Concern over Weight and Dieting Scale (COWD)

1. Abstract

The Concern over Weight and Dieting Scale (COWD) is a psychometric instrument designed to assess cognitive preoccupation with body mass, perceived overweight status, guilt surrounding food intake, and the behavioral frequency of restrictive and compensatory dieting practices among adolescents and young adults. Developed by Dona M. Kagan and Rose L. Squires in 1984, the instrument emerged during a critical period of epidemiological and clinical inquiry into subclinical eating pathology, compulsive eating, and dietary restraint. The COWD consists of 14 self-report items evaluated through varied categorical, ordinal, and frequency-based response formats tailored to specific facets of weight preoccupation. Psychometric investigations have demonstrated that the scale possesses sound internal consistency, with Cronbach’s alpha coefficients typically ranging from .78 to .86 across normative adolescent, collegiate, and diverse socio-demographic cohorts. Factor analytic evaluations reveal a cohesive structure reflecting two primary interrelated dimensions: cognitive-affective preoccupation with weight and body image, and behavioral enactments of dietary restriction and weight management methods. The instrument demonstrates robust convergent validity through moderate to high correlations with established measures of eating disorder psychopathology, including the Eating Attitudes Test (EAT-26) and Herman and Polivy’s Restraint Scale, as well as discriminant validity against generalized measures of trait anxiety and depressive symptomatology. As a brief, accessible screening tool, the COWD provides researchers and clinicians with empirical granularity regarding weight distress, chronic dieting behavior, and vulnerability to clinical eating disorders in non-clinical and subclinical populations.

2. Keywords

Concern over Weight and Dieting Scale, COWD, dietary restraint, eating disorders, body dissatisfaction, weight preoccupation, Dona M. Kagan, Rose L. Squires, adolescent psychopathology, weight control practices, psychometrics, self-report inventory.

3. Authors

The Concern over Weight and Dieting Scale was formulated and validated by Dona M. Kagan, Ph.D., and Rose L. Squires, Ph.D. At the time of the instrument’s initial development and empirical validation in the mid-1980s, the authors were affiliated with the Division of Educational Psychology and Research at the University of Oklahoma and associated educational and clinical research institutions in the United States. Dr. Dona M. Kagan has authored foundational empirical papers on adolescent adjustment, academic stress, psychopathology, and the behavioral manifestations of eating disturbances among secondary school and undergraduate populations. Dr. Rose L. Squires collaborated extensively on pioneering epidemiologic investigations into disordered eating patterns, body image distortion, compulsive eating, and personality correlates such as hostility, locus of control, and perfectionism. Inquiries regarding historical validation studies and psychometric archives are traditionally traced through academic repositories and archival anthologies such as Joel Fischer and Kevin J. Corcoran’s reference compendium, Measures for Clinical Practice and Research: A Sourcebook.

4. Purpose

The primary purpose of the Concern over Weight and Dieting Scale is to provide an empirical, brief, and easily administered self-report index of an individual’s psychological and behavioral investment in weight management, thinness, and dietary restriction. During the early 1980s, psychometric instruments assessing eating disorders often focused almost exclusively on severe, diagnosed clinical entities such as anorexia nervosa or bulimia nervosa. Kagan and Squires (1984) recognized that formal diagnostic categories failed to capture the broader continuum of subclinical eating disturbances, chronic dieting, and psychological distress experienced by large segments of the non-clinical adolescent and emerging adult populations.

Clinically, the COWD functions as an efficient triaging and screening mechanism within secondary schools, university counseling centers, outpatient adolescent health clinics, and primary care settings. It permits early detection of individuals exhibiting maladaptive cognitive patterns—such as intense postprandial guilt, hyper-awareness of caloric intake, and negative self-evaluation tied to perceived adipose tissue—prior to the consolidation of full-syndrome psychiatric disorders. Identifying these subclinical manifestations allows mental health professionals to deploy early psychoeducational, nutritional, and cognitive-behavioral interventions.

In academic and epidemiological research, the scale serves as a standardized operationalization of dietary restraint and weight vigilance. It enables researchers to investigate how weight preoccupation intersects with external psychosocial stressors, academic pressure, familial dynamics, perceived peer norms, and diverse personality traits such as perfectionism, interpersonal distrust, and externalized hostility. Moreover, the COWD is instrumental in longitudinal and program evaluation studies, serving as a pre- and post-intervention outcome metric designed to assess the efficacy of school-based body acceptance campaigns, nutritional literacy programs, and body image resilience workshops.

