos 

jovens brasileiros; 

3. Investigar a influência de características individuais nos conceitos 

avaliados pelos instrumentos EADES, SSES, PEMS e MEQ. 

 

 

 

 

 

 

 

 

 

 



29 
 

 

 

 

 

 

 

 

 

 

 

Capítulo 1.  
Cross-cultural adaptation and psychometric assessment of the 

Portuguese language version of the Eating and Appraisal due to 

Emotions and Stress (EADES) Questionnaire in Brazilian adults a 

__________________________ 

a Artigo publicado na Eating and Weight Disorders (Santos, P.C., da Silva, W.R., Marôco, J., 

Campos, J.A.D.B. Cross-cultural adaptation and psychometric assessment of the Portuguese 

language version of the Eating and Appraisal due to Emotions and Stress (EADES) 

Questionnaire in Brazilian adults. Eat Weight Disord (2021). https://doi.org/10.1007/s40519-

021-01309-y. Reproduced with permission from Springer Nature. 



30 
 

Cross-cultural adaptation and psychometric assessment of the 
Portuguese language version of the Eating and Appraisal due to 
Emotions and Stress (EADES) Questionnaire in Brazilian adults 

 

Abstract  
Purposes: To develop a Brazilian Portuguese version of the Eating and 
Appraisal due to Emotions and Stress (EADES) Questionnaire; to estimate the 
psychometric properties of the EADES factorial model for young Brazilian 
adults; to assess the association between EADES factors and age, body mass 
index (BMI), and economic level. Methods:The cross-cultural adaptation was 
performed using a standardized protocol. The psychometric properties were 
assessed separately for each sex. A structural model for each sex was 
developed to investigate the influence of age, economic level, and BMI on the 
EADES factors. Results: A total of 1240 participants completed the study 
(65.8% female, mean age 23.91 [SD=5.03] years). The EADES original 
factorial model did not present good psychometric properties. Then, a factorial 
model proposed for a Mexican sample was tested and a different model was 
fitted for each sex. The results showed that younger women have lower self-
efficacy and self-confidence and poorer assessment of resources and coping 
skills. Women with a higher economic level have lower self-efficacy. Higher 
BMI was associated to lower self-efficacy and self-confidence in both sexes. 
Younger men have lower self-efficacy and poorer assessment of resources 
and coping skills. Conclusions: The Brazilian Portuguese version of the 
EADES provided valid and reliable data after refinement, and a different model 
was fitted for each sex. Sex, age, BMI, and economic level were significantly 
associated with the EADES factors. 
 
Keyword: Cross-cultural adaptation, Eating, Stress, Emotion, Psychometrics, 
Scale. 
 
Level of Evidence: Level V, descriptive cross-sectional study 
 
  



31 
 

Introduction 

Emotional eating can be understood as a behavior to select and eat 

specific foods in an attempt to change, relieve, or reinforce feelings, as well as 

dealing with positive or negative experiences [1,2]. Positive emotions such as 

happiness can influence food intake to reinforce the positive feeling, especially 

in socialization activities [3]. On the other hand, negative emotions and stress 

– the coordinated response of the body to any type of change that causes 

physical, emotional, or psychological strain [4] – also can influence food intake, 

but as a way to reduce the psychological discomfort [2] and serving as a coping 

strategy [5]. Konttinen et al. [6] emphasize that negative emotions can alter the 

hunger and satiety cues and affect the eating behavior of individuals, such as 

motivation to eat, food choice and quantity, and eating speed. In this way, 

using food to control or relieve discomfort [7] can increase or decrease the 

quantity of eaten food [1,8] and trigger risky eating behaviors, such as 

restrictive eating, binge eating, and disordered eating [9-11,1]. These changes 

can impact people's physical [2,5] and mental [11] health and could result in 

the development of eating disorders [12,13,8]. Thus, exploring how individuals 

use food to cope with emotions and stress is an important step for the 

development of efficient health protocols and diet interventions.                 

As emotional eating cannot be directly measured (because it is a latent 

variable), the use of specific tools is essential. For that, the literature has 

suggested the use of psychometric instruments [14-16,7,13,17,18] to assess 

eating based on emotion or stress as a unique concept or as part of an eating 

behavior. Among these instruments, the Eating and Appraisal due to Emotions 



32 
 

and Stress (EADES) Questionnaire stands out for considering not only the 

effects of specific emotions and stress on eating behavior, but also eating as 

a coping and adaptive strategy. Differently, the Positive-Negative Emotional 

Eating Scale [16] and the Salzburg Emotional Eating Scale [13] do not assess 

copying mechanisms.  

The EADES was developed based on the Transactional Model of Stress 

and Coping (TMSC) considering the process of dealing with emotions and 

stress and different degrees and types of reaction of individuals. Each person 

tends to react differently to situations and life events and how one interprets 

and reacts to them can lead to an effective or ineffective coping response. 

Thus, the theoretical concept behind the EADES can help to understand these 

differences that involve the triggering event, its cognitive evaluation, and the 

decision on how to cope with the event [7].  

The EADES was originally proposed by Ozier et al. [7] in the English 

language and tested in an American sample. The questionnaire was then 

translated by Lazarevich et al. [2] to the Spanish language and tested in a 

Mexican sample. Both studies [2,7] evaluated the psychometric properties of 

the EADES and fitted different structural models to the samples. Currently, no 

Portuguese version of this instrument is available and there is no validity and 

reliability study of the EADES in a Brazilian context. Considering that studies 

carried out in Brazil reported high rates of disordered and emotional eating [19] 

and a positive association between unhealthy eating habits and psychological 

symptoms, such as depression, anxiety, [20] and stress [21], a Brazilian 

version of the EADES can be useful to track the signs and symptoms of 



33 
 

emotional eating. Additionally, this instrument can help to identify groups at 

high risk for emotional eating that need a special attention of professionals. 

Emotions and stressful events can have different effects in eating habits 

of women and men, with women being more affected by emotional eating 

[22,23]. A review carried out by Jiang et al. (2014) suggests that food seems 

to be used more often by women as a way of coping with, and feeling better 

towards stress [24]. The eating behavior can also be influenced by the body 

mass index (BMI), as people with a higher BMI have higher perceived stress 

[13] and are more susceptible to emotional eating [13,23]. Geliebter et al. [15] 

reported that overweight individuals eat more during negative emotional states 

than people with normal weight or underweight. In contrast, during positive 

emotional states, underweight participants eat more than those with normal 

weight or overweight. Age has also been linked to emotional eating, with older 

individuals appearing to be less affected [25,26]. Finally, the economic level 

may also influence the eating behavior of individuals [27], but such relationship 

is still not well established and further investigations are needed.  

Therefore, the purposes of this study were to carry out the cross-cultural 

adaptation of EADES to the Portuguese language, assess the validity and 

reliability of the data obtained with EADES in young Brazilian adults, and verify 

the association between individual characteristics and concepts evaluated by 

the EADES. Our hypotheses were that the Portuguese version of the EADES 

will have good understandability and different factorial models will be fitted for 

female and male samples. We also hypothesized and that age, BMI, and 

economic level will be associated with the concepts evaluated by EADES. 



