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PubMed2001

A comparison of three questionnaires (EAT-12, EDI, and EDE-Q) for assessment of eating problems in healthy female adolescents.

On the basis of the restraint theory and the continuum hypothesis of eating disorders, the objective of this paper was twofold. First, subjects who, on the basis of items from the Eating Disorder Examination Questionnaire (EDE-Q) which are generated from DSM-III-R diagnostic criteria, fulfilled the diagnostic criteria for anorexia nervosa (AN) and bulimia nervosa (BN) were identified. Second, differences in scale scores between a case group and a non-case group were tested, and case group distribution of the two self-report questionnaires Eating Attitudes Test (EAT-12) and Eating Disorder Inventory (EDI) was compared as a means for investigating the sensitivity of the instruments in detecting eating disorder cases. In a classroom setting 224 8th-grade female students from 5 schools in western Norway completed the questionnaires. The responses to the questionnaires were analysed by case group and instrument/subscales by using the t test, Cohen's d-values, eta squared statistic, point biserial correlation, and two-way ANOVA. No BN cases and 10 AN cases were identified. AN cases scored significantly higher on all measures of eating problems than normal subjects and differed most from non-cases on the "dieting" dimension. Clinical implications are discussed in the light of screening.

Adolescent↗

PubMed2004

The Three-Factor Eating Questionnaire-R18 is able to distinguish among different eating patterns in a general population.

A revised version of the Three-Factor Eating Questionnaire (TFEQ) was developed in an obese population, but its applicability to the general population was not assessed. We aimed to define the relationship between eating behavior and reported food intake. This was a cross-sectional study of 529 middle-aged adults and 358 teenagers and young adults recruited on a geographical basis. The TFEQ-R18 measures 3 aspects of eating behavior: cognitive restraint (CR), uncontrolled eating (UE), and emotional eating. Reported food intake was calculated from a food frequency questionnaire. Girls who scored higher on restrained eating had a lower energy intake than the other girls (9164 kJ vs. 13,163 kJ, P < 0.001). In adult men, energy intake increased with UE (9663 kJ vs. 11,029 kJ in the lower and higher UE tertiles, respectively, P < 0.05). When specific food groups were analyzed, higher CR was positively associated in adults with healthy food groups like green vegetables [OR = 1.92 (0.68-2.44)] and negatively associated with French fries [OR = 0.35 (0.22-0.57)] and sugar [OR = 0.38 (0.23-0.61)]. Energy-dense foods, such as fat, were positively associated with UE [OR = 2.28 (1.46-3.57) for dietary fat]. Finally, emotional eaters had a higher snacking food intake. In teenagers and young adults, most associations were seen with CR. Converse to observations in adults, teenagers and young adults who exhibited a high cognitive restraint reported consumption of fewer energy-dense foods rather than more "healthy foods." The TFEQ-R18 was therefore able to distinguish among different eating patterns in our sample of a French general population.

Adolescent↗

PubMed1995

Under-eating and over-eating concerns among adolescents.

462 adolescents were given a set of scales to determine their concerns about eating (under-eating or over-eating), and perceptions of family and peer intimacy, social support, self-esteem, depression and exercise. Although only 10% stated that they were "underweight" and 21% that they were "overweight", as many as 50% reported having eating concerns. As compared to those who did not have concerns about eating, those who were concerned about undereating felt that they had poorer relationships with their mothers and fathers, less social support, lower self-esteem and low levels of exercise. In contrast, those who were concerned about overeating perceived having an intimacy problem only with their fathers. Like those concerned about undereating, the group concerned about overeating also had lower self-esteem and low levels of exercise. But, unlike the under-eating concern group, the over-eating concern group scored higher on the depression scale.

Adolescent↗

PubMed2003

Childhood obsessive-compulsive personality traits in adult women with eating disorders: defining a broader eating disorder phenotype.

OBJECTIVE: The authors retrospectively examined a spectrum of childhood traits that reflect obsessive-compulsive personality in adult women with eating disorders and assessed the predictive value of the traits for the development of eating disorders. METHOD: In a case-control design, 44 women with anorexia nervosa, 28 women with bulimia nervosa, and 28 healthy female comparison subjects were assessed with an interview instrument that asked them to recall whether they had experienced various types of childhood behavior suggesting traits associated with obsessive-compulsive personality. The subjects also completed a self-report inventory of obsessive-compulsive disorder (OCD) symptoms. RESULTS: Childhood obsessive-compulsive personality traits showed a high predictive value for development of eating disorders, with the estimated odds ratio for eating disorders increasing by a factor of 6.9 for every additional trait present. Subjects with eating disorders who reported perfectionism and rigidity in childhood had significantly higher rates of obsessive-compulsive personality disorder and OCD comorbidity later in life, compared with eating disorder subjects who did not report those traits. CONCLUSIONS: Childhood traits reflecting obsessive-compulsive personality appear to be important risk factors for the development of eating disorders and may represent markers of a broader phenotype for a specific subgroup of patients with anorexia nervosa.

