Using the EAT-26 to Screen Nonclinical Populations

A team of Italian researchers recently found that the shorter version of the Eating Attitudes Test, the EAT-26, was useful for detecting subjects at high risk of binge eating disorder (BED) and eating disorders not otherwise specified (EDNOS) when given in a non-clinical setting (Int J Obesity January 2006). They also reported that a cutoff point different from that generally given in the medical literature was more effective for uncovering patients at risk of eating disorders.

Dr. B. Orbitello and colleagues at the University of Udine, Udine, Italy used the Eating Attitudes Test-26 (EAT-26) to screen a group of obese patients from the general community for possible eating disorders. Their subjects were 835 men and women seeking treatment and nutritional advice for obesity for the first time. The final group included 231 subjects (39 males, 192 females) with a mean body mass index of 32.5 kg/m2.

The researchers theorized that a cutoff point different from that used in clinical populations (usually 20) would be more effective in a nonclinical setting. Dr. Orbitello reported that 250 subjects from the original group were also randomly selected and given the Semistructured Clinical Interview for DSM-IV (SCID, version 2.0).

What the tests showed

Logistic regression analysis pinpointed three EAT-26 subscales that were especially helpful. High dieting (D) or Bulimia (B) subscale scores indicated risk for EDNOS or bulimia nervosa (BN) cases; on the other hand, a high Oral Control (O) subscale score represented a protecting factor for BED. The researchers note that the standard EAT-26 cutoff score of 20 suggested in the literature will not be effective for detecting AN and BN among community and nonclinical groups. Instead, they propose a lower cutoff score of 11. Using the lower score cutoff led to a 31.9% reduction in the false-negative rate.