(P13-12-26) Optimizing the Lifestyle Wellness Assessment: A Confirmatory Factor Analysis

Objectives: Previous exploratory factor analysis (EFA) of the Lifestyle Wellness Assessment (LWA) in people with obesity yielded five dimensions: Psychosocial (mindfulness, resilience, quality of life, happiness surveys), Fitness (grip strength, jump height, body fat % [BF%]), Blood Pressure (BP [systolic and diastolic]), Lipids (total cholesterol, [TC], LDL cholesterol [LDL-C), and Body Size (waist circumference [WC], BMI). This research tested model fit via confirmatory factor analysis.

Methods: Using baseline data (N=315) from three convenience samples (n= 114, n=41, n=160) of people with obesity (mean BMI: 35.5±8.5 kg/m²), we tested two models with ML/MLR estimation and FIML for missingness: 1) a strict model with no cross‑loadings, 2) a theory‑driven model permitting BF% to cross-load on Body Size while retaining its primary Fitness loading.

Results: The strict model showed adequate fit, χ² (55) =126.94, p < .001; RMSEA=.078 (90% CI .043–.109); CFI=.955; TLI=.937; SRMR=.092. Allowing BF% to cross‑load on Body Size improved fit: χ² (54) =106.63, p < .001; RMSEA=.064 (90% CI .015–.098); CFI=.970; TLI=.957; SRMR=.082. Allowing BF% to cross-load also improved explained variance for the Fitness factor (Grip R²: 0.031 vs 0.780; Jump R²: 0.001 vs 0.205) and resolved a negative residual variance for BF% observed in the strict model (-474.79). BMI and WC remained strong indicators of Body Size in both models (Strict: BMI=0.937, WC=0.925; Cross‑loading: BMI=0.943, WC=0.920). Notably, BF% exhibited a stronger association with Body Size (0.765) than with Fitness (−0.452), which contrasts with the EFA results that informed model development. We noted Heywood cases in both models for TC (loadings >1.0) plausibly reflecting TC’s compositional overlap with LDL‑C.

Conclusions: Although the original five‑factor LWA model fit adequately, a theory‑driven model with a targeted cross‑loading that permits BF% to reflect both Fitness and Body Size was superior. Even so, BMI and WC continue to anchor the factor while the cross‑loading captures the dual influence of BF% across Fitness and Body Size. Accordingly, we adopt the cross‑loaded LWA model as the primary scoring framework for body‑composition assessment and obesity care.

Funding Sources: General Mills, National Dairy Council, National Cattleman’s Beef Association, NIMHD, NIDDK.