Adolescent↗

PubMed2004

Disturbed eating behavior and eating disorders in preteen and early teenage girls with type 1 diabetes: a case-controlled study.

OBJECTIVE: To compare the prevalence of eating disturbances in preteen and early teenage girls with type 1 diabetes to their nondiabetic peers. RESEARCH DESIGN AND METHODS: A cross-sectional, case-controlled study of 101 girls with type 1 diabetes, ages 9-14 years, and 303 age-matched, female nondiabetic control subjects was conducted. Participants completed a Children's Eating Disorder Examination interview. Socioeconomic status, BMI, and diabetes-related variables were assessed. Groups were compared using chi(2) analyses. RESULTS: Binge eating; the use of intense, excessive exercise for weight control; the combination of two disturbed eating-related behaviors; and subthreshold eating disorders were all more common in girls with type 1 diabetes. Metabolic control was not related to eating behavior in this study population. CONCLUSIONS: Eating disturbances, though mostly mild, were significantly more common in preteen and early teenage girls with type 1 diabetes. Screening and prevention programs for this high-risk group should begin in the preteen years.

Adolescent↗

PubMed2002

Discriminant validity of the Eating Attitudes Test according to American Psychiatric Association and World Health Organization criteria of eating disorders.

The purpose of this study was to assess the sensitivity, the specificity, and the positive predictive value of the Eating Attitudes Test in a sample of Spanish nonclinical 18-yr.-olds. 304 subjects answered the Eating Attitudes Test-40, 290 of whom were interviewed individually with the Spanish version of the Schedules for Clinical Assessment in Neuropsychiatry. Eating disorders were diagnosed using ICD-10 and DSM-III-R criteria. The prevalence of eating disorders was higher for ICD-10 (5.2%) than for DSM-III-R (2.6%) and only affected the rate of diagnosis in women. According to ICD-10 criteria, the cut-off of 25 was more sensitive (87.5%) than the cut-off of 30 (75%) and varied little in specificity (93.9% vs 97.1%). The positive predictive value of the Eating Attitudes Test cut-off of 30 for eating disorders (ICD-10) was 36%. Our results support the test as useful for identifying eating disturbances in 18-yr.-olds and suggest assessment of a cut-off lower than 30 may be appropriate in the general population if confirmed in further research with a representative sample of adults.

Adolescent↗

PubMed2000

The Eating Attitudes Test (EAT) in Turkish university students: relationship with sociodemographic, social and individual variables.

OBJECTIVE: The primary purpose of this study was to establish the frequency of abnormal eating attitudes and behaviours, as measured by the Eating Attitude Test (EAT 40) in a sample of Turkish university students and to examine the relationship of such abnormalities to socio economic status, social and individual variables. METHOD: The EAT 40, two other questionnaires and a personal data sheet were administered to a sample of 253 female undergraduates at Bogazici and Marmara Universities in Istanbul, Turkey. RESULTS: Using the EAT 40 cut-off score of 30 established by (16) 7.9% of subjects were classified as having abnormal eating attitudes and behaviours. This subgroup of subjects was then compared with the remainder on all the other measures. No group differences were found for any of the SES variables. However, both social and individual variables were found to distinguish between groups in the predicted directions. DISCUSSION: Abnormal eating attitudes and behaviours are now as common in Turkish students as they are in many other comparable western and, increasingly, non-western societies. In the current student sample these attitudes and behaviours were found to be related to social factors such as the perceived traditionality of parents as well as to individual risk factors such as negative perfectionism.

Adolescent↗

PubMed2000

[Eating at night--eating during sleep].

This 45-years old female, who was referred to us for controlled weight-reduction reports an unusual eating behaviour: No food intake during daytime, uncontrolled eating in the evening and repetitive eating during the night. Eating in the night is a heterogeneous symptom regarding pathogenesis and phenotypic expression. Possible entities are the so called "night-eating syndrome" or "sleep-related eating disorders" with attenuated awareness. Referring to a case report the differential diagnosis of nightly eating disorders will be given and the symptoms and signs of selected pathologies will be discussed shortly.

Circadian Rhythm↗

PubMedDate not supplied

[Barcelona Bipolar Eating Disorder Scale (BEDS): a self-administered scale for eating disturbances in bipolar patients].