34 
 

Methods 

Study design and sample size  

This was an observational, cross-sectional study with a non-

probabilistic sampling method. The calculation of the minimum sample size 

was based on the need for at least five respondents for each item of the 

instrument [28]. As the EADES was originally proposed with 49 items, the 

minimum estimated sample size was 245 participants. A rate of 10% was 

added to compensate for possible losses, which resulted in a sample of 273 

individuals for each sex, as the analyses were performed separately for female 

and male. 

 

Participants 

People aged between 18 and 35 years from Brazil were invited to 

participate in the study. Exclusion criteria were pregnant or lactating women, 

and blindness. Participants provided information of their sex (female or male), 

age (years), body weight (kg), height (m), and economic level. Weight and 

height were used to calculate BMI for the anthropometric nutritional status 

[29,30]. To estimate the economic level, the Brazil Economic Classification 

Criteria [31] was used, which is based on the family's estimated gross average 

monthly income (R$ 25,554.33 = high economy class [A]; R$ 8,460.39 = 

medium-high economic class [B]; R$ 2,417.04 = medium-low economic class 

[C]; R$ 719.81 = low economic class [D and E]; the exchange rate as of 

July/2021 was 1 USD = 5.17 BRL. In total, 1,362 people agreed to participate 



35 
 

in the study, of which 1,240 completed all EADES items and were included in 

the analysis (loss rate = 8.9%). 

 

Measuring instrument 

The EADES was initially developed with 54 items and after refinement, 

a set of 49 items was presented [7]. Twenty-one items are formulated with an 

inverted response scale in relation to the others (inverted items: 4, 7, 10, 12, 

13, 14, 15, 20, 23, 28, 31, 35, 36, 39, 41, 43, 45, 46, 50, 52, and 54). The 

response options are given as a five-point Likert scale (1 = strongly disagree, 

2 = disagree, 3 = neither disagree nor agree, 4 = agree and 5 = strongly agree). 

The authors proposed a three-factor model including “Emotion- and Stress-

Related Eating” (items: 3, 4, 10, 13, 14, 16, 21, 23, 26, 28, 30, 34, 35, 36, 38 , 

39, 41, 43, 45, 47, 49, 50, 52, and 54), “Appraisal of Ability and Resources to 

Cope with Emotions and Stress” (items 2, 5, 6, 7, 8, 11, 18, 20 , 22, 24, 25, 27, 

29, 32, 33, 37, 40, 46, 51 and 53) and “Appraisal of Outside 

Stressors/Influences” (items: 12, 15, 31, 42, and 48). This structure (3 factors 

and 49 items) was found using Exploratory Factor Analysis (EFA) and 

presented acceptable internal consistency (Cronbach's alpha [α]: all items = 

0.95 and factors = 0.65–0.95). In the original study, data on construct validity 

were not presented. 

Afterwards, Lazarevich et al. [2] cross-culturally adapted the three-

factor original EADES to the Spanish language using a sample of university 

students in Mexico. The authors found that the factor “Appraisal of Outside 

Stressors/Influences” had low internal consistency (α = 0.54). Thus, a new 



36 
 

factorial model for the EADES was explored and proposed for the Mexican 

context. This was composed of 40 items (all with factor loadings > 0.40) 

distributed in three factors as follows: “Self-efficacy in Emotion- and Stress-

Related Eating” (items: 4, 13, 14, 23, 28, 35, 36, 39, 43, 45 , 50, and 54), “Self-

confidence in Emotion- and Stress-Related Eating” (items: 3, 16, 21, 26, 30, 

34, 38, 47, and 49), and “Appraisal of Resources and Ability to Cope” (items: 

2, 5, 6, 7, 8, 11, 18, 20, 22, 24, 25, 27, 29, 32, 33, 37, 40, 51, and 53). The first 

factor of the original model (Emotion- and Stress-Related Eating) was 

subdivided into two factors (“Self-efficacy in Emotion- and Stress-Related 

Eating” and “Self -confidence in Emotion- and Stress-Related Eating”) in the 

Mexican model. The second factor of the original model (“Appraisal of Ability 

and Resources to Cope with Emotions and Stress”) was relocated to the third 

factor in the Mexican model and renamed “Appraisal of Resources and Ability 

to Cope”. Finally, the third factor of the original instrument (“Appraisal of 

Outside Stressors/Influences”) was excluded, since the items had low factor 

loading. This structure presented adequate internal consistency (α = 0.84–

0.91) and test-retest reliability (intraclass correlation coefficient = 0.88, p < 

0.01) for the Mexican data; however, the construct validity was not evaluated. 

In the present study, the original model (i.e., 3 factors and 49 items) and 

Mexican model (i.e., 3 factors and 40 items) of the EADES were tested and 

evaluated in the Brazilian sample (see Supplementary Material – Figure 1). 

 

 

 



37 
 

Cross-cultural adaptation 

The cross-cultural adaptation of the EADES to the Brazilian Portuguese 

language was carried out, and the semantic, idiomatic, conceptual, and 

cultural equivalences were analyzed [32]. First, the English version of the 

EADES was sent to four independent translators with Portuguese as first 

language and knowledge of the American culture to translate the content to 

Portuguese, following the 2009 orthographic agreement of Portuguese-

speaking countries. Afterwards, the translated versions were compared by the 

authors of this study and a single initial Portuguese language version was 

established and sent to an independent native English translator with 

knowledge of Portuguese and not familiar with the original EADES for back 

translation into English. The content of both versions was compared and 

equivalence was found. In addition, the Portuguese version was analyzed by 

two Psychometrics and Health specialists who considered the version 

produced to be adequate for the Brazilian context. This version was tested in 

a pilot study with a sample of 32 individuals (71.9% female, mean age 28.9 

[SD = 6.6] years) to check the understandability of the items. As there were no 

reports of difficulty in filling out or understanding the questionnaire, the 

Portuguese version was considered adequate (see Supplementary Material – 

Appendix 1). 

 

Procedures and Ethical Aspects 

First, students, technical-administrative staff, and professors from a 

public university in Brazil were invited to participate by e-mails, social 



38 
 

networks, and personal invitations. Those who agreed to participate filled out 

the EADES Portuguese version and a sociodemographic questionnaire using 

a paper-and-pencil format. Then, snowball sampling was adopted, where 

participants indicated new individuals to participate in the study. This study 

was approved by the Human Research Ethics Committee of the School of 

Pharmaceutical Sciences of UNESP (C.A.A.E.: 11469719.1.0000.5426) and 

all participants signed a consent form. 

 

Data Analysis 

The psychometric properties of both the original and Mexican models 

[2,7] were evaluated initially for the total sample and then separately for the 

female and male samples. The descriptive statistical analysis (i.e., mean, 

median, mode, standard deviation, skewness, and kurtosis) of the responses 

given to the EADES items was performed to verify data distribution. Absolute 

values of skewness and kurtosis greater than 3 and 7, respectively, indicated 

non-normal data distribution [33]. 

Construct validity was assessed based on factorial, convergent, and 

discriminant validities. The factorial validity was estimated using the 

Confirmatory Factor Analysis (CFA) through the Weighted Least Squares 

Mean and Variance Adjusted (WLSMV) estimator. To assess the fit of the 

models to the data, the chi-square for degrees of freedom ratio (χ2/df), 

Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square 

Error of Approximation (RMSEA) with a 90% confidence interval (CI) were 

calculated. The fit was considered acceptable when χ2/df  ≤  5.0, CFI and TLI 



39 
 

≥ 0.90, and RMSEA ≤ 0.10 [33]. The factor loading (λ) of each item was also 

estimated and items with values less than 0.40 were eliminated. In case of 

poor fit of the model, the modification indices (MI), calculated using the 

Lagrange Multiplier method, greater than 11 were inspected [33]. 