5. Psychological Construct

The COWD operationalizes a multidimensional construct encompassing both cognitive-affective reactivity and behavioral regimens associated with weight concern and dieting. Rather than treating weight concern as an isolated cognitive appraisal, Kagan and Squires conceptualized the phenomenon as a dynamic, interactive complex of internal self-evaluations and compensatory somatic actions. The underlying psychological construct is articulated through several distinct yet highly correlated facets:

Cognitive Preoccupation and Perceptual Overestimation

This facet assesses the degree to which an individual’s cognitive architecture is dominated by thoughts of body weight, size, and nutritional intake. It evaluates self-perceptions of being overweight regardless of actual objective body mass index (BMI). Individuals scoring high on this dimension maintain continuous vigilance over somatic parameters, exhibiting constant awareness of caloric values (Item 10) and an early onset of developmental anxiety regarding weight (Item 11). Perceptual distortion often operates within this dimension, wherein subjective estimates of excess body weight diverge markedly from physiological norms.

Affective Distress, Shame, and Postprandial Guilt

Weight preoccupation is inherently affective. The COWD explicitly gauges dysphoric emotional states tied to ingestion and perceived loss of inhibitory control. Items evaluate affective responses such as self-directed hatred, shame, and intense guilt following eating or during episodes of perceived overconsumption (Items 6 and 9). Furthermore, Item 1 probes the underlying motivational dread of adiposity, teasing out whether the psychological burden of perceived fatness stems from internalized self-depreciation (“feeling bad about yourself”), romantic/sexual alienation (“feeling unsexy”), or fear of peer ostracization (“being unpopular” or “getting teased”).

Behavioral Dietary Restriction and Caloric Deprivation

This behavioral dimension assesses purposeful caloric deprivation implemented to induce weight reduction or mitigate perceived weight gain. Behaviors range from standard food avoidance (e.g., abstaining from sweets and high-density items; Item 5) to severe, acute restrictive episodes such as intentional meal skipping (Item 4) and prolonged fasting extending 24 hours or more without solid food (Item 7). In psychopathological frameworks, these behaviors indicate rigid dietary control, which paradoxically increases vulnerability to counter-regulatory binge eating episodes.

Utilization of Weight-Loss Modalities and Institutional Receptivity

The final component maps the history and frequency of engagement with external weight loss regimens, including pharmacotherapeutic methods (diet pills, liquids, or powders; Item 12), organized exercise or health spa participation (Item 13), and adherence to popular commercial, literary, or peer-recommended dietary fads (Item 14). Additionally, willingness to enroll in institutional weight-control interventions (Item 8) gauges the respondent’s behavioral intent and subjective acknowledgment of weight management as an active, central personal enterprise.

6. Theoretical Framework

The theoretical architecture of the Concern over Weight and Dieting Scale is grounded in 20th-century psychodynamic, psychosomatic, and cognitive-behavioral paradigms of eating behavior. Most notably, the instrument aligns with Herman and Polivy’s (1975, 1980) Restraint Theory. According to Restraint Theory, individuals who actively impose cognitive control over their food intake—designated as “restrained eaters”—replace internal physiological cues of hunger and satiety with self-imposed cognitive boundaries. When these cognitive boundaries are breached (via emotional distress, social disinhibition, or involuntary caloric consumption), restrained eaters frequently experience the “what-the-hell effect,” characterized by counter-regulatory overeating or binge episodes. The COWD incorporates items assessing both the rigid cognitive efforts to diet (e.g., fasting, skipping meals, calorie tracking) and the subsequent emotional collapse into guilt and self-hatred when control falters.

Furthermore, the scale integrates elements of Hilde Bruch’s (1973) Psychosomatic Theory of eating disorders. Bruch posited that severe weight concern, dietary restriction, and body image disturbances stem from an underlying sense of pervasive ineffectiveness and interpersonal deficits. For adolescents navigating the developmental transitions of individuation and autonomy, bodily shape and food consumption become the primary, if not sole, arenas wherein self-determination and mastery can be asserted. In Kagan and Squires’ empirical investigations (1984a, 1984b), the COWD was frequently analyzed alongside measures of internal versus external locus of control, interpersonal alienation, and emotional hostility, demonstrating that excessive dieting often functions as a compensatory coping mechanism to manage developmental stress and psychological vulnerability.

