Table 4 Assessment instruments recommended for use with people with higher weight
From: Management of eating disorders for people with higher weight: clinical practice guideline
| Â | Format | Useful for | Considerations for use |
|---|---|---|---|
Self-report | |||
Eating Disorders Examination Questionnaire (EDE-Q) Version 6 [143] | 28-items, with 22-items assessed on a 7-point Likert scale generate four subscale scores (Restraint, Eating Concern, Weight Concern, and Shape Concern), averaged to create a global score. Higher scores equal greater severity Specific behavioural components of disordered eating are also assessed, including binge episodes, self-induced purging, laxative misuse, diuretic misuse, and excessive exercise (not included in the global score) | Evaluating the occurrence and severity of eating disorder features in adolescents (YEDE-Q) and adults of higher weight. The YEDE-Q [144] includes age appropriate language and examples A revised version of the EDE-Q can be considered in people who have had, or are candidates for, bariatric surgery [145] | The most common and well-known tool for assessing eating disorders, the EDE-Q is faster that the EDE (interview version). The EDE-Q may overestimate the frequency of binge eating relative to the EDE The EDE-Q is not a diagnostic instrument and should not be used as an alternative to the clinical interview or the EDE in making a diagnosis Notes: EDE-Q subscale scores can still be computed provided at least half the items for the particular subscale are completed which would allow an item which may be not appropriate for a person with higher weight (e.g. Item 11—Have you felt fat?) to be skipped EDE-Q scores may vary for age, BMI and other features [e.g. 146–148] Available online with scoring: https://www.credo-oxford.com/pdfs/EDE-Q_6.0.pdf https://insideoutinstitute.org.au/assessment?started=true Accessed 10/2/2021 |
ED-15 | Consists of 10 attitudinal items and 5 behavioural items, all rated on a 7-point Likert scale | May be useful for monitoring session-by-session change in core eating disorder features commonly targeted in treatment. Has reasonable face validity however direct validation studies in people of higher weight are lacking for the ED-15 | Not suggested as a replacement for EDE-Q. ED-15 can be used as a brief complementary tool for evaluating the impact of eating disorder treatment session-by-session Available online with scoring: http://cbt-t.group.shef.ac.uk/wp-content/uploads/2019/05/ED-15-Appendix-2.pdf Accessed 25/5/2021 |
Binge Eating Scale (BES) [149] | 16-items, each item presents three or four differently weighted statements with a final score varying from 0 to 46. Higher scores equal greater severity | Useful for the assessment of binge eating severity and BED in people of higher weight | A useful tool to rapidly screen/assess for BED however should be followed up with full clinical interview May be administered as an adjunct to the EDE-Q which does not assess for all diagnostic criteria for BED |
Diagnostic interview | |||
Eating Disorder Examination (EDE) Version 17D [150] | A lengthy interview assessing core cognitions and behaviours over the preceding 3-months Regarded as a ‘gold-standard’ | Most widely used measure and provides severity levels of key eating disorder features as well as generating diagnoses. Normative values are published | Available online (https://www.credo-oxford.com/7.2.html; accessed 10/02/2021) but requires training in administration Approx. 45–90 min to administer |
Eating Disorder Assessment for DSM-5 (EDA-5) [151] | A semi-structured interview for feeding and eating disorder diagnosis | Assessment of DSM-5 feeding and eating disorders including bulimia nervosa and BED however validation studies are limited | A newer tool designed specifically for the assessment of DSM-5. Focus on diagnostic evaluation not related psychopathology Approx. 20Â min to administer |