1 Department of Psychology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada.
2 Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, QC, H3A 1G1, Canada.
3 Faculty of Land and Food Systems, Food, Nutrition and Health, University of British Columbia, 248-2357 Main Mall, Vancouver, BC, V6T 1Z4, Canada.
4 Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada; School of Health, Concordia University, 7200 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada; Metabolism, Obesity, Nutrition Lab, School of Health, Concordia University, 7200 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada.
5 Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada; School of Health, Concordia University, 7200 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada.
6 School of Health, Concordia University, 7200 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada; Department of Mathematics and Statistics, Concordia University, 1455 de Maisonneuve West, Montreal, QC, H3G 1M8, Canada. Electronic address: lisa.kakinami@concordia.ca.

The "Compensatory Health Beliefs" scale assesses the degree to which one believes that unhealthy behaviours can be compensated through healthier ones. However, no validated scale to assess compensatory weight-related behaviors exists. The study's objective was to develop (Study 1) and validate (Study 2) a questionnaire measuring compensatory health motivations and behaviors (CHMB) and to assess their associations with body mass index (BMI) and psychological weight-related measures. An initial 34-item measure was constructed based on a target sample's (Study 1, n = 158) suggestions and refined based on expert feedback. The measure was then tested in a representative Canadian adult sample (N = 1400, 48.7% male). The sample was stratified by sex and age and then randomly split into two (N = 701 for exploratory factor analysis; N = 699 for confirmatory factor analysis (CFA) cross-validation). Fit indices, standardized Cronbach's alphas and the associations between the CHMB model with cognitive restraint, weight concerns, and BMI were assessed in multiple linear regression models controlling for age and sex. The final CHMB model (n = 17 items) consisted of four subscales: (1) motivation, (2) use on special occasions, (3) general use, (4) compensatory health beliefs. Fit indices (Goodness of Fit Index = 0.922) and Cronbach's alphas were good (a = 0.88). In multiple linear regression models, all CHMB subscales were associated with greater cognitive restraint in eating. Compensatory behavior use on special occasions was associated with greater weight concern (B = 0.12, p < .0001), while general compensatory behavior use was associated with lower weight concern (B = -0.07, p < .05). None of the subscales were associated with BMI. The validated CHMB scale allows for the assessment of compensatory health motivations and behaviors in a Canadian population. Research on whether this scale can predict weight changes and general health is needed.