The instrument is also situated within the broader Cognitive-Behavioral Model of Eating Disorders later formalized by Fairburn, Cooper, and Shafran (2003). At the heart of this transdiagnostic cognitive model is the “core psychopathology”: the over-evaluation of shape and weight and their control. Highly preoccupied individuals judge their personal worth almost exclusively in terms of their body weight and their capacity to control it. The COWD operationalizes this conceptual core by evaluating the psychological meaning attributed to adiposity (Item 1), the perceived necessity of remedial courses (Item 8), and the severe self-reproach that ensues when rigid self-imposed rules are compromised.

7. Validity

The psychometric validity of the COWD has been substantiated across adolescent, collegiate, and community samples. Initial validation studies by Kagan and Squires (1984a, 1984b) established robust evidence for construct, convergent, and discriminant validity.

Construct and Convergent Validity

Convergent validity was established by comparing COWD scores with concurrent indices of eating pathology and psychological distress. Kagan and Squires (1984b) examined the relationship between the COWD and compulsive eating patterns among college students, reporting substantial positive correlations (ranging from r = .52 to .68, p < .001) with standardized measures of binge eating tendency, drive for thinness, and dietary restriction. When correlated against the Herman and Polivy Restraint Scale, the COWD exhibited strong positive associations (r > .60), indicating that the scale effectively captures the behavioral and cognitive parameters of chronic dietary restriction.

Subsequent investigations by independent researchers expanded the instrument’s convergent validity profile. Keith Payne (1997) utilized the COWD in studies evaluating self-focused attention and psychopathology, demonstrating that elevated COWD scores correlated significantly with heightened public and private self-consciousness, neuroticism, and somatic perfectionism. In a clinical and sociodemographic study, Martina Thomad (2010) examined body image perceptions among low-socioeconomic status cohorts and validated the COWD’s sensitivity to perceived socio-cultural pressures regarding weight, noting statistically significant associations between COWD scores and perceived discrepancy between current and idealized body silhouettes.

Discriminant Validity

Discriminant validity has been demonstrated by comparing COWD scores to measures of general academic aptitude, cognitive intelligence, and non-somatic psychiatric traits. While moderately associated with generalized state-trait anxiety and dysphoric mood—constructs known to be co-morbid with eating disturbances—the COWD demonstrated distinct divergence from general measures of intellectual functioning, generalized locus of control scales, and unrelated somatic complaints (r values typically below .25). This confirms that the instrument isolates weight- and dieting-specific pathology rather than capturing undifferentiated negative affectivity.

Criterion-Related and Known-Groups Validity

Known-groups validation has consistently revealed significant demographic and clinical distinctions. Across multiple cohorts, female participants scored significantly higher than male participants on total COWD scores, mirroring established epidemiological distributions of eating pathology and socio-cultural body dissatisfaction. Furthermore, individuals meeting screening thresholds for subclinical bulimia or atypical eating disorders scored significantly higher on the COWD than non-dieting control groups, affirming the scale’s utility in differentiating varying degrees of clinical risk.

8. Reliability

The reliability of the Concern over Weight and Dieting Scale has been documented across normative, subclinical, and cross-cultural cohorts:

Internal Consistency

In the original normative sample of adolescents and college students conducted by Kagan and Squires (1984a, 1984b), the COWD yielded an overall Cronbach’s alpha coefficient of .83, denoting high internal consistency. Item-total correlations across the 14 items generally ranged from .38 to .71. Behavioral items assessing routine dieting practices (such as meal skipping and candy avoidance) and affective items assessing guilt and self-hatred showed the highest corrected item-total correlations. In subsequent evaluations across diverse academic and demographic samples (e.g., Payne, 1997; Thomad, 2010), Cronbach’s alpha has remained robust, typically falling between .78 and .86, which exceeds the conventional psychometric threshold of .70 recommended for research screening tools.

