Structural Validity of the Eating Disorder Examination-Questionnaire: A Systematic Review

Objective: The main aim was to perform a systematic literature review of studies investigating the factor structure of the Eating Disorder Examination-Questionnaire (EDE-Q), a widely used measure of eating pathology. Secondary aims were to summarize the quality of reporting of latent variable (factor) analyses in these studies and review support for different factor solutions.

Method: Literature was identified through Scopus, Medline, PsycInfo, and ProQuest databases published up to February 23, 2022 and outreach via an international listserv. All studies published in English reporting factor analysis of the EDE-Q were included with few restrictions. Sixty studies including 63,389 participants met inclusion criteria.

Results: The originally proposed four-factor solution received little empirical support, although few alternative models have been robustly evaluated. Items assessing shape and weight concerns frequently coalesce in factor solutions, suggesting that these constructs are closely related. Investigations of brief versions of the EDE-Q have produced more consistent findings, suggesting that these measures, particularly a seven-item version, might be useful alternatives to the full version. Quality of studies was reasonable, with important methodological elements of factor analysis often reported.

Discussion: The findings are of relevance to practitioners and researchers, suggesting that the "original" factor structure of the EDE-Q should be reconsidered and that use of a seven-item version is to be encouraged.

Public Significance: Self-report questionnaires are widely used in the assessment of disordered eating. The current study found that there is little consensus about the structure of a common measure of eating psychopathology. There is more consistent support for a brief, seven-item, version assessing dietary restraint, body dissatisfaction, and overvaluation of weight and shape.