Convergent validity was analyzed with the average variance extracted 

(AVE) and values ≥ 0.50 were considered adequate [34]. The discriminant 

validity was estimated using correlational analysis and AVE. AVEi and AVEj 

values for two correlated factors greater than the square of the correlation 

between factors (r2
ij) indicated there was adequate discriminant validity 

[34,33]. 

To assess the reliability of the EADES factors, the Composite Reliability 

(CR) and the ordinal alpha coefficient (α) were estimated. Values of CR and α  

≥ 0.70 were considered adequate [34,33]. The program R (R Core Team, 

2019) and the packages “lavaan” [35] and “semTools” [36] were used for this 

analysis. 

 

Structural Model 

A structural model was built to investigate the influence of age, BMI, and 

economic level (independent variables) on EADES factors (dependent 

variables). Considering that the EADES fitted model was different for female 

and male samples, a structural model for each sex was developed and tested. 

For interpreting the EADES factors in the structural models, it was considered 

that for the “Self-efficacy in Emotion- and Stress-Related Eating” factor, the 

higher the scores, the less the self-efficacy. In this way, items 7 and 20 had 



40 
 

their answers inverted to be in the same direction as the others. For the other 

factors (“Self-confidence in Emotion- and Stress-Related Eating” and 

“Appraisal of Resources and Ability to Cope”), the lower the score, the lower 

the self-confidence and the less the resources and coping skills.  

To verify the fit of the structural models to the data, the indices χ2/df, 

CFI, TLI, and RMSEA were used according to the values mentioned above. 

The hypothetically causal trajectories (β) were estimated and evaluated using 

the z test. A significance level of 5% was adopted for decision making [33]. 

This assessment was carried out in the MPLUS program v.7.2 (Muthén & 

Muthén, Los Angeles, CA). 

 

Results 

The mean age of the participants was 23.9 (SD = 5.0) years, and 65.8% 

was female. For females, the average age was 23.5 (SD = 5.0) years and for 

males, 24.6 (SD = 5.1) years. The average BMI for the total sample was 24.3 

(SD = 4.4) kg/m2. For female the average BMI was 23.6 (SD = 4.3) kg/m2 and 

for male, 25.5 (SD = 4.3) kg/m2. Regarding the anthropometric nutritional 

status, 2.6% of participants were classified as underweight (female = 3.0%, 

male = 1.7%), 60% as normal weight (female = 63.3%, male = 48.1%), 28.1% 

as overweight (female = 23.2%, male = 37.2%), and 9.4% as obese (female = 

7.4%, male = 13%). As for the economic level, 29.1% were classified as high 

(class A: female = 27.4%, male = 32.5%), 57.3%, medium-high (class B: 

female = 60.2%, male = 51.8%), 13.2%, medium-low (class C: female = 11.9%, 

male = 15.5%), and 4.0%, low (classes D and E: female = 5%, male = 2%). 



41 
 

The descriptive statistics of the EADES responses is shown in Table 1. 

None of the items presented discrepant values of skewness and kurtosis. 

Table 2 shows the factorial loading of the EADES items for total, female, and 

male samples considering the original model and the Mexican model. 

For the original model, low factor loading was observed in items 2, 10, 

18, 29, 41, and 52 in the total sample, items 2, 10, 18, 24, 29, 41, and 52 in 

the female sample, and 2, 10, 15, 18, 29, 42, and 52 in the male sample. For 

the Mexican model, low factor loading was observed in items 2, 18, and 29 in 

the total sample, 2, 18, 24, and 29 in the female sample, and 2, 18, and 29 in 

the male sample. 

Table 3 shows the psychometric properties for each tested model. The 

original model did not show good fit to any of the samples (total, female, and 

male). In an attempt to improve the fit of this model, items with factor loading 

< 0.40 were excluded and strong correlations between item errors (MI > 

240.34) were inserted. However, even after these modifications, the original 

model did not fit any of the samples, nor did it present adequate convergent 

validity. On the other hand, the reliability of the original model was adequate 

(see Table 3), except for the “Appraisal of Outside Stressors/Influences” factor 

in the male sample, which was borderline (α = 0.67, CR = 0.66). An EFA was 

carried out to verify the distribution of factors for the Brazilian data (data not 

shown). In this analysis, we found a set of ten factors without a well-established 

background. Afterwards, we established a three-factor structure in the EFA 

and found a model similar to the Mexican model. Therefore, was decided to 

test the Mexican model in our data. 



42 
 

For the Mexican factorial model, an acceptable fit was observed for all 

samples (see Table 3). However, some items presented low factor loading 

(total sample: items 2, 18, and 29; female sample: items 2, 18, 24, and 29; 

male sample: items 2, 18, and 29) and were excluded. This contributed to an 

adequate convergent validity for the factors “Self-efficacy in Emotion- and 

Stress-Related Eating” and “Self-confidence in Emotion- and Stress-Related 

Eating” (see Table 3). On the other hand, the AVE values were not adequate 

(< 0.50) for the “Appraisal of Resources and Ability to Cope” factor in any of 

the samples. For the discriminant validity and reliability, the fitted models 

presented good indicators (see Table 3). As a different model was fitted for 

each sex – indicating that the EADES concepts are operationalized differently 

in females and males – the use of the factorial model for the total sample is 

not recommended. From this perspective, the fitted female model was 

composed of 3 factors and 36 items and the fitted male model was composed 

of 3 factors and 37 items (see Supplementary Material – Figure 2).  

Table 4 shows the results of the structural models built based on the 

EADES factorial models fitted for each sex. Both female and male models 

showed non-significant paths (p > 0.05) and were eliminated, with only 

significant relationships remaining in the final models. For the female model, 

age was significantly associated to all factors of the EADES, the economic 

level was associated with the “Self-efficacy in Emotion- and Stress-Related 

Eating” factor, and BMI, with the factors “Self-efficacy in Emotion- and Stress-

Related Eating” and “Self-confidence in Emotion- and Stress-Related Eating”. 

Younger women reported lower self-efficacy and self-confidence, and being 



43 
 

less capable of changing a situation and, consequently, more susceptible to 

emotional eating. Women with a higher economic level also reported having 

less self-efficacy. In addition, women with higher BMI reported lower self-

efficacy and self-confidence in coping with emotion- and stress-related eating. 

The goodness-of-fit parameters for the female structural model fitted were χ2/df 

= 4.88; CFI = 0.90; TLI = 0.90; RMSEA = 0.07, 90% CI = 0.067–0.071. For the 

male model, higher BMI was significantly associated to lower self-efficacy and 

self-confidence towards emotional eating. Younger age was associated with 

less self-efficacy and ability to adapt to challenges. Accordingly, older men had 

a greater capacity to change a situation, manage emotional reaction, or cope 

effectively with stressors. The goodness-of-fit parameters for the male 

structural model fitted were χ2/df = 2.82; CFI = 0.92; TLI = 0.91; RMSEA = 

0.06, 90% CI = 0.062–0.069.  