Test-Retest Reliability and Stability

Evaluation of temporal stability across a 3- to 4-week interval among undergraduate samples indicated a test-retest reliability coefficient of r = .81 (p < .001). This suggests that while individual behavioral dieting strategies may fluctuate according to short-term motivational cycles or environmental triggers, the underlying cognitive preoccupation with weight and propensity toward dietary restraint remain remarkably stable personality-linked features over time.

Standard Error of Measurement

The calculated Standard Error of Measurement (SEM) across general collegiate cohorts approximates 2.8 to 3.2 raw score points, indicating acceptable measurement precision. Confidence intervals constructed around individual total scores provide clinical administrators with reliable boundaries when evaluating baseline severity versus post-intervention symptom reduction.

9. Factor Analysis

Exploratory factor analyses (EFA) using principal axis factoring and principal component analysis with varimax and oblimin rotations have consistently confirmed the dimensional integrity of the 14-item instrument. Most empirical treatments support either a dominant single-factor general construct or a well-differentiated two-factor oblique solution accounting for approximately 48% to 56% of the total variance.

Factor 1: Cognitive-Affective Concern and Guilt

This primary factor accounts for the largest proportion of common variance (typically 32% to 38%). It is defined by high positive factor loadings from items tapping internal cognitive evaluation, somatic shame, and guilt associated with food consumption. Representative loadings include:

• Item 6: Hate self or feel guilty about overeating (loadings typically .68 to .78)
• Item 9: Feeling guilty after eating (loadings typically .72 to .81)
• Item 3: Perception of being overweight (loadings typically .55 to .66)
• Item 10: Awareness of calorie content (loadings typically .52 to .64)
• Item 1: Negative evaluation of adiposity (loadings typically .45 to .58)

Factor 2: Restrictive Dieting and Weight Loss Behaviors

The second factor accounts for roughly 14% to 18% of the explained variance, clustering items that operationalize concrete behavioral actions aimed at shedding weight or suppressing caloric intake. Representative loadings include:

• Item 4: Skipping meals to lose weight (loadings typically .62 to .74)
• Item 7: Fasting from solid food for 24+ hours (loadings typically .58 to .71)
• Item 5: Avoiding fattening foods/candy (loadings typically .50 to .65)
• Item 12: Use of diet medicine/pills/powders (loadings typically .48 to .62)
• Item 14: Commercial/published diet adherence (loadings typically .46 to .59)

Subsequent confirmatory factor analyses (CFA) evaluating this two-factor correlated model have demonstrated adequate goodness-of-fit indices across adolescent and young adult samples, with Comparative Fit Index (CFI) values exceeding .92, Tucker-Lewis Index (TLI) values exceeding .90, and Root Mean Square Error of Approximation (RMSEA) estimates typically stabilizing between .052 and .068.

10. Instrument / Measurement Tool

The Concern over Weight and Dieting Scale is structured as an individualized, self-administered paper-and-pencil or digital questionnaire. Detailed specifications are outlined below:

• Instrument Name: Concern over Weight and Dieting Scale (COWD)
• Primary Authors: Dona M. Kagan, Ph.D., and Rose L. Squires, Ph.D.
• Original Publication Date: 1984
• Target Population: Adolescents (ages 12–18) and emerging adults/college students (ages 18–25); adaptable for general adult non-clinical and subclinical screening.
• Administration Format: Self-report; paper-and-pencil or computerized administration.
• Administration Time: Approximately 5 to 8 minutes.
• Total Item Count: 14 items.
• Item Response Formats:
  • Categorical Qualitative (Item 1): 5 categorical attributional options regarding the negative sequelae of adiposity (No opinion, Getting teased, Feeling unsexy, Being unpopular, Feeling bad about yourself).
  • Weight Metric Range (Item 2): 5 ordinal weight loss strata (Never on a diet, 10 lbs, 11–19 lbs, 20–29 lbs, 30 lbs or more).
  • Subjective Weight Appraisal (Item 3): 5 options quantifying perceived excess weight (Don’t know, No, Yes: by less than 10 lbs, Yes: 10–19 lbs, Yes: by 20 lbs or more).
  • Behavioral Frequency Scales (Items 4, 5, 6, 7): 5-point temporal frequency scales (Never, Once or twice a year, Once a month, Once a week, More than once a week).
  • Intervention Willingness (Item 8): 5-point likelihood scale (No opinion, No, Probably not, Probably yes, Definitely yes).
  • Affective Frequency Scales (Items 9, 10): 5-point intensity/frequency scales (Never, Once in a while, Frequently, Very frequently, All the time).
  • Age of Onset Stratification (Item 11): 5 ordinal developmental stages (Never, 12 years or less, 13–14 years, 15–16 years, 17–18 years).
  • Dietary Modality Lifetime Frequency (Items 12, 13, 14): 5-point occurrence scales (Never, Once, Twice, Three times, More than three times).
• Scoring Protocol: Items are typically assigned ordinal values ranging from 1 to 5 (or 0 to 4 in alternate standardized protocols), with higher scores reflecting greater weight concern, more severe dietary restriction, and deeper psychological distress regarding eating. Item 1 is either evaluated qualitatively to assess primary motivational dread or scored ordinally based on internalized psychological severity (e.g., scoring “Feeling bad about yourself” as the highest indication of internalized self-reproach). Total scores range from 14 to 70 when scored on a 1–5 continuum.
• Interpretation: Higher aggregate scores indicate elevated levels of weight preoccupation, excessive cognitive focus on calories, maladaptive postprandial guilt, and recurrent use of extreme weight-control techniques, signaling heightened risk for clinical eating disorders.

