The second analysis stage was an attempt to discern the relationships among obesity predictors selected from the variables listed in Tables 1 and 2. It employed structural equation modeling (SEM; Kline, 2004) as the analytic method. Structural equation modeling is an elaboration of an older method—path analysis—that permits simultaneous testing of multiple paths toward the outcome(s). The conceptual model tested by SEM may include single or multiple indicators of a construct (e.g., mood dysregulation, disease severity), mediating and moderating factors, as well as other interactions (e.g., correlated error terms). SEM is typically used as a confirmatory procedure. Yet, it can also be used to develop a conceptual model through an iterative process of comparing changes in the goodness-of-fit indices associated with changes in the path relationships, indicators, or hypothetical constructs.