INTRODUCTION: The presence of eating disorders in bipolar population is not rare, with rates over 10 %, according to the few available epidemiologic studies, however the literature on this issue is still scarce. An even higher percentage of bipolar individuals suffer from serious problems related to eating behavior without fulfilling criteria for DSM-IV eating disorder. METHODS: The Bipolar Eating Disorders Scale (BEDS) was designed on the basis of the existing eating scales, adjusted to the characteristics of bipolar disorders from the complaints of our sample of patients (n=350). Subsequently, a group of experts made the selection of the most representative and independent items in order to obtain a short, 10-item scale, aimed at assessing the intensity and frequency of eating dysfunctions in the bipolar population and not at diagnosis. We administered the scale to a healthy control group (n=55) to evaluate feasibility and to determine the cut-off score. RESULTS: The BEDS is a 10-item simple, self-administered scale. Average time of completing this scale is about 1.13 min (1 min, 21 seconds) +/-26 seconds. Median score was 6 and the mean score was 6.6 with a standard deviation of 3.7, this being the reason why the cut-off point was found to be around 13 points. Patients receiving scores over 13 may require an individualized intervention to evaluate which were the main difficulties and to propose treatment. CONCLUSIONS: The BEDS allows for a rapid and effective evaluation of both the intensity and the frequency of eating dysfunctions in bipolar patients in order to perform an adequate intervention for the specific needs of each one of the patients.

Bipolar Disorder↗

PubMed2026

A narrative systematic review of definitions and diagnostic criteria for disordered eating and eating disorders in type 1 diabetes.

AIMS/HYPOTHESIS: Type 1 diabetes and disordered eating (T1DE) affects 8-37.1% of adults and is associated with high rates of morbidity and mortality. The absence of a standardised case definition of T1DE and its severity hinders effective screening, diagnosis and treatment. This systematic review aimed to (1) synthesise existing case definitions and diagnostic criteria for T1DE in adults and (2) identify key characteristics to inform consensus for future diagnostic criteria. METHODS: A systematic review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Eligible studies involved adults (≥18 years) with type 1 diabetes assessing disordered eating; paediatric studies, mixed samples without disaggregated data, non-empirical designs and non-English publications were excluded. PubMed, MEDLINE, EMBASE, CINAHL and PsycINFO were searched up to November 2025 for peer-reviewed studies involving adults with T1DE. Qualitative and quantitative data on definitions, diagnostic criteria and assessment tools were extracted. Study quality was appraised using a modified Graphical Appraisal Tool for Epidemiological studies (GATE) checklist. Due to heterogeneity of data, a narrative synthesis of findings was performed to describe current definitions of T1DE. RESULTS: Sixty-one studies met the inclusion criteria, with a pooled sample of 111,208 participants (76% women) from over 22 countries. T1DE was defined using a heterogeneous array of terms, diagnostic frameworks and assessment tools (29 distinct methods). The Diabetes Eating Problem Survey-Revised (DEPS-R) was the most used questionnaire, but many studies relied on criteria adapted from general eating disorder classifications or generic questionnaires. Approximately three-quarters of the studies assessed insulin omission behaviours, but the operationalisation of the cognitions for insulin omission varied widely. Beyond physiological markers such as HbA1c and BMI, studies explored various diabetes-related and psychological constructs, although often considering diabetes and disordered eating separately rather than as an integrated condition. CONCLUSIONS/INTERPRETATION: This systematic review highlights the lack of a unified, evidence-based definition of T1DE, resulting in inconsistent screening, diagnostic and reporting practices. Establishing clear, consistent, evidence-based diagnostic criteria and screening questionnaires for T1DE is critical to improving early detection and developing targeted interventions. These findings provide a foundation for refining T1DE definitions as a stepping stone to an international consensus definition. STUDY REGISTRATION: PROSPERO registration no. CRD420250223622 FUNDING: King's College London and King's College Hospital through the KMRT KCH Joint Research Committee studentship. This work was also conducted as part of the National Institute for Health Research (NIHR; CS-2017-17-023)-funded STEADY project (Safe management of people with Type 1 diabetes and EAting Disorders studY). NZ's salary was part-funded by the NIHR via the NIHR Clinician Scientist award to MS; JT and KI are part-funded by the NIHR Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. MS was funded through her NIHR Clinician Scientist Fellowship (CS-2017-17-023).

Humans↗

PubMed1999

Hedonics of binge eating in women with bulimia nervosa and binge eating disorder.

