Eating Disorder Examination Questionnaire (EDE-Q)

Overview

The Eating Disorder Examination Questionnaire (EDE-Q) is a 28-item self-report questionnaire, adapted from the semi-structured interview, the Eating Disorder Examination (EDE). The questionnaire is designed to assess the range, frequency and severity of behaviours associated with a diagnosis of an eating disorder. It is categorised into 4 subscales (Restraint, Eating Concern, Shape Concern and Weight Concern) and an overall global score, with a higher score indicating more problematic eating difficulties.

There are several adaptations of the EDE-Q including the Eating Disorder Examination for Adolescents (EDE-A), the Youth Eating Disorder Examination Questionnaire (YEDE-Q), the Eating Disorder Examination Questionnaire Short (EDE-QS) and the Eating Disorder Examination Questionnaire Parent Version (EDE-Q-PV), all listed below in ‘Other versions’.

Terms of use

The EDE-Q (and its items) is under copyright. It is freely available for non-commercial research use only and no permission need to be sought. This includes using the EDE-Q digitally as long as it is for non-commercial clinical or research use. However, please also (i) include copyright information, (ii) replicate the measure exactly (including response categories) and (iii) be aware that the information on norms and use has been designed for the pen and paper version.

For queries relating to commercial use of the measure (including commercial software), please contact credo@medsci.ox.ac.uk.

Scale/Subscales

Suitability

The EDE-Q is designed for completion by those aged 14 and over. For those under 14, please consider adapted versions such as the YEDE-Q or EDE-A, listed under ‘Other Versions’ below.

An adapted version of the EDE-Q, the EDE-Q-PV, is available for parent/carer completion.

We are not currently aware of any evidence regarding the accessibility of the EDE-Q for children and young people with learning disabilities.

Research into use of the EDE-Q in ethnically diverse groups has found significant differences in data completeness by participant race/ethnicity, with Asian American participants most likely to provide incomplete survey responses, and White participants most likely to provide complete responses (Kelly et al., 2016). Secondly, findings from Kelly et al. (2012) suggest the validity of the EDE-Q clinical cut-offs are lower in samples of Black women compared with samples of White women, as Black women endorse significantly less binge eating and compensatory behaviours than White women.

EDE-Q norms have been published for a range of gender identifications (Nagata et al., 2020).

Please do get in touch at CORC@annafreud.org if you are aware of any information that may be of interest to users of the measure as we may be able to update our webpage to include it.

Administration

The EDE-Q is a self-report measure which can be completed in person or electronically. When introducing and using the EDE-Q (including all versions) with young people please consider feedback from young people about how they would like measures to be used as part of their support: How do young people relate to filling in outcome questionnaires?

We also recommend exploring the free CORC training session: How to use mental health measurement questionnaires: six steps to good practice

Working remotely

The EDE-Q can be used digitally as long as it is for non-commercial clinical or research use. However, please also (i) include copyright information, (ii) replicate the measure exactly (including response categories) and (iii) be aware that the information on norms and use has been designed for the pen and paper version.

For more information of working remotely with outcome measures, please read our guide

Scoring and Interpretation

The following link is to the user guide. This details how to score the EDE-Q along with norms for a community sample of young women.
Higher scores on the individual subscales and global score indicate problematic eating behaviours and attitudes.
Norms have been published for the following UK populations:
- UK adolescent boys and girls (aged 14-18 years) - White, Haycraft, Goodwin & Meyer (2013)
- UK early adolescent girls (aged 12-14) - Carter, Stewart & Fairburn (2001)
- UK adult community males and females - Carey at al. (2019)

There are many papers which have published norms for variations of the above groups , as well as for use in e.g., USA and Spain.

