Identifying eating behaviour phenotype cut-off scores for childhood obesity: an individual participant data meta-analysis using the Child Eating Behaviour Questionnaire (CEBQ)
23 affiliations
- 1Institute of Metabolic Science Epidemiology, University of Cambridge
- 2Department of Health and Primary Care, University of Cambridge
- 3School of Food Science and Nutrition, University of Leeds
- 4Department of Psychology, Norwegian University of Science and Technology
- 5Department of Psychology, Education and Child Studies, Erasmus University Rotterdam
- 6School of Food and Nutritional Sciences, University College Cork
- 7Department of Pediatrics, University of Minnesota
- 8Faculty of Food Sciences and Nutrition, University of Porto
- 9Department of Paediatrics, Division of Paediatric Cardiology Erasmus MC-Sophia Children’s Hospital Rotterdam
- 10Faculty of Kinesiology, Sport, & Recreation, University of Alberta
- 11Department of Social and Behavioral Sciences, College of Public Health, Temple University
- 12Alpert Medical School of Brown University and The Miriam Hospital
- 13School of Sport, Exercise and Health Sciences, Loughborough University
- 14Department of Psychology, University of Liverpool
- 15Department of Psychiatry, McGill University
- 16Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth College
- 17Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland
- 18Department of Nutrition, Federal University of Pelotas
- 19Department of Pediatrics, University of Michigan
- 20USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine
- 21Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine
- 22School of Psychology, University of Leeds
- 23Department of Behavioural Science and Health, University College London
Abstract
Background Weight management interventions targeting appetitive traits show promise in treating childhood obesity, yet a tool to identify appetitive phenotypes for personalised treatment is missing. The Child Eating Behaviour Questionnaire (CEBQ) is a widely used measure of eight parent-reported appetitive traits associated with childhood obesity. We aimed to explore the utility of the CEBQ for phenotyping childhood obesity and derive cut-off scores to support clinical decision-making. Methods This individual participant data meta-analysis combined cross-sectional data from 17 international studies (N = 15,273) on CEBQ scores and Body Mass Index Standard Deviation Scores from children (2–18 years). The potential of CEBQ subscales (Food Responsiveness, Enjoyment of Food, Emotional Over-eating, Desire to Drink, Satiety Responsiveness, Slowness in Eating, Emotional Under-eating, Food Fussiness) to discriminate weight status was explored in random-effect meta-analyses of Area Under the Curve (AUC) metrics. We explored heterogeneity across studies and age- and sex- specific subgroups. Cut-off scores were derived within subgroups using (a) the Youden’s Index and (b) the point maximising specificity after a minimum sensitivity of 60%. We meta-analysed study-specific performance with the selected cut-offs to describe heterogeneity across studies. Results AUCs for CEBQ subscales ranged from 0.60 to 0.71. The magnitude and shape of associations between CEBQ scores and obesity varied by age and sex. Cut-off performance was generally better in middle- than early childhood. The best performing cut-off score of 2.6 was observed for females aged 7–12 years for Food Responsiveness (Sensitivity: 0.81 [95%CI 0.77, 0.85]; Specificity: 0.85 [95%CI 0.82, 0.88]). High heterogeneity in cut-off performance across studies and wide prediction intervals suggest the need to further investigate external validity. Conclusions We provide the first empirically derived CEBQ subscale cut-offs to phenotype children with obesity based on weight-related eating behaviours. Cut-offs could support personalised treatment in clinical and research contexts. Funding MC_UU_00006/6 and MC_UU_00006/5.
