Self-Screening Tools for Detecting Eating Disorders among College Students

Vol. 31 / No. 1 — Eating Disorders Review

 Disappointing results from a large study.

Since the peak time of the onset of an eating disorder is usually between adolescence and early adulthood, a self-screening questionnaire targeted at this age group would have obvious benefits.  But screening in a way that identifies those with an eating disorder while not mis-identifying those without may be a challenge. Selecting the correct screening instrument may be the key. However, when Japanese researchers recently studied the screening accuracy of the Eating Attitudes Test(EAT-26) and self-reported body frame, followed by a semi-structured interview with the  Structured Clinical Interview for DSM-IV Axis 1 Disorders(SCID)  among new college students, the test results were disappointing (BMC Res Notes. 2019; 12:613).

Earlier studies in Japan using the EAT-26to detect eating disorders and abnormal eating behaviors among high school and college students have yielded inconsistent results. Dr. Norika Hayakawa and four colleagues at Nagoya University designed a larger-scale anonymous study of new college students from 2012 to 2015; the survey was administered during the students’ college entrance medical checkup. The 5275 students who agreed to participate provided self-reported body weight and height and completed the EAT-26. Then, the SCID ED module was conducted among 131 students to provide an eating disorder diagnosis.

Among the 131 students who completed the semi-structured interview, no student with a high EAT-26 score was diagnosed as having an eating disorder based on the SCID. Conversely, 3 students were diagnosed with an eating disorder but none had an elevated EAT-26 score.  One limitation of the study was that only 1.7% of new students were included in the semi-structured interviews, and it is unclear if these were randomly selected.

After assessing their results, the authors concluded that when the EAT-26 alone is used, it is not possible to identify individuals with an eating disorder. Another interpretation of the findings is that a measure such as the EAT-26 is best used for identifying disordered eating attitudes or behaviors, but not to make diagnoses.