OBJECTIVE: Potential differences in the hedonics of binge eating between female subjects with bulimia nervosa (BN) and female subjects with binge eating disorder (BED) were examined. METHOD: Women seeking treatment for BN (N = 29) and BED (N = 49) completed the Eating Hedonics Questionnaire. RESULTS: Subjects in both groups reported similar precipitants and levels of distress associated with binge eating. Of interest, BED subjects were more likely to report that they enjoyed the food, the taste of the food, the smell and the texture of the food while binge eating. In addition, the BED group reported more relaxation and less physical discomfort and anxiety as a consequence of binge eating compared to the BN group. DISCUSSION: There are interesting and potentially important differences between individuals with BN and BED in the cognitions and behaviors associated with binge eating.

Adult↗

PubMed2002

Screening Chinese patients with eating disorders using the Eating Attitudes Test in Hong Kong.

OBJECTIVE: To evaluate the Chinese Eating Attitudes Test (EAT-26) in screening patients with anorexia nervosa (AN) and bulimia nervosa (BN) in Hong Kong. METHOD: A consecutive series of Chinese patients with BN (N = 67) and typical (fat phobic; N = 65) and atypical (nonfat phobic; N = 44) AN underwent clinical assessment and completed the EAT-26. Results were compared with those of Chinese female undergraduates (N = 646). RESULTS: The mean EAT scores for bulimic and typical AN patients were significantly higher than those of undergraduates, but the scores of atypical AN patients were anomalously low. The dieting and bulimia factor, scores and body mass indices entered the classification tree. When compared with using the conventional EAT-26 cutoff, the misclassification rate for typical AN, atypical AN, and BN changed from 41.4% to 52.3%, 88.6% to 43.2%, and 23.9% to 29.9%, respectively. DISCUSSION: Using the EAT-26 in the conventional manner would lead to an underestimate of atypical AN in community surveys. Complementary use of a classification tree improved the prediction of atypical AN, but the EAT-26 remains a suboptimal screening instrument for the community epidemiological study of AN.

Adult↗

PubMed2005

Personality correlates of obese eating behaviour: Swedish universities Scales of Personality and the Three Factor Eating Questionnaire.

OBJECTIVE: To study the relationship between personality characteristics and eating behaviour in obese patients. METHOD: The participants were 45 patients with a mean body mass index (BMI) of 39 kg/m2. Eating behaviour was measured with the Three Factor Eating Questionnaire (TFEQ) also taking the subscales Flexible Control and Rigid Control into account, and Personality was assessed with the Swedish universities Scales of Personality (SSP). RESULTS: In linear regression analyses the personality characteristic greater Lack of Assertiveness could explain 17% of Disinhibited eating and 13% of Hunger scores, whereas less Lack of Assertiveness could explain 12% of Flexible Control. BMI was negatively related to one of the personality characteristics, Adventure Seeking. DISCUSSION: A lacking ability to be socially self-assertive and confident characterized obese patients with more problematic eating behaviours that imply a risk for over consumption of food. A greater self-assertiveness was found in patients with a relatively more efficient eating strategy such as flexible control over eating.

Adult↗

PubMed2005

Eating patterns and breakfast consumption in obese patients with binge eating disorder.

This study examined eating patterns and breakfast consumption, and their relationships to weight and binge eating, in obese individuals with binge eating disorder (BED). One-hundred seventy-three consecutively evaluated men (n=46) and women (n=127) with BED were administered semi-structured interviews and self-report measures to assess the frequency of meals and snacks eaten, as well as binge eating and eating disorder features. Overall, those who consumed more frequent meals, particularly breakfast, and snacks, weighed less. Breakfast, which was eaten on a daily basis by less than half of participants (n=74; 43%), was the least frequently eaten meal of the day. Participants (n=56; 32%) who ate three meals per day weighed significantly less, and had significantly fewer binges, than participants (n=117; 68%) who did not regularly eat three meals per day. Thus, eating more frequently, having breakfast and consuming three meals every day, have potentially important clinical applications for the treatment of BED given that the effectiveness of specific interventions within treatments for BED are unknown, and that weight loss outcome for BED has been poor.

Adolescent↗

PubMed2006

Recurrent binge eating with and without the "undue influence of weight or shape on self-evaluation": implications for the diagnosis of binge eating disorder.