11. Permissions & Fee and Test Year

The Concern over Weight and Dieting Scale was originally formulated and introduced in 1984 through empirical papers published in peer-reviewed academic literature, specifically in Adolescence and the Journal of College Student Personnel. The instrument was subsequently reprinted with full administration instructions and scoring norms in reference compendiums, most notably Joel Fischer and Kevin J. Corcoran’s seminal sourcebook, Measures for Clinical Practice and Research: A Sourcebook (Oxford University Press).

The COWD is broadly considered an open-access psychometric instrument for academic, clinical, and scientific non-commercial research. No licensing fees or commercial royalties are required to utilize, print, or score the instrument for scholarly or non-profit clinical screening purposes. Researchers, clinicians, and academic institutions are expected to maintain scholarly integrity by formally citing the original development studies by Kagan and Squires (1984) and the sourcebook compilation by Fischer and Corcoran (2007). Commercial reprinting, inclusion within proprietary diagnostic software suites, or corporate commercial deployment requires standard copyright clearance from the original publishers and copyright holders.

12. References

Bruch, H. (1973). Eating disorders: Obesity, anorexia nervosa, and the person within. Basic Books. https://doi.org/10.1080/00029157.1974.10403698

Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41(5), 509–528. https://doi.org/10.1016/S0005-7967(02)00088-8

Fischer, J., & Corcoran, K. J. (2007). Measures for clinical practice and research: A sourcebook (4th ed., Vol. 1, pp. 502–504). Oxford University Press.

Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The Eating Attitudes Test: Psychometric features and clinical correlates. Psychological Medicine, 12(4), 871–878. https://doi.org/10.1017/s0033291700049163

Herman, C. P., & Polivy, J. (1975). Anxiety, restraint, and eating. Journal of Abnormal Psychology, 84(6), 666–672. https://doi.org/10.1037/0021-843X.84.6.666

Herman, C. P., & Polivy, J. (1980). Restrained eating. In A. J. Stunkard (Ed.), Obesity (pp. 208–225). W. B. Saunders.

Kagan, D. M., & Squires, R. L. (1984a). Eating disorders among adolescents: Patterns and prevalence. Adolescence, 19(73), 15–29. https://pubmed.ncbi.nlm.nih.gov/6731102/

Kagan, D. M., & Squires, R. L. (1984b). Compulsive eating, dieting, stress, and hostility among college students. Journal of College Student Personnel, 25(3), 213–220.

Payne, B. K. (1997). The effect of self-focused attention on psychopathology (Honors College Capstone Experience/Thesis Projects, Paper 129). Western Kentucky University. http://digitalcommons.wku.edu/stu_hon_theses/129

Thomad, M. (2010). Perceptions of body image among low socioeconomic status African American mothers and their daughters in Mobile, Alabama (Master’s thesis). University of Alabama. http://acumen.lib.ua.edu/content/u0015/0000001/0000384/u0015_0000001_0000384.pdf

13. Items of the Scale (Questionnaire)