The Eating Attitudes Test (EAT-26) was the screening instrument used in the 1998 National Eating Disorders Screening Program. The EAT-26 is probably the most widely used standardized measure of symptoms and concerns characteristic of eating disorders.

The EAT-26 alone does not yield a specific diagnosis of an eating disorder. Neither the EAT-26, nor any other screening instrument, has been established as highly efficient as the sole means for identifying eating disorders. However, studies have shown that the EAT-26 can be an efficient screening instrument as part of a two-stage screening process in which those who score at or above a cut-off score of 20 are referred for a diagnostic interview.

Surveys of adolescents or young adult women indicate that about 15% score at or above 20 on the EAT-26. Interviews of those who score below 20 on the EAT-26 show that the test produces very few false negatives (i.e. those with low EAT-26 scores who have eating disorders or serious eating concerns on being interviewed).

Based on follow-up interviews of 720 people who took the EAT-26, high scorers were divided into 6 groups:

1. Eating Disorders: persons who met strict diagnostic criteria;
2. Partial Syndrome: persons who report marked dietary restriction, weight preoccupation, bingeing, vomiting, and other symptoms of clinical significance, but who fail to meet all of the diagnostic criteria for an eating disorder;
3. Obsessive Dieters or "weight-preoccupied" individuals: persons who express significant concerns about weight and shape, but who do not present the clinical concerns of those with the "partial syndrome";
4. Normal Dieters: persons who are actively trying to lose weight, but who show no evidence of "morbid" or obsessive concern about weight or shape;
5. Obese Individuals
6. Disturbed Individuals: persons who respond positively on the EAT-26, but who do not have significant concerns about weight or shape on interview.

Of those who scored above 20 on the EAT-26, a third had clinically significant eating concerns or weight preoccupations. In a follow-up of high scorers 12-18 months later, 20% of those who initially had a "partial syndrome" now met diagnostic criteria for an eating disorder. Moreover, more than 30% of the initial "normal dieters" became "obsessive dieters."

Given these findings, if you score above 20 on the EAT-26, please contact your doctor or an eating disorders treatment specialist for a follow-up evaluation.

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