Improving the EDE-Q for Men

Two important areas for men may be missing in its current form

Two areas on the Eating Disorder Examination-Questionnaire (EDE-Q) are body concerns and body dissatisfaction. Both need improvement to better detect eating disorders among men, according to a recent German study.

Dr. Nora M. Laskowski and her colleagues recently described the use of the validated German version of the EDE-Q in adult inpatient men with eating disorders as an improvement to the current widely used screening questionnaire (J Eat Disord. 2023. 11:34). They report that the current version of the EDE-Q could be improved by including two areas specific to men. The authors note that gender differences may play a large role in overlooked and underrepresentation of men in eating disorders research largely because standard assessments were developed based on eating disorder symptoms in adolescents and young women.

One area that has led to continual discussion and debate is the structure of the EDE-Q, where the four subscales, Restraint, Eating Concern, Shape Concern, and Weight Concern, do not include men’s concerns about musculature and concerns of males in special cohorts, such as gay men, bisexual men, or non-heterosexual men.

The German group studied 188 adult men diagnosed with eating disorders who had been admitted for inpatient treatment between January 2018 and December 2021. The mean age was 33 years, and the mean body mass index was 37.8 mg/kg2. Their results suggested a five-factor solution, with a slightly shorter version of the EDE-Q (17 items). The proposed new questionnaire included the following factors, “Restraint,” “Body Dissatisfaction,” “Weight Concerns,” Preoccupation,” and “Importance.”

Is a five-factor model of the EDE-Q justified?

The authors believe that maintaining a distinction between Weight Concern, Body Dissatisfaction, and Importance is justified in men with eating disorders. While the EDE-Q includes items that assess general discomfort, for example, discomfort in seeing one’s body and thinness-related discomfort, this might be too limiting to include eating disordered psychopathology in men. They add that men are just as concerned about their body mass and musculature, pointing to the need to consider a broad range of body images in ED assessments.

The authors noted one of the study’s limitations was that their findings involved German men and might not be generalized to other locations. Still, they concluded that adding the five subscales—Restraint, Body Dissatisfaction, Weight Concern, and Preoccupation, and Importance—to the EDE-Q may help.

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