Eating Attitudes Test

The Eating Attitudes Test (EAT) is a widely used standardized self-report measure of symptoms and concerns characteristic of eating disorders. The original 40-item version of the EAT was published in 1979; it was developed for a study to examine socio-cultural factors in the development and maintenance of eating disorders A 1982 publication by Garner and colleagues described a 26-item refinement of the original test. Since that time, the EAT has been translated into many different languages and used in hundreds of studies. The original 1979 paper is a Current Contents Citation Classic. Both the original paper and the subsequent 1982 publication are 3rd and 4th on the list of the 10 most cited articles in the history of the journal Psychological Medicine, a journal founded more than 40 years ago with a high Impact Factor in the fields of psychology and psychiatry.

The EAT-26 can be used in a non-clinical as well as a clinical setting not specifically focused on eating disorders. It can be administered in group or individual settings and is designed to be administered by mental health professionals, school counselors, coaches, camp counselors, and others with interest in gathering information to determine if an individual should be referred to a specialist for evaluation for an eating disorder. It is ideally suited for school settings, athletic programs, fitness centers, infertility clinics, pediatric practices, general practice settings, and outpatient psychiatric departments. It is intended primarily for adolescents and adults.

The EAT-26 is not designed to make a diagnosis of an eating disorder or to take the place of a professional diagnosis or consultation. 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.

The EAT-26 has been particularly useful a screening tool to assess "eating disorder risk" in high school, college and other special risk samples such as athletes. Screening for eating disorders is based on the assumption that early identification can lead to earlier treatment, thereby reducing serious physical and psychological complications or even death. The EAT-26 should be used as the first step in a two-stage screening process. According to this methodology, individuals who score 20 or more on the test should be interviewed by a qualified professional to determine if they meet the diagnostic criteria for an eating disorder.

The tests are rated on a six-point scale in response to how often the individual engages in specific behaviors. The questions may be answered: Always, Usually, Often, Rarely, Sometimes, and Never.

Completing the EAT-26 yields a "referral index" based on three criteria: 1) the total score based on the answers to the EAT-26 questions; 2) answers to the behavioral questions related to eating symptoms and weight loss, and 3) the individual’s body mass index (BMI) calculated from their height and weight. Generally a referral is recommended if a respondent scores "positively" or meets the "cut off" scores or threshold on one or more criteria.

Permission to use the EAT-40 or EAT-26 can be obtained from David Garner through the EAT-26 website or the River Centre Clinic. The EAT-26, scoring instructions can be downloaded and website links (with automated scoring and feedback) can be obtained without cost from the EAT-26 website.