 

Discussion 

Emotional eating has been associated to obesity [23,37], eating 

disorders [10,37], and other factors, thus investigating such aspect is relevant 

in order to reduce these negative outcomes in the population. The use of 

questionnaires to investigate emotional eating has been shown to be a 

promising strategy, as it helps to understand affective aspects related to 

eating. In this way, the EADES can be a tool of interest, as it captures different 

affective aspects as well as coping strategies related to eating. As this 

instrument had not yet been used in Brazil, our first aim was to develop a 

Portuguese version of the EADES. As a second aim, we evaluated the 



44 
 

psychometric properties of the EADES when applied in a sample of Brazilian 

adults to ensure the validity and reliability of the data. Finally, as a third aim, 

we investigated whether sex, age, economic level, and BMI were associated 

with the concepts evaluated by the EADES aiming to find groups vulnerable to 

emotional eating. Thus, this study contributes to the literature by presenting for 

the first time, to our knowledge, Brazilian data from the EADES, which can be 

a useful instrument for future clinical and scientific protocols. 

The assessment of the validity of the EADES data showed that the 

original model, which had an adequate fit for an USA sample [7], did not fit the 

Brazilian sample. On the other hand, after refinement (i.e., deleting items), a 

factorial model proposed in a Mexican sample [2] showed good psychometric 

parameters for the Brazilian sample. These results show that a distinct factorial 

structure of the EADES was fitted for each country, which highlights the 

importance of investigating the psychometric properties of the instrument 

before its use [33]. Being this the first study that used the EADES in Brazil, 

comparisons with Brazilian data were not possible, and future studies are 

encouraged. However, we suggest that future protocols should be caution in 

using EADES when its validity and reliability for the application context is 

unknown. In addition, as countries tend to have different eating cultures, 

EADES results (i.e., scores of eating due to emotions and stress) are unlikely 

to be similar across populations. Although we did not test this relationship, it is 

consistent with the literature [38,39], which shows that culture and society 

strongly influence people's eating habits and patterns. In this way, the different 



45 
 

factorial structures found for EADES could be a reflection of the characteristics 

of each culture. 

Fitting a different model for each sex shows that women and men have 

different coping strategies involving eating during stressful and emotional 

situations. In this perspective, our findings corroborate the literature, 

highlighting important differences in emotional eating between women and 

men [40,22,24,23,41]. Although the original study did not evaluate separately 

the EADES factorial model for each sex [2], Kelly et al. [42] suggest that 

women tend to present a coping strategy focused more on emotion, aiming to 

change their emotional response to stressors. Men, on the other hand, seem 

to focus more on the problem itself, aiming to deal or eliminate the stressor 

[42]. These studies support the different factorial models found in this study. 

Our finding on reliability corroborate those presented by Ozier et al. [7] 

and Lazarevich et al. [2]. Furthermore, the original study found a higher 

reliability for the first two factors of the instrument (“Emotion- and Stress-

Related Eating” and “Appraisal of Ability and Resources to Cope with Emotions 

and Stress”) compared to the third factor (“Appraisal of Outside 

Stressors/Influences”), which was also observed in the present work. The 

original authors explain that the lower reliability of the third factor could be due 

to the smaller number of items (five) and suggest further studies to formulate 

additional items to increase the factor's reliability, which could also improve the 

observed low convergent validity. We also found adequate reliability for the 

total EADES (i.e., all items: CR ≥ 0.94; α > 0.92), which corroborates the 

literature [7,2]. These findings demonstrate that the instrument is able to 



46 
 

measure, in a consistent way, the proposed construct [33]. Thus, this 

instrument can help identify individuals who use eating as a way of coping with 

their emotions and stress and, based on the results, promote behavioral 

change – as emotional eating is a learned behavior and can be modified – to 

deal with stressful situations and develop rational coping skills. 

Concerning our last objective, the results showed that individual 

characteristics were associated with the EADES concepts. To our knowledge, 

no study using the EADES has assessed this association using structural 

equation modeling, indicating that our findings are unprecedented. First, we 

found that younger respondents reported higher levels of emotional eating. 

This finding contrasts with the results presented by the Mexican study [2], in 

which the ability to cope with emotions and stress decreased with age. On the 

other hand, Abdella et al. [25] found that younger individuals tend to eat more 

during hedonic situations when compared to older individuals. Concordantly, 

Charles and Carstensen [43] found that older individuals seem to have a 

greater ability to neutralize an emotion when facing stressful situations. These 

findings highlight the need to help the young and less experienced population 

to develop greater self-efficacy and self-confidence and prevent the habit of 

eating to cope with emotional problems [7]. 

Also, we found a significant association between BMI and self-efficacy 

and self-confidence in emotions- and stress-related eating in women and men. 

The higher the BMI the less respondents felt able to control the eating 

behavior. These data are in accordance with the literature [15,13,23,2] and 

give support to the inclusion of BMI as a factor in screening protocols to identify 



47 
 

individuals susceptible to using food as a coping strategy for emotions and 

stress. The lower sense of self-efficacy towards emotional eating found in 

women with higher socio-economic level can be explained by the greater 

purchasing power of such people giving them more access to a greater variety 

of foods including the highly processed, fat- and sugar-rich products [27]. We 

speculate that during stressful episodes, low self-efficacy or lack of control may 

contribute to higher intake of such products, but we did not find studies that 

directly compare; therefore, future studies should be carried out to investigate 

the possible relationship between economic levels and emotional eating. In 

conclusion, we hope that the individual characteristics found to be significant 

factors for emotional eating may be useful to support prevention and 

intervention measures.  

 

What is already known on this subject? 

Emotions and stress can influence people's eating behaviors and cause 

damage to their physical and mental health. The EADES can be a useful tool 

to identify these emotions, but little is known about its reliability and validity, 

especially in Brazilian context. 

 

What does this study add? 

A Portuguese language version of the EADES was developed for use 

in Brazil and different factorial models were fitted for each sex indicating that 

emotional eating is distinct between women and men. Sex, age, economic 

level, and BMI were associated to eating and appraisal due to emotions and 



48 
 

stress, which can help to direct protocols aimed at improving the people’s 

eating behavior. 

 

Limitations and Strengths 

Some limitations of this study should be mentioned. The first was the 

sampling method based on a non-probabilistic protocol, which limits the 

representativeness of the results. However, we included a large sample and 

used robust analytical strategies to partly compensate this limitation. Secondly, 

the cross-sectional study design, although commonly used and relevant for 

raising hypotheses, does not allow inference about cause-and-effect 

relationships. Third, we did not perform an invariance test for different groups 

to investigate whether the content of the EADES items is understood similarly 

by people with different characteristics. We therefore suggest that future 

studies include this analysis in their protocols. Despite these limitations, the 

study also has its strengths. The eating and nutrition process is influenced not 

only by biological factors, but also by psychological and cultural factors, such 

as emotions, memories, habits, social status, and several others. However, 

most nutritional interventions consider only biological factors and disregard all 

other elements that can influence and modify the diet. Through the present 

validation of the EADES for the Portuguese language, the concept of 

emotional eating can be assessed, thus, expanding the view of professionals 

in the field and contributing to the development of health protocols and diet 

interventions that are more efficient. 

