Assessing maladaptive sugar-rich food consumption: development and preliminary validation of the sugar misuse questionnaire

Objective Excessive consumption of sugar-rich foods is associated with adverse metabolic and health outcomes. Beyond the amount of sugar consumed, growing evidence suggests that some individuals experience maladaptive patterns of sugar-rich food consumption characterized by craving, loss of control, and persistence despite negative consequences. However, existing instruments primarily assess general food addiction or eating disorders and may not adequately capture behavioral patterns specifically related to sugar-rich products. Method The sugar misuse questionnaire (SuMQ) was developed using a mixed-methods approach. First, a qualitative study was conducted with individuals reporting severe difficulties related to sugar-rich food consumption to identify salient experiential dimensions of sugar misuse (SuM). Key themes were extracted through thematic analysis and used to generate questionnaire items. Second, the psychometric properties of the SuMQ were evaluated in a general population sample. Item functioning and scale structure were examined using Rasch modeling, followed by dimensionality analyses. ROC analyses were conducted to explore preliminary severity thresholds. Results Qualitative analyses identified 25 recurrent concepts related to maladaptive sugar-rich food consumption, which informed the initial version of the questionnaire. Rasch analysis supported a reduced 11-item version with strong internal consistency and a unidimensional structure. Exploratory threshold analyses identified score ranges associated with higher self-reported severity of SuM. Discussion The SuMQ provides a behaviorally grounded, preliminary psychometrically validated instrument for assessing sugar-focused maladaptive eating patterns within a dimensional framework. It may support research exploring the boundaries between addictive-like eating and established eating disorder constructs.