Levels of eating disorder psychopathology, impairment in psycho-social functioning and use of health services were compared among probable cases of binge eating disorder (BED) with and without extreme weight or shape concerns ("undue influence of weight or shape on self-evaluation") recruited from a large community sample of women. Data for obese non-binge eaters (n=457), also recruited from the community sample, and for a clinical sample of eating disorder patients (n=128), recruited separately, were included for comparative purposes. BED cases who reported extreme weight or shape concerns (n=51, 46.4%) had significantly higher levels of eating disorder psychopathology and functional impairment than those who did not report such concerns (n=59), after controlling for between-group differences in age and body weight. In addition, BED cases who reported extreme weight or shape concerns were more likely to have sought treatment for an eating or weight problem than those who did not. Whereas levels of eating disorder psychopathology and functional impairment were markedly elevated among BED cases with extreme weight or shape concerns, BED cases who did not report extreme weight or shape concerns resembled obese non-binge eaters in most respects. The findings support the inclusion of an undue influence of weight or shape on self-evaluation as a diagnostic criterion for BED. In the absence of this influence, eating disorders that otherwise resemble BED do not appear to be "clinically significant".

Adolescent↗

PubMed2000

Serotonergic dysfunction across the eating disorders: relationship to eating behaviour, purging behaviour, nutritional status and general psychopathology.

BACKGROUND: Several recent studies have pointed to a dysfunction of serotonin transmission in patients with eating disorders. Notwithstanding, it is not known whether serotonergic abnormalities are related primarily to eating and/or purging behaviour, nutritional status or general psychopathological dimensions. Therefore, by using a validated neuroendocrine strategy, we investigated central serotonergic function in patients with anorexia nervosa, bulimia nervosa or binge-eating disorder who differ on the above parameters. METHODS: Plasma prolactin response to D-fenfluramine (30 mg p.o.) or placebo was measured in 58 drug-free female volunteers, comprising 15 underweight anorexic women, 18 bulimic women, 10 women with binge-eating disorder and 15 female healthy controls. Behavioural assessment included ratings of eating disorder symptoms, depression, aggression and food-related obsessions and compulsions. RESULTS: A significantly decreased prolactin response to D-fenfluramine was found in underweight anorexic women and in bulimics with high frequency bingeing ( > 2 binge episodes/day), but not in patients with binge-eating disorder or in bulimics with low frequency bingeing (< I binge episode/day). In the whole bulimic group, a negative correlation emerged between frequency of bingeing and prolactin response. No significant correlation was found between physical or psychopathological measures and the hormonal response in any group. CONCLUSIONS: These results confirm our previous findings of an impaired serotonergic transmission in underweight anorexics and in bulimics with high frequency bingeing, but not in patients with less severe bulimia nervosa. Moreover, they show, for the first time, that the hypothalamic serotonergic system is not altered in women with binge-eating disorder.

Adult↗

PubMed2000

Binge eating and eating attitudes among Nazi concentration camp survivors.

BACKGROUND: Prisoners in Nazi concentration camps lived through extreme situations that included starvation. We test our hypothesis that there is a greater lifetime presence of binge eating among survivors from concentration camps than in a control group. METHODS: The subjects were 51 political prisoners who survived Nazi concentration camps and 47 ex-partisans of similar age and sex. A clinical interview investigated the lifetime occurrence of binge eating. The Eating Attitudes Test was also administered. RESULTS: The mean reported loss of weight among survivors was 27-3 kg. Thirty-three per cent of them and 4% of the ex-partisans reported going on eating binges at some time in their lives (P < 0.0007). There was no significant difference in the Eating Attitudes Test scores of survivors and ex-partisans, but, among survivors, the Bulimia subscale significantly discriminated subjects who reported current binge eating. CONCLUSIONS: Our study confirms that subjects who have survived a period of extreme food deprivation are more likely to develop binge eating behaviour.

Aged↗

PubMed2003

Binge eating and eating-related cognitions and behavior in ethnically diverse obese women.

OBJECTIVE: To examine binge eating and eating-related cognitions and behavior in a sample of ethnically diverse women who are severely obese and seeking bariatric surgery. RESEARCH METHODS AND PROCEDURES: Female bariatric surgery candidates (62 African Americans, 18 Latinas, 130 whites) completed questionnaires on binge eating and eating-related cognitions and behavior and completed a structured clinical interview to confirm binge-eating disorder diagnosis. RESULTS: Ethnic minorities and whites did not differ in rates of binge-eating disorder (26.3%), binges per week (M = 0.95), or dietary restraint. Ethnic minorities reported less disinhibition, and there was a trend to report less hunger awareness than whites. After controlling for BMI and education, ethnicity accounted for significant variance in disinhibition (4%; p < 0.01). Ethnic minorities were younger, became overweight at a later age, and were overweight for fewer years than whites. DISCUSSION: Results suggest that ethnicity exerts an important influence on disinhibition and that ethnic differences are not caused by BMI or education. Findings point to the need to continue to investigate the role of ethnicity, binge eating, and disinhibition in severely obese women, so that culturally appropriate services can be provided.

Adult↗