EDE-Q PDF Download
Eating Disorder Examination Questionnaire
Gold standard self-report eating disorder assessment with four subscales.
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The EDE-Q is the gold standard self-report eating disorder measure
When to Use the EDE-Q
EDE-Q Scoring Guide (Score Range: 0-6)
| Score | Severity Level | Clinical Action |
|---|---|---|
| 0-1.5 | Non-clinical | Monitor |
| 1.5-2.5 | Mild concern | Assessment recommended |
| 2.5-4 | Clinical range | Treatment warranted |
| 4+ | Severe | Intensive treatment |
Key Features of the EDE-Q
- Gold standard ED measure
- Four validated subscales
- Free for clinical use
What the EDE-Q Actually Measures
The EDE-Q captures the core psychopathology of eating disorders through four subscales measuring dietary restraint, eating concerns, shape concerns, and weight concerns. It also assesses behavioral symptoms including binge eating, self-induced vomiting, laxative misuse, and excessive exercise over the past 28 days.
Restraint (5 items)
Dietary restriction, fasting, food rules, avoidance—the cognitive driver of restrictive eating
Eating Concern (5 items)
Preoccupation with food, fear of losing control, eating in secret, guilt about eating—food-focused anxiety
Shape Concern (8 items)
Dissatisfaction with body shape, desire to be thinner, flat stomach, discomfort seeing body—body image disturbance
Weight Concern (5 items)
Preoccupation with weight, reaction to weighing, desire to lose weight—weight as self-evaluation
Behavioral Items
Frequency of binge eating, purging, laxative use, excessive exercise, dietary restriction—observable symptoms
What Scores Actually Mean in Practice
Eating concerns within population norms. Some dietary restraint or body dissatisfaction may be present but not at clinical levels.
"I watch what I eat sometimes and wish I looked different, but it doesn't really bother me that much."
Elevated eating pathology that may not meet full diagnostic criteria but indicates risk. May represent subclinical eating disorder or early-stage presentation.
"I think about my weight a lot. I've tried lots of diets. Sometimes I feel guilty after eating."
Scores consistent with clinical eating disorder. Global score above 2.8 has good sensitivity for eating disorder diagnosis. Full assessment and treatment indicated.
"Food controls my life. I'm always thinking about what I can and can't eat. I hate my body."
Severe eating pathology with likely significant functional impairment. Consider medical monitoring, intensive outpatient, or higher level of care.
"I restrict most of the day, then lose control at night. I can't look in mirrors. My whole life revolves around food and my body."
Common Misinterpretations
The EDE-Q can diagnose specific eating disorders
The EDE-Q measures transdiagnostic eating pathology but doesn't distinguish between anorexia, bulimia, and binge eating disorder. Diagnosis requires clinical interview considering weight history, frequency of behaviors, and physical symptoms.
Low EDE-Q scores in a thin patient rule out anorexia
Patients with anorexia often have poor insight and may not endorse shape/weight concern because they don't recognize their perception as distorted. An underweight patient with denial requires clinical attention regardless of score.
The behavioral frequency items are the most important
The cognitive subscales (restraint, shape concern, weight concern) often persist after behavioral symptoms resolve and predict relapse. Full recovery requires addressing the underlying overvaluation of shape and weight.
Men can use the same cutoffs as women
EDE-Q norms were primarily established in female samples. Men typically score lower on shape/weight concern. Use clinical judgment rather than strict cutoffs for male patients.
A global score is sufficient for treatment planning
Subscale patterns matter clinically. A patient high in restraint but low in shape concern differs from one high in shape concern but low in restraint. Treatment should target the specific pattern.
What High EDE-Q Scores Mean for Treatment Retention
Eating disorder patients with high EDE-Q scores face unique retention challenges. The ego-syntonic nature of restraint, ambivalence about weight gain, and shame about binge/purge behaviors all create barriers to sustained treatment engagement.
Key Retention Strategies:
- High restraint scores indicate the patient values control—frame treatment as 'gaining control over the eating disorder' rather than 'giving up control'
- Shape and weight concern predict dropout when treatment requires weight restoration—address cognitive symptoms alongside behavioral ones
- Patients with high eating concern often hide symptoms; non-judgmental, curious stance improves disclosure
- Binge eating is often shame-inducing; normalize as a common response to restriction rather than a personal failure
- Co-occurring depression and anxiety are common—untreated mood symptoms undermine eating disorder treatment
- Family involvement improves outcomes in adolescents and can help in adults—consider FBT or family therapy components
- Weight monitoring in treatment must be handled carefully—too much focus on weight reinforces the disorder
- Early behavioral changes (regularized eating) can precede cognitive change—don't wait for insight
- Recovery is non-linear; expect setbacks and normalize them as part of the process
Frequently Asked Questions About the EDE-Q
What is the EDE-Q?
The EDE-Q (Eating Disorder Examination Questionnaire) is a 28-item self-report measure assessing eating disorder symptoms across four subscales: Restraint, Eating Concern, Shape Concern, and Weight Concern.
How is the EDE-Q scored?
Items are scored 0-6. Subscale and global scores are calculated as means. A global score above 2.8 suggests clinical-level eating pathology.
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