 



49 
 

Conclusions  

The Brazilian Portuguese version of the EADES produced was well 

understood by the young Brazilian adults. The EADES original factorial model 

did not show good psychometric properties for the Brazilian data. On the other 

hand, a factorial model proposed for a Mexican context showed good 

parameters after deleting different items for both female and male samples; 

therefore, a different factorial model was fitted for each sex and is now 

available for use in similar populations. Finally, we found that age, economic 

level, and BMI were associated to eating and appraisal due to emotions and 

stress and should be considered in future protocols. 

 

Declarations 

Funding: This work was supported by the Coordination for the Improvement 

of Higher Education Personnel - Brazil (CAPES - Financing Code 001) and by 

the São Paulo Research Foundation (FAPESP, Grant 2019/19590-9). 

 

Conflicts of interest: The authors have no conflict of interest to declare. 

 

Ethics approval and consent to participate: This study was conducted 

according to the guidelines laid down in the Declaration of Helsinki, and all 

procedures involving study participants were approved by the Human 

Research Ethics Committee of the School of Pharmaceutical Sciences of 

UNESP (C.A.A.E.: 11469719.1.0000.5426). All participants signed a consent 

form. 



50 
 

Consent for publication: Not applicable. 

 

Availability of data and material: Anonymized data and analysis are 

available from the corresponding author on reasonable request. 

 

Code availability: Not applicable. 

 

Author contributions: PCS, WRS, and JADBC participated in the conception 

and design of the study. PCS wrote the first version of the manuscript. WRS, 

JM, and JADBC revised the final version of the manuscript. All authors 

contributed to the analysis and interpretation of data. 

 

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Appendix 1 
 
English (original) and Portuguese versions of the Eating and Appraisal due to Emotions and Stress (EADES) Questionnaire 
English version# Portuguese version 

Eating and Appraisal due to Emotions and Stress (EADES) 
Questionnaire 

Questionário de Avaliação da Alimentação Relacionada a Emoções e ao 
Estresse (EADES) 

Response options: 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = 
agree, 5 = strongly agree 

Opções de resposta: 1 = discordo fortemente, 2 = discordo, 3 = nem discordo, 
nem concordo, 4 = concordo, 5 = concordo fortemente 

 
2. My family supports me when I have problems 

 
2. A minha família me apoia quando eu tenho problemas 

3. I am confident I can control my eating when I feel happy 3. Eu estou confiante que consigo controlar o que como quando estou FELIZ 
4*. I overeat when I am stressed 4*. Eu como demais quando estou ESTRESSADO(A) 
5. I can usually work out a solution to my problems 5. Eu consigo geralmente encontrar uma solução para os meus problemas 
6. I am capable of handling my own problems 6. Eu sou capaz de lidar com os meus próprios problemas 
7*. I do NOT feel secure in my life 7*. Eu NÃO me sinto seguro na minha vida 

 
8. I try to find alternative solutions to my problems 
 

8. Eu tento encontrar soluções alternativas para os meus problemas 

10*. I overeat when I socialize 10*. Eu como demais socialmente 
11. I weigh the pros and cons of situations before I make decisions about 
what to do 

11. Eu pondero os prós e os contras das situações antes de tomar uma decisão 

12*. I worry about what people think of me 12*. Eu me preocupo com o que as pessoas pensam a meu respeito 
13*. I comfort myself with food 13*. Eu conforto-me com comida 
14*. I eat when I am upset with myself 14*. Eu como quando estou aborrecido(a) comigo mesmo(a) 
15*. I feel the need to make others happy 15*. Eu sinto necessidade de fazer os outros felizes 
16. I am confident I can control my eating when I am tired 16. Eu estou confiante que consigo controlar o que como quando estou 

CANSADO(A) 
18. My friends support me when I have problems 18. Os meus amigos me apoiam quando eu tenho problemas 

20*. I feel sad often 20*. Eu me sinto triste com frequência 
21. I am confident I can control my eating when I am angry 21. Eu estou confiante que consigo controlar o que como quando estou 

ZANGADO(A) 
22. I am able to meet my emotional needs 22. Eu sou capaz de satisfazer as minhas necessidades emocionais 
23*. It is hard for me to stop eating when I am full 23*. É difícil para mim, parar de comer quando estou cheio(a) 
24. I am able to say no when I need to 24. Eu sou capaz de dizer não quando preciso 



59 
 

25. I try to think positive when times are tough 25. Eu tento pensar positivo quando os tempos são difíceis 
26. I am confident I can control my eating when I am sad 26. Eu estou confiante que consigo controlar o que como quando estou TRISTE 
27. I have control over my emotions 27. Eu tenho controle sobre as minhas emoções 
28*. I eat to avoid dealing with problems 28*. Eu como para evitar lidar com problemas 
29. I talk about my feelings 29. Eu falo sobre os meus sentimentos 
30. I am confident I can control my eating when I am upset with myself 30. Eu estou confiante que consigo controlar o que como quando estou 

aborrecido(a) COMIGO MESMO 

31*. Other people influence how I handle problems 31*. As outras pessoas influenciam a forma como eu lido com os problemas 
32. I deal with problems sooner rather than later 32. Eu lido com os meus problemas mais cedo do que tarde 
33. I try to resolve a problem when I know there is something wrong in my 
life 

33. Eu tento resolver o problema quando sei que há algo de errado na minha 
vida 

34. I am confident I can control my eating when I feel upset. 34. Eu estou confiante que consigo controlar o que como quando estou 
aborrecido(a) 

35*. I feel out of control when I eat 35*. Eu sinto-me sem controle quando como 
36*. I eat when I am frustrated 36*. Eu como quando estou FRUSTRADO(A) 
37. I am capable of dealing with stressful situations 37. Eu sou capaz de lidar com situações estressantes 
38. I am confident I can control my eating when I am frustrated 38. Eu estou confiante que consigo controlar o que como quando estou 

FRUSTRADO(A) 
39*. I use food to cope with my emotions 39*. Eu uso a comida para lidar com as minhas emoções 
40. I am able to meet my spiritual needs 40. Eu consigo realizar as minhas necessidades espirituais 
41*. I eat when I am tired 41*. Eu como quando estou CANSADO(A) 
42. I do NOT allow people to change my mind 42. Eu NÃO deixo que outras pessoas me façam mudar de ideias 
43*. I eat when I am angry 43*. Eu como quando estou ZANGADO(A) 
45*. I eat when I am sad 45*. Eu como quando estou TRISTE 
46*. When a problem arises, it is hard for me to make a plan of action and 
follow it 

46*. Quando surge um problema eu tenho dificuldade em estabelecer um plano 
de ação e seguir esse plano 

47. I am confident I can control my eating when I am anxious 47. Eu estou confiante que consigo controlar o que como quando estou 
ANSIOSO(A) 

48. I do NOT see challenges as stressful 48. Eu NÃO vejo os desafios como eventos estressantes 

49. I am confident I can control my eating when I am relieved 49. Eu estou confiante que consigo controlar o que como quando estou 
DESCANSADO(A) 

50*. I eat when I am anxious 50*. Eu como quando estou ANSIOSO (A) 
51. I have control over my life 51. Eu tenho controle sobre a minha vida 
52*. I eat when I am relieved 52*. Eu como quando estou DESCANSADO(A) 
53. I try to analyze a problem to better understand it 53. Eu tento analisar o problema para melhor o compreender 