Related
- Vitamin D supplementation to prevent tuberculosis infection and disease: systematic review and individual participant data meta-analysis of randomised controlled trials
- Efficacy and safety of finerenone in patients with chronic kidney disease: an individual participant data pooled analysis (INFINITY)
- Intravascular imaging-guided versus angiography-guided percutaneous coronary intervention: a reconstructed individual participant data meta-analysis of randomized controlled trials of intravascular ultrasound- and optical coherence tomography-guided strategies
- Omega‐6 Polyunsaturated Fatty Acids and Peripheral Artery Disease: An Individual Participant‐Level Analysis of 9 International Prospective Studies
- Pooling individual off-pump and on-pump coronary artery bypass patient records from three contemporary multicenter, randomized, controlled trials: an individual participant data meta-analysis protocol
BibTeX
@article{kudlek2026identifying,
title = {{Identifying eating behaviour phenotype cut-off scores for childhood obesity: an individual participant data meta-analysis using the Child Eating Behaviour Questionnaire (CEBQ)}},
author = {Laura Kudlek and Andrea D. Smith and Cara F. Ruggiero and Lisa Pennells and Alice R. Kininmonth and Silje Steinsbekk and Pauline W. Jansen and Amy L. Ahern and Elaine K. McCarthy and Amy Gross and Victor Viana and Arend W. van Deutekom and John C. Spence and Jennifer Orlet Fisher and Jacqueline Hayes and Emma Haycraft and Charlotte A. Hardman and Patricia P. Silveira and Jennifer A. Emond and Aino-Maija Eloranta and Darlise R. dos Passos Gomes and Julie C. Lumeng and Matthew B. Cross and Susan Carnell and Alison Fildes and Clare Llewellyn},
journal = {International Journal of Behavioral Nutrition and Physical Activity},
year = {2026},
month = jul,
doi = {10.1186/s12966-026-01951-8},
url = {https://doi.org/10.1186/s12966-026-01951-8},
note = {CC BY},
}
RIS
TY - JOUR
TI - Identifying eating behaviour phenotype cut-off scores for childhood obesity: an individual participant data meta-analysis using the Child Eating Behaviour Questionnaire (CEBQ)
AU - Laura Kudlek
AU - Andrea D. Smith
AU - Cara F. Ruggiero
AU - Lisa Pennells
AU - Alice R. Kininmonth
AU - Silje Steinsbekk
AU - Pauline W. Jansen
AU - Amy L. Ahern
AU - Elaine K. McCarthy
AU - Amy Gross
AU - Victor Viana
AU - Arend W. van Deutekom
AU - John C. Spence
AU - Jennifer Orlet Fisher
AU - Jacqueline Hayes
AU - Emma Haycraft
AU - Charlotte A. Hardman
AU - Patricia P. Silveira
AU - Jennifer A. Emond
AU - Aino-Maija Eloranta
AU - Darlise R. dos Passos Gomes
AU - Julie C. Lumeng
AU - Matthew B. Cross
AU - Susan Carnell
AU - Alison Fildes
AU - Clare Llewellyn
PY - 2026
DA - 2026/07/01
JO - International Journal of Behavioral Nutrition and Physical Activity
DO - 10.1186/s12966-026-01951-8
UR - https://doi.org/10.1186/s12966-026-01951-8
AB - Background Weight management interventions targeting appetitive traits show promise in treating childhood obesity, yet a tool to identify appetitive phenotypes for personalised treatment is missing. The Child Eating Behaviour Questionnaire (CEBQ) is a widely used measure of eight parent-reported appetitive traits associated with childhood obesity. We aimed to explore the utility of the CEBQ for phenotyping childhood obesity and derive cut-off scores to support clinical decision-making. Methods This individual participant data meta-analysis combined cross-sectional data from 17 international studies (N = 15,273) on CEBQ scores and Body Mass Index Standard Deviation Scores from children (2–18 years). The potential of CEBQ subscales (Food Responsiveness, Enjoyment of Food, Emotional Over-eating, Desire to Drink, Satiety Responsiveness, Slowness in Eating, Emotional Under-eating, Food Fussiness) to discriminate weight status was explored in random-effect meta-analyses of Area Under the Curve (AUC) metrics. We explored heterogeneity across studies and age- and sex- specific subgroups. Cut-off scores were derived within subgroups using (a) the Youden’s Index and (b) the point maximising specificity after a minimum sensitivity of 60%. We meta-analysed study-specific performance with the selected cut-offs to describe heterogeneity across studies. Results AUCs for CEBQ subscales ranged from 0.60 to 0.71. The magnitude and shape of associations between CEBQ scores and obesity varied by age and sex. Cut-off performance was generally better in middle- than early childhood. The best performing cut-off score of 2.6 was observed for females aged 7–12 years for Food Responsiveness (Sensitivity: 0.81 [95%CI 0.77, 0.85]; Specificity: 0.85 [95%CI 0.82, 0.88]). High heterogeneity in cut-off performance across studies and wide prediction intervals suggest the need to further investigate external validity. Conclusions We provide the first empirically derived CEBQ subscale cut-offs to phenotype children with obesity based on weight-related eating behaviours. Cut-offs could support personalised treatment in clinical and research contexts. Funding MC_UU_00006/6 and MC_UU_00006/5.
SN - 1479-5868
ER -