Development of the Weight Management Skills Questionnaire in a Prebariatric Surgery Sample

Background: Weight loss after bariatric surgery is largely predicted by adherence to diet and lifestyle changes. There is no validated measure of self-reported adherence to a range of behaviors including self-monitoring, portion control, healthy food choice, and awareness of hunger and satiety. Objectives: The goal of the present study was to develop and provide initial evidence for the validity of the Weight Management Skills Questionnaire, a measure of adherence to these changes, by identifying its factor structure and relating the total score and subscale scores to baseline BMI, weight change during a preoperative education program, dysregulated eating, and binge eating disorder (BED). Setting: University hospital, USA. Methods: Four hundred twenty-two bariatric surgery candidates responded the WMSQ and measures of eating behavior. Weight collected at the beginning, midpoint, and end of the presurgical program was used to compute percent total weight loss (%TWL) prior to surgery. Hierarchical factor analysis was used to explore the factor structure of the WMSQ while allowing the items to load onto a single general factor reflecting overall adherence to behavioral weight management. Results: The WMSQ has three interpretable subfactors, with all items loading onto the general factor. All scales were unrelated to starting BMI; total score and subfactors measuring general and bariatric-specific weight management skills were associated with %TWL. The scale measuring hunger/satiety responsiveness was negatively related to dysregulated eating/BED. Conclusions: The WMSQ may be a useful tool in future research exploring the key weight management skills associated with successful weight loss before and after bariatric surgery.