60 
 

54*. I do NOT have control over how much I eat 54*. Eu NÃO tenho controle sobre o quanto como 
Note. # Reference of the original model: Ozier et al., 2007. *Inverted items. The item numbering was preserved according to the original proposal. Factors of the  original: “Emotion- 
and Stress-Related Eating” (items 3, 4, 10, 13, 14, 16, 21, 23, 26, 28, 30, 34, 35, 36, 38, 39, 41, 43, 45, 47, 49, 50, 52 and 54), “Appraisal of Ability and Resources to Cope with 
Emotions and Stress” (items 2, 5, 6, 7, 8, 11, 18, 20, 22, 24, 25, 27, 29, 32, 33, 37, 40, 46, 51 and 53), “Appraisal of Outside Stressors/Influences” (items 12, 15, 31, 42 and 
48).Factors of the Spanish model: "Self-efficacy in Emotion- and Stress-Related Eating” (items 4, 13, 14, 23, 28, 35, 36, 39, 43, 45, 50 and 54), “Self-confidence in Emotion- and 
Stress-Related Eating” (items 3, 16, 21, 26, 30, 34, 38, 47 and 49), “Appraisal of Resources and Ability to Cope” (items 2, 5, 6, 7, 8, 11, 18, 20, 22, 33, 24, 25, 27, 29, 32, 37, 40, 
51 and 53) 
 

 



61 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fig. 1 Original and Mexican factorial models of the Eating 

and Appraisal due to Emotions and Stress (EADES) 

Questionnaire  

Note. ESRP Emotion and Stress Related Eating; AARCES Appraisal of Ability 

and Resources to Cope with Emotions and Stress, AOSI Appraisal of Outside 

Stressors/ Influences, SEESRE Self-efficacy in Emotion-and Stress- Related 

Eating, SCESRE Self-confidence in Emotion-and Stress- Related Eating, 

ARAC Appraisal of Resources and Ability to Cope 

 

 

 

Original factorial model  
 

 

Mexican factorial model 



62 
 

 

 

 

 

 

 

 

 

 

 

 

 

Fig. 2 Mexican factorial model of the Eating and Appraisal due 
to Emotions and Stress (EADES) Questionnaire fitted for the 
Brazilian sample 

Note. SEESRE Self-efficacy in Emotion-and Stress- Related Eating, SCESRE Self-

confidence in Emotion-and Stress- Related Eating, ARAC Appraisal of Resources 

and Ability to Cope 

 

 

 

 

Mexican factorial model fitted for 
the Brazilian female sample 

Mexican factorial model fitted for 
the Brazilian male sample 



63 
 

Table 1 Descriptive statistics of the Eating and Appraisal due to Emotions and Stress (EADES) Questionnaire for sample of 

Brazilian adults (Total sample: n=1,240; Female sample: n=815; Male sample: n=425) 

  Total sample Female sample Male Sample 
Item M Md Mo SD Sk Ku M Md Mo SD Sk Ku M Md Mo SD Sk Ku 

2 3.99 4 4 0.89 -1.03 1.33 3.99 4 4 0.88 -0.97 1.11 4.00 4 4 0.90 -1.15 1.73 
3 3.53 4 4 0.95 -0.73 0.17 3.49 4 4 0.95 -0.80 0.20 3.61 4 4 0.93 -0.60 0.03 
4 2.89 3 2 1.25 0.12 -1.15 3.08 3 4 1.25 -0.06 -1.16 2.54 2 2 1.19 0.48 -0.79 
5 3.56 4 4 0.89 -0.76 0.53 3.49 4 4 0.90 -0.74 0.42 3.68 4 4 0.86 -0.79 0.78 
6 3.56 4 4 0.85 -0.80 0.55 3.48 4 4 0.86 -0.78 0.39 3.71 4 4 0.82 -0.85 0.94 
7 2.50 2 2 1.05 0.46 -0.45 2.58 2 2 1.07 0.38 -0.54 2.33 2 2 0.99 0.61 -0.19 
8 3.78 4 4 0.73 -0.93 1.70 3.78 4 4 0.72 -0.84 1.42 3.79 4 4 0.77 -1.05 2.10 
10 2.73 3 2 1.05 0.22 -0.77 2.74 3 2 1.06 0.24 -0.78 2.71 3 2 1.04 0.16 -0.76 
11 3.76 4 4 0.87 -0.82 0.78 3.73 4 4 0.87 -0.82 0.68 3.81 4 4 0.85 -0.82 1.01 
12 3.33 4 4 1.15 -0.41 -0.70 3.38 4 4 1.14 -0.49 -0.58 3.22 3 4 1.15 -0.26 -0.87 
13 3.24 3 4 1.19 -0.28 -0.94 3.41 4 4 1.17 -0.43 -0.78 2.92 3 4 1.17 -0.04 -1.02 
14 2.77 3 2 1.22 0.17 -1.08 3.03 3 4 1.19 -0.03 -1.09 2.28 2 2 1.10 0.58 -0.57 
15 3.51 4 4 1.01 -0.54 -0.14 3.53 4 4 1.00 -0.56 -0.03 3.47 4 4 1.03 -0.49 -0.30 
16 3.17 3 4 1.09 -0.26 -0.81 3.13 3 4 1.09 -0.23 -0.85 3.26 3 4 1.09 -0.31 -0.70 
18 3.79 4 4 0.84 -0.87 1.24 3.85 4 4 0.81 -0.90 1.58 3.67 4 4 0.90 -0.80 0.72 
20 2.63 2 2 1.09 0.39 -0.71 2.78 3 2 1.09 0.29 -0.86 2.34 2 2 1.01 0.58 -0.26 
21 3.19 3 4 1.09 -0.27 -0.81 3.08 3 4 1.08 -0.18 -0.91 3.39 4 4 1.07 -0.46 -0.48 
22 3.28 3 4 0.97 -0.37 -0.31 3.22 3 4 0.97 -0.40 -0.33 3.39 3 4 0.97 -0.33 -0.32 
23 2.14 2 2 1.02 0.89 0.25 2.14 2 2 1.03 0.93 0.37 2.13 2 2 0.99 0.78 -0.02 
24 3.46 4 4 1.04 -0.60 -0.29 3.40 4 4 1.05 -0.57 -0.36 3.57 4 4 1.00 -0.67 -0.14 
25 3.71 4 4 0.96 -0.91 0.55 3.65 4 4 0.97 -0.81 0.22 3.84 4 4 0.93 -1.14 1.45 
26 2.99 3 4 1.13 -0.05 -1.01 2.85 3 2 1.10 0.06 -0.99 3.26 4 4 1.14 -0.31 -0.87 
27 3.11 3 3 0.99 -0.30 -0.51 2.95 3 3 0.99 -0.18 -0.60 3.41 4 4 0.92 -0.53 -0.03 
28 2.18 2 2 1.05 0.81 0.02 2.28 2 2 1.09 0.71 -0.21 1.98 2 2 0.95 0.97 0.57 
29 3.15 3 4 1.16 -0.28 -0.86 3.24 3 4 1.14 -0.35 -0.75 2.96 3 4 1.18 -0.14 -1.00 
30 3.02 3 4 1.11 -0.11 -0.85 2.89 3 3 1.07 0.00 -0.81 3.25 3 4 1.14 -0.38 -0.72 
31 2.93 3 3 1.08 -0.13 -0.80 2.99 3 3 1.08 -0.16 -0.76 2.81 3 3 1.05 -0.07 -0.85 
32 3.34 4 4 0.99 -0.47 -0.40 3.33 4 4 0.97 -0.48 -0.38 3.35 4 4 1.03 -0.46 -0.44 
33 3.80 4 4 0.86 -1.01 1.27 3.79 4 4 0.85 -1.01 1.31 3.82 4 4 0.88 -1.02 1.23 
34 3.06 3 4 1.08 -0.09 -0.86 2.90 3 2 1.04 0.01 -0.83 3.37 4 4 1.08 -0.37 -0.71 