Psychometric properties

Property	Definition	Measure name
Internal consistency	Degree to which similar items within a scale correlate with each other.	Internal consistency for the four EDE-Q subscales has been found to be acceptable for both men and women; Rose et al. (2013) reported a Cronbach’s α ranging from .74 (Restraint) to .89 (Shape Concern) for men and .75 (Restraint) to .93 (Shape Concern) for women. Similar results have been found in other studies (e.g., Bardone-Cone & Boyd, 2007; Luce & Crowther, 1999).
Construct validity	Degree to which the questionnaire actually measures the specific trait or attribute it is intended to measure.	Researchers propose different factor structures for the EDE-Q, with the original four-factor structure receiving limited support. Grilo et al. (2015) suggested a modified seven item, three- factor structure; the three factors were dietary restraint, shape/weight overvaluation, and body dissatisfaction. Carey et al. (2019) described a three-factor structure with eighteen items for females and sixteen for males, with factors being shape and weight concern, preoccupation and eating concern, and restriction. More recently, Rand-Giovanetti (2020) evaluated twelve models of EDE-Q factor structure and suggested a four-factor model with factors of dietary restraint, preoccupation and restriction, weight and shape concern, and eating shame.
Test-retest reliability	Degree to which the same respondents have the same score after period of time when trait shouldn't have changed.	Test re-test reliability was high for the four subscales (r = 0.75 to 0.91) and global score (r = 0.92) for both men and women in a college sample (Rose et al., 2013). In patients with binge eating disorder, Reas et al. (2006) reported good short term test re-test reliability for the four subscales (r = .66 to .77) and global score (r = .76).
Convergent validity	Degree to which two measures of constructs that theoretically should be related are in fact related.	The EDE-Q has high convergent validity with the more recently developed ED-15 (Accurso & Waller, 2020).
Concurrent validity	Correlation of the measure with others measuring same concept.	The EDE-Q has moderate to high concurrent validity with the Eating Problems Checklist (Dalle Grave et al., 2018).
Discriminant validity	Lack of correlation with opposite concepts.	The EDE-Q was found to be highly accurate in discriminating between individuals with and without an eating disorder (Mond et al., 2004; Aarrdoom et al., 2012) and moderately accurate in discriminating between individuals with binge eating disorder from those with obesity (Aardoom et al., 2012).

Translations

The EDE-Q is very widely used and is also available in many languages. Please contact credo@medsci.ox.ac.uk for more information.

Other Versions

EDE-A – The EDE-A is an adapted version of the EDE-Q which was first mentioned and used in Carter, Stewart & Fairburn (2001). It was designed for use with those aged 12-13. It contains 36 items and yields the same four subscales and global score as the EDE-Q. The time frame was shortened from 28 to 14 days as this was considered to be more appropriate for the age group, and certain words and phrases were replaced with more simplified language. To aid interpretation of EDE-A scores, normative data for UK early adolescents can be found in the aforementioned paper. Please be aware there is scarce evidence for the use of the EDE-A. Please also note that there is a missing response option for 11 days on the EDE-A.

YEDE-Q – The YEDE-Q was adapted from the EDE-Q and is designed for use with children and adolescents. It has a literacy level consistent with third grade (aged 8-9 years) reading ability.

It was first mentioned and validated by Goldschmidt et al. (2007) who used it with adolescents (aged 12-17) who were overweight. It has also been validated in an adolescent population with Type 1 Diabetes (d’Emden et al., 2012). It has been administered to a population with Anorexia Nervosa, but we are not aware of any validation for this population. It appears that more studies have used the YEDE-Q in comparison to the EDE-A.

EDE-QS – The EDE-QS is a 12-item measure, derived from the EDE-Q and intended to be shorter. It was developed and validated by Gideon et al. (2016) for use with individuals with eating disorders such as Anorexia Nervosa – Restrictive subtype, Anorexia Nervosa – Binge/Purge subtype, Bulimia Nervosa, Binge Eating Disorder, and other specified feeding and eating disorders (OSFED). It was designed for use in routine outcome assessment, including session by session monitoring.

EDE-Q-PV – The EDE-Q-PV is an adapted parent/carer version of the EDE-Q, where the word ‘you’ has been replaced with ‘your child’. It was designed to assess parent/carers’ attitudes about their children’s eating and weight. It was first used and mentioned by Lydecker & Grilo (2017).

Useful Resources

Coming soon....

References

Aardoom, J. J., Dingemans, A. E., Op't Landt, M. C. S., & Van Furth, E. F. (2012). Norms and discriminative validity of the Eating Disorder Examination Questionnaire (EDE-Q). Eating behaviors, 13(4), 305-309.

Bardone-Cone, A. M., & Boyd, C. A. (2007). Psychometric properties of eating disorder instruments in Black and White young women: Internal consistency, temporal stability, and validity. Psychological Assessment, 19(3), 356–362. https://doi.org/10.1037/1040-3590.19.3.356

Black, C. M. D, & Wilson, G. T. (1996). Assessment of eating disorders: interview versus questionnaire. International Journal of Eating Disorders, 30, 187–92

Carey, M., Kupeli, N., Knight, R., Troop, N. A., Jenkinson, P. M., & Preston, C. (2019). Eating Disorder Examination Questionnaire (EDE-Q): Norms and psychometric properties in UK females and males. Psychological Assessment, 31(7), 839.

Carter, J. C., Stewart, D. A., & Fairburn, C. G. (2001). Eating disorder examination questionnaire: norms for young adolescent girls. Behaviour research and therapy, 39(5), 625-632.

