266456 Overeater's CAGE: A screening questionnaire for overeating behaviors among teens

Tuesday, October 30, 2012

Scott Frank, MD, MS , Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH
Deanna Shuster, MPH Candidate , MPH Program, Case Western Reserve University, Cleveland, OH
Background: This project explores adolescent overweight and obesity by examining not what teens eat, but how they eat. The 4-item Overeater's CAGE was developed to examine the relationship of overeating with nutritional and fitness variables; and with other health behaviors and outcomes. While researchers have investigated overeating in an addiction model, it is unclear what proportion of the teen obesity epidemic is attributable to “Food Addiction,” that may fit this paradigm. Methods: This study, conducted in a diverse Midwestern suburban high school (n=1272), utilizes the Youth Risk Behavior Survey and the Overeater's CAGE based, on the alcohol CAGE questionnaire modified for eating behavior. Paralleling the alcohol CAGE, this instrument addresses Control; Affect; Guilt; and Eye-opener. Analysis includes reliability testing; factor analysis; descriptive statistics; and tests of association including chi-square, t-tests, ANOVA/MANOVA; and logistical regression. Results: The Overeater's CAGE is a one-dimensional scale demonstrating strong reliability (alpha=.80, all items contribute). There is a significant relationship between BMI and the Overeater's CAGE (F=4.09, p=.003). Among teens, 21.1% often or always demonstrate loss of control over eating; 15.3% report stress related eating; 15.9% relate feelings of guilt regarding their eating; and 19.1% report eye-opening eating behavior. Overeater's CAGE scores show stronger relationships than BMI with lower physical activity, more soda consumption, poorer mental and physical health, higher spiritual dissonance, and higher rates of tobacco and alcohol use. Conclusion: The Overeater's CAGE offers useful insights regarding teen eating patterns associated with unhealthy behavior and health outcomes that may be applied in clinical and public health settings.

Learning Areas:
Assessment of individual and community needs for health education
Chronic disease management and prevention
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
List the domains addressed by the Overeater’s CAGE and the items addressing these domains. Describe the utility of screening for overeating behaviors rather than quantity or quality of food consumed. Identify relationships between the Overeater’s CAGE responses and health and obesity related outcomes.

Keywords: Obesity, Adolescent Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Family Physician and public health practitioner. Director of a local health department; director of the community coalition gather data used in this study; director of CWRU MPH program. Involved with development of brief measures for public health and primary care practice.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.