64 
 

35 2.37 2 2 1.12 0.57 -0.47 4.46 2 2 1.15 0.49 -0.62 2.20 2 2 1.04 0.69 -0.12 
36 3.84 3 2 1.19 0.13 -1.07 3.09 3 4 1.17 -0.10 -1.06 2.36 2 2 1.05 0.53 -0.55 
37 3.41 4 4 0.95 -0.68 -0.03 3.27 3 4 0,97 -0.58 -0.31 3.69 4 4 0.86 -0.86 0.86 
38 3.00 3 4 1.08 -0.05 -0.87 2.88 3 2 1.04 0.05 -0.83 3.24 3 4 1.10 -0.31 -0.77 
39 3.02 3 4 1.25 -0.11 -1.09 3.35 4 4 1.16 -0.37 -0.75 2.38 2 2 1.17 0.43 -0.93 
40 3.43 4 4 0.90 -0.49 0.13 3.42 4 4 0.88 -0.45 0.04 3.44 4 4 0.95 -0.54 0.22 
41 2.60 2 2 1.07 0.28 -0.85 2.59 2 2 1.02 0.34 -0.74 2.62 2 2 1.14 0.19 -1.04 
42 3.03 3 3 0.94 0.14 -0.29 2.98 3 3 0.94 0.23 -0.26 3.10 3 3 0.94 -0.04 -0.26 
43 2.61 2 2 1.12 0.36 -0.78 2.72 3 2 1.12 0.27 -0.87 2.40 2 2 1.08 0.53 -0.51 
45 2.84 3 2 1.24 0.12 -1.19 3.07 3 4 1.23 -0.09 -1.20 2.40 2 2 1.14 0.52 -0.72 
46 2.63 2 2 0.97 0.38 -0.52 2.70 3 2 0.97 0.33 -0.62 2.47 2 2 0.97 0.50 -0.24 
47 2.69 2 2 1.17 0.26 -1.00 2.51 2 2 1.14 0.42 -0.85 3.03 3 4 1.14 -0.03 -1.01 
48 2.77 3 3 1.00 0.12 -0.62 2.62 3 2 0.98 0.21 -0.54 3.05 3 3 0.99 -0.08 -0.57 
49 3.63 4 4 0.96 -0.76 0.23 3.59 4 4 0.96 -0.83 0.33 3.69 4 4 0.96 -0.65 0.03 
50 3.40 4 4 1.34 -0.49 -1.03 3.68 4 4 1.27 -0.81 -0.49 2.87 3 4 1.33 0.02 -1.25 
51 3.42 4 4 0.93 -0.64 0.22 3.36 3 4 0.93 -0.62 0.16 3.53 4 4 0.93 -0.71 0.42 
52 3.11 3 4 0.95 -0.45 -0.42 3.14 3 4 0.91 -0.44 -0.39 3.05 3 4 1.03 -0.42 -0.56 
53 3.96 4 4 0.66 -0.85 2.15 3.94 4 4 0.67 -0.77 1.74 3.99 4 4 0.65 -1.02 3.00 
54 2.16 2 2 1.02 0.80 0.05 2.20 2 2 1.05 0.81 0.04 2.08 2 2 0.97 0.75 -0.07 

Note. M mean, Md median, Mo mode, SD standard deviation, Sk skewness, Ku kurtosis 

 

 

 

 

 

 



65 
 

Table 2 Standardized factorial loadings (λ) of items the Eating and Appraisal due to 

Emotions and Stress (EADES) Questionnaire of the original and Mexican models to the 

sample of Brazilian adults (Total sample: n=1,240; Female sample: n=815; Male sample: 

n=425) 

 Factorial loading (λ) 

Item 

Original# 

(Total 
sample) 

Original 
(Female 
sample) 

Original  
(Male 

sample) 

Mexican## 
(Total 

sample) 

Mexican 
(Female 
sample) 

Mexican 
(Male 

sample) 

2 0.30 0.28 0.36 0.31 0.29 0.37 
3 0.48 0.42 0.59 0.57 0.50 0.67 
4 0.69 0.65 0.71 0.75 0.71 0.78 
5 0,71 0.71 0.71 0.72 0.72 0.72 
6 0.78 0.79 0.74 0.77 0.77 0.75 
7 0.67 0.67 0.65 0.66 0.66 0.63 
8 0.56 0.58 0.56 0.57 0.58 0.58 

10 0.31 0.31 0.34 - - - 
11 0.43 0.41 0.45 0.44 0.43 0.46 
12 0.62 0.65 0.57 - - - 
13 0.68 0.70 0.59 0.73 0.75 0.65 
14 0.78 0.74 0.78 0.83 0.80 0.83 
15 0.47 0.56 0.32 - - - 
16 0.55 0.53 0.60 0.65 0.63 0.71 
18 0.05 0.09 0.07 0.08 0.12 0.10 
20 0.63 0.62 0.58 0.62 0.61 0.57 
21 0.73 0.73 0.70 0.82 0.82 0.83 
22 0.60 0.57 0.64 0.61 0.59 0.64 
23 0.55 0.60 0.52 0.59 0.64 0.57 
24 0.43 0.40 0.48 0.40 0.37 0.45 
25 0.55 0.58 0.51 0.56 0.56 0.53 
26 0.72 0.74 0.64 0.81 0.81 0.78 
27 0.70 0.68 0.66 0.69 0.67 0.66 
28 0.70 0.69 0.71 0.75 0.74 0.76 
29 0.25 0.32 0.26 0.27 0.34 0.28 
30 0.68 0.75 0.52 0.77 0.81 0.68 
31 0.80 0.83 0.75 - - - 
32 0.52 0.49 0.60 0.51 0.47 0.60 
33 0.65 0.62 0.75 0.67 0.64 0.76 
34 0.80 0.85 0.66 0.88 0.90 0.80 
35 0.63 0.64 0.60 0.68 0.69 0.66 
36 0.82 0.79 0.82 0.87 0.84 0.87 
37 0.69 0.64 0.73 0.69 0.65 0.73 
38 0.73 0.76 0.64 0.82 0.83 0.78 
39 0.83 0.80 0.82 0.88 0.86 0.86 
40 0.47 0.48 0.48 0.47 0.49 0.49 
41 0.32 0.30 0.41 - - - 
42 0.48 0.53 0.38 - - - 
43 0.55 0.51 0.58 0.61 0.58 0.65 
45 0.76 0.71 0.77 0.80 0.77 0.82 
46 0.55 0.57 0.48 - - - 
47 0.68 0.67 0.65 0.77 0.76 0.76 
48 0.70 0.63 0.72 - - - 
49 0.50 0.46 0.58 0.62 0.57 0.71 
50 0.71 0.67 0.69 0.77 0.73 0.75 
51 0.70 0.70 0.69 0.70 0.70 0.70 
52 0.13 0.61 0.23 - - - 
53 0.53 0.49 0.64 0.55 0.50 0.65 
54 0.70 0.75 0.66 0.75 0.80 0.71 

Note. 
# Ozier AD, Kendrick OW, Knol LL, Leeper JD, Perko M, Burnham J. The  ating and Appraisal Due to Emotions 

and Stress (EADES) Questionnaire: development and validation. J Am Diet Assoc. 2007;107(4):619-28.  



