Investigating the factor structure and measurement invariance of the Eating Disorder Examination‐Questionnaire (EDE‐Q) in a community sample of gender minority adults from the United States

Abstract

ObjectiveThe Eating Disorder Examination‐Questionnaire (EDE‐Q) is one of the most widely used self‐report assessments of eating disorder symptoms. However, evidence indicates potential problems with its original factor structure and associated psychometric properties in a variety of populations, including gender minority populations. The aim of the current investigation was to explore several previously published EDE‐Q factor structures and to examine internal consistency and measurement invariance of the best‐fitting EDE‐Q model in a large community sample of gender minority adults.MethodsData were drawn from 1567 adults (337 transgender men, 180 transgender women, and 1050 gender‐expansive individuals) who participated in The PRIDE Study, a large‐scale longitudinal cohort study of sexual and gender minorities from the United States. A series of confirmatory factor analyses (CFAs) were conducted to explore the fit of eight proposed EDE‐Q models; internal consistency (Cronbach's alphas, Omega coefficients) and measurement invariance (multi‐group CFA) were subsequently evaluated.ResultsA brief seven‐item, three‐factor (dietary restraint, shape/weight overvaluation, body dissatisfaction) model of the EDE‐Q consistently evidenced the best fit across gender minority groups (transgender men, transgender women, gender‐expansive individuals). The internal consistencies of the three subscales were adequate in all groups, and measurement invariance across the groups was supported.DiscussionTaken together, these findings support the use of the seven‐item, three‐factor version of the EDE‐Q for assessing eating disorder symptomatology in gender minority populations. Future studies can confirm the current findings in focused examinations of the seven‐item