The impact of age and BMI on Eating Disorder Examination Questionnaire (EDE-Q) scores in a community sample

doi:10.1016/j.eatbeh.2011.12.001

Eating Behaviors

Volume 13, Issue 2, April 2012, Pages 158-161

https://doi.org/10.1016/j.eatbeh.2011.12.001 Get rights and content

Abstract

Objectives

The primary objectives for this study were to establish normative data for the EDE-Q in a nationally representative sample of women and to investigate the unique and relative effects of age and BMI.

Methods

A community sample of 3000 women aged 16–50 was randomly selected from the Norwegian National Population Register.

Results

Mean global EDE-Q was 1.27 (SD = 1.19). EDE-Q scores decreased significantly with age yet increased with BMI. In the regression model, BMI and age accounted for 19% versus 2%, respectively, of the global EDE-Q. Extreme shape and weight concerns appeared to drive the higher global EDE-Q scores for individuals with overweight or obesity, with 30–40% scoring above the recommended clinical cut-off for Shape and Weight Concern.

Conclusions

Higher EDE-Q scores, largely driven by elevated shape and weight concerns, appear normative among individuals with obesity in a nationally representative population. BMI should be routinely considered when establishing criteria for defining recovery and determining clinical significance using the EDE-Q.

Highlights

► In a national sample of women aged 16–50 we established norms for EDE-Q scores. ► We investigated the effects of age and BMI on EDE-Q scores. ► EDE-Q scores decreased significantly with age yet increased with BMI. ► BMI had a much higher impact on EDE-Q scores than age.

Introduction

The Eating Disorder Examination-Questionnaire (EDE-Q) has been developed as a reliable and valid self-report questionnaire version (Luce and Crowther, 1999, Peterson et al., 2007) of the Eating Disorder Examination (EDE) (Fairburn, Cooper, & O'Conner, 2008) and is widely used in both research and clinical settings worldwide. Normative data are increasingly available from various community settings in England, USA, Fiji, Australia, Sweden, and Norway, yet most studies have focused on younger samples of women aged 15 to 30 years (Becker et al., 2010, Carter et al., 2001, Luce et al., 2008, Ro et al., 2010, Welch et al., 2011). A study of 5255 women aged 18 to 42 years generally found less pathology among older women (Mond, Hay, Rodgers, & Owen, 2006). Other research, however, has documented high levels of disordered eating and body dissatisfaction among middle-aged women aged 35 to 55 years (Perez, Hernandez, Clarke, & Joiner, 2007), rendering the relationship between age and pathology less clear.

Elevated BMI is a widely demonstrated risk factor for body dissatisfaction and dieting among women of all ages (McLean et al., 2010, Slevec and Tiggemann, 2011) and some authors have proposed a higher cut-point on the EDE-Q to more accurately detect eating disorders among populations overrepresented with older and/or overweight individuals (Mond et al., 2008). Given the well-documented association between increasing age and higher BMI on a population level (Haslam & James, 2005), it is important to ascertain their relative influence to better interpret scores. Few studies have included samples large enough to accurately detect age and BMI-related trends. The aims of this study were to investigate the unique and relative effects of age and BMI on pathology as measured by the EDE-Q in a nationally representative sample of women to provide a normative context for interpreting scores and determining clinical significance.

Section snippets

Study design and participants

A representative community sample of 3000 Norwegian women aged 16–50 years was randomly selected from the Norwegian National Population Register. Questionnaires were mailed to the selected addresses via post, and the respondents were asked to either return the questionnaires via post or to complete the questionnaires online. After about 4 weeks, a reminder notice was sent to all 3000 women. Participation in the study was completely anonymous. However, the participants were invited to participate

Results

Completed questionnaires were received from 1094 individuals, of whom 1005 (91.9%) had responded by post and 89 (8.1%) had responded online. The overall response rate was 37.4% after accounting for incorrect addresses (n = 78), which were confirmed by envelopes marked ‘return to sender due to the wrong address’. Approximately 1% of the items required for scoring the EDE-Q subscales and global score were missing. Subscale scores were computed only if more than half of the relevant items were

Discussion

This study investigated the unique and relative effects of age and BMI in a large community sample of non-treatment seeking women. Our results demonstrated two significant linear trends, specifically EDE-Q scores decreased with age yet increased with BMI. Two notable exceptions were levels of purging behavior, which did not vary significantly across age or weight status, and dietary restraint, which did not differ by age. In contrast with prior research (Mond et al., 2006), we did not find that

Role of funding sources

Not applicable.

Contributors

Authors Rosenvinge and Ro designed the study and wrote the protocol. All authors contributed to data management and statistical analysis. Author Reas conducted the literature search. Dr. Reas and Ro wrote the first draft of the manuscript. All authors contributed to and have approved the final manuscript.

Conflict of interest

No conflicts of interest exist by any author.

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Abstract:
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View full text

The impact of age and BMI on Eating Disorder Examination Questionnaire (EDE-Q) scores in a community sample

Abstract

Objectives

Methods

Results

Conclusions

Highlights

Introduction

Section snippets

Study design and participants

Results

Discussion

Role of funding sources

Contributors

Conflict of interest

Psychiatry Research

Lancet

Behaviour Research and Therapy

Behaviour Research and Therapy

Eating Behaviors

Clinical Psychology Review

Behaviour Research and Therapy

Validity and reliability of a Fijian translation and adaptation of the Eating Disorder Examination Questionnaire

International Journal of Eating Disorders

Assessment of bulimia nervosa: A comparison of interview and self-report questionnaire methods

International Journal of Eating Disorders