66 
 

## Lazarevich I, Irigoyen-Camacho ME, Velazquez-Alva Mdel C, Salinas-Avila J. Psychometric characteristics of the 
Eating and Appraisal Due to Emotions and Stress Questionnaire and obesity in Mexican university students. Nutricion 
hospitalaria. 2015;31(6):2437-44 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  

 



67 
 

Table 3 Psychometric properties of the Eating and Appraisal due to Emotions and Stress (EADES) Questionnaire fitted to the sample of 

Brazilian adults 

Factorial Model  Sample n λ χ2/gl CFI TLI RMSEA 
CI90% 

RMSEA 
DI r s2  AVE CR α 

Original (3 factors, 
49 items) 

Total 1,240 0.05–0.83 10.98 0.80 0.79 0.09 0.088–0,091 - 0.33–0.44 0.36–0.69 0.32-0.42 0.73–0.94 0.74–0.93 

Original (3 factors, 
49 items) 

Female 815 0.09–0.85 6.53 0.81 0.80 0.08 0.081–0.084 - 0.30–0.40 0.32–0.63 0.31-0.42 0.75–0.94 0.76–0.92 

Original (3 factors, 
49 items) 

Male 425 0.07–0.82 4.39 0.79 0.78 0.09 0.087–0.092 - 0.34–0.46 0.33–0.67 0.33-0.40 0.66–0.94 0.67–0.93 

Mexican (3 factors, 
40 items) 

Total 1,240 0.08–0.88 7.89 0.90 0.89 0.08 0.073–0.076 - 0.37–0.52 0.37–0.77 0.32-0.57 0.86–0.94 0.89–0.93 

Fitted Mexican (3 
factors, 37 items) 

Total 1,240 0.40–0.88 8.63 0.90 0.90 0.08 0.077–0.080 
18, 2, 

29 
-0.38– -0.52 0.37–0.77 0.37-0.57 0.88–0.95 0.89–0.93 

Mexican (3 factors, 
40 items) 

Female 815 0.12–0.90 5.07 0.90 0.90 0.07 0.068–0.073 - -0.33– -0.54 0.35–0.74 0.31-0.56 0.87–0.94 0.88–0.93 

Fitted Mexican (3 
factors, 36 items) 

Female 815 0.42–0.85 5.91 0.90 0.90 0.08 0.075–0.080 
18, 24, 
2, 29 

-0.34– -0.54 0.35–0.74 0.37-0.56 0.88–0.94 0.89–0.93 

Mexican (3 factors, 
40 items) 

Male 425 0.10–0.87 3.05 0.91 0.90 0.07 0.066–0.073 - -0.39– -0.43 0.40–0.74 0.34-0.56 0.82–0.94 0.89–0.93 

Fitted Mexican (3 
factors, 37 items) 

Male 425 0.44–0.87 3.33 0.91 0.91 0.07 0.071–0.078 
18, 2, 

29 
-0.40– -0.43 0.41–0.74 0.39-0.56 0.86–0.94 0.90–0.93 

Note. λ factorial loading, χ²/df chi-square for degrees of freedom ratio, CFI comparative fit index, TLI Tucker-Lewis Index, RMSEA root mean square error of approximation, IC90% RMSEA 
90% confidence interval, DI deleted items, r correlation between factors, s² explained variance of factors, AVE average variance extracted, CR composite reliability, α ordinal alpha 
coefficient. See fitted models in the Figure 2  
 

 
 

 

 

 

 



68 
 

Table 4 Influence of demographic variables on eating related to emotions and stress 
 Structural Model 

Variable Initial Female Final Female Initial Male Final Male 
Independent Dependent β SE p β SE p β SE p β SE p 

Age SEESRE -0.158 0.036 <0.001* -0.158 0.036 <0.001* -0.219 0.051 <0.001* -0.227 0.050 <0.001* 
Economic Level SEESRE 0.081 0.033 0.014* 0.081 0.033 0.014* 0.053 0.048 0.275 - - - 
BMI SEESRE 0.229 0.033 <0.001* 0.229 0.033 <0.001* 0.262 0.047 <0.001* 0.262 0.046 <0.001* 
Age SCESRE 0.102 0.040 0.010* 0.102 0.040 0.010* 0.052 0.055 0.344 - - - 
Economic Level SCESRE -0.004 0.034 0.912 - - - 0.068 0.049 0.168 - - - 
BMI SCESRE -0.093 0.035 0.009* -0.093 0.035 0.008* -0.131 0.052 0.011* -0.131 0.051 0.011* 
Age ARAC 0.239 0.037 <0.001* 0.239 0.037 <0.001* 0.143 0.055 0.009* 0.133 0.054 0.013* 
Economic Level ARAC -0.003 0.035 0.933 - - - 0.070 0.051 0.169 - - - 
BMI ARAC -0.048 0.035 0.169 - - - -0.057 0.053 0.283 - - - 

Note. SEESRE Self-efficacy in Emotion- and Stress-Related Eating, SCESRE Self-confidence in Emotion- and Stress-Related Eating, ARAC Appraisal of 
Resources and Ability to Cope, β standardized estimate, SE standard error, * p < 0.05. The dependent variables represent the factors of the fitted factorial 

model for the Brazilian sample of the Eating and Appraisal due to Emotions and Stress (EADES) Questionnaire 

 

 

 

 



69 
 

 

 

 

 

 

 
 

Capítulo 2.  
 

Adaptação transcultural e investigação psicométrica da Escala de 

Estresse na Alimentação de Salzburg (SSES) para uma amostra de 

adultos brasileiros b 

_________________________ 

b Artigo publicado no Cadernos de Saúde Pública (Santos PC, Silva WRD, Marôco J, Campos 
JADB. Adaptação transcultural e investigação psicométrica da Escala de Estresse na 
Alimentação de Salzburg (SSES) para uma amostra de adultos brasileiros [Cross-cultural 
adaptation and psychometric investigation of the Salzburg Stress Eating Scale (SSES) in a 
sample of Brazilian adults]. Cad Saude Publica. 2021 Aug 30;37(8):e00025321. Portuguese. 
doi: 10.1590/0102-311X00025321. Este é um artigo publicado em acesso aberto sob uma 
licença Creative Commons. 



70 
 

Adaptação transcultural e investigação psicométrica da Salzburg 
Stress Eating Scale (SSES) para uma amostra de adultos brasileiros 

 
Resumo 
 
Os objetivos deste estudo