Dalle Grave, R., Sartirana, M., Milanese, C., El Ghoch, M., Brocco, C., Pellicone, C., & Calugi, S. (2019). Validity and reliability of the Eating Problem Checklist. Eating Disorders, 27(4), 384-399.

d’Emden, H., Holden, L., McDermott, B., Harris, M., Gibbons, K., Gledhill, A., & Cotterill, A. (2012). Concurrent validity of self‐report measures of eating disorders in adolescents with type 1 diabetes. Acta Paediatrica, 101(9), 973-978.

Fairburn, C. G., & Beglin, S. J. (1994). Assessment of eating disorders: Interview or self‐report questionnaire?. International journal of eating disorders, 16(4), 363-370.

Gideon, N., Hawkes, N., Mond, J., Saunders, R., Tchanturia, K., & Serpell, L. (2016). Development and psychometric validation of the EDE-QS, a 12 item short form of the Eating Disorder Examination Questionnaire (EDE-Q). PloS one, 11(5), e0152744.

Goldfein, J. A., Devlin, M. J., & Kamenetz, C. (2005). Eating Disorder Examination‐Questionnaire with and without instruction to assess binge eating in patients with binge eating disorder. International Journal of Eating Disorders, 37(2), 107-111.

Goldschmidt, A. B., Doyle, A. C., & Wilfley, D. E. (2007). Assessment of binge eating in overweight youth using a questionnaire version of the child eating disorder examination with instructions. International journal of eating disorders, 40(5), 460-467.

Grilo, C. M., Reas, D. L., Hopwood, C. J., & Crosby, R. D. (2015). Factor structure and construct validity of the eating disorder examination‐questionnaire in college students: Further support for a modified brief version. International Journal of Eating Disorders, 48(3), 284-289.

Jennings, K. M., & Phillips, K. E. (2017). Eating disorder examination–questionnaire (EDE–Q): norms for clinical sample of female adolescents with anorexia nervosa. Archives of psychiatric nursing, 31(6), 578-581.

Kelly, N. R., Cotter, E. W., Lydecker, J. A., & Mazzeo, S. E. (2017). Missing and discrepant data on the Eating Disorder Examination Questionnaire (EDE-Q): Quantity, quality, and implications. Eating behaviors, 24, 1-6.

Lavender, J. M., De Young, K. P., & Anderson, D. A. (2010). Eating Disorder Examination Questionnaire (EDE-Q): norms for undergraduate men. Eating Behaviours, 11(2), 119-121.

Luce, K. H., & Crowther, J. H. (1999). The reliability of the eating disorder examination—Self‐report questionnaire version (EDE‐Q). International Journal of Eating Disorders, 25(3), 349-351.

Luce, K. H., Crowther, J. H., & Pole, M. (2008). Eating disorder examination questionnaire (EDE‐Q): Norms for undergraduate women.International Journal of Eating Disorders, 41(3), 273-276.

Lydecker, J. A., & Grilo, C. M. (2017). Does your child's weight influence how you judge yourself as a parent? A cross-sectional study to define and examine parental overvaluation of weight/shape. Preventive medicine, 105, 265-270.

Mond, J. M., Hay, P. J., Rodgers, B., Owen, C., & Beumont, P. J. V. (2004). Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples. Behaviour research and therapy, 42(5), 551-567.

Nagata, J. M., Murray, S. B., Compte, E. J., Pak, E. H., Schauer, R., Flentje, A., ... & Obedin-Maliver, J. (2020). Community norms for the Eating Disorder Examination Questionnaire (EDE-Q) among transgender men and women. Eating behaviors, 37, 101381.

Rand-Giovannetti, D., Cicero, D. C., Mond, J. M., & Latner, J. D. (2020). Psychometric properties of the Eating Disorder Examination–Questionnaire (EDE-Q): A confirmatory factor analysis and assessment of measurement invariance by sex. Assessment, 27(1), 164-177.

Reas, D. L., Grilo, C. M., & Masheb, R. M. (2006). Reliability of the Eating Disorder Examination-Questionnaire in patients with binge eating disorder. Behaviour research and therapy, 44(1), 43-51.

Rose, J. S., Vaewsorn, A., Rosselli-Navarra, F., Wilson, G. T., & Weissman, R. S. (2013). Test-retest reliability of the eating disorder examination-questionnaire (EDE-Q) in a college sample. Journal of eating disorders, 1(1), 1-10.

Wilfley, D. E., Schwartz, M. B., Spurrell, E. B., & Fairburn, C. G. (1997). Assessing the specific psychopathology of binge eating disorder patients: interview or self-report?. Behaviour Research and Therapy, 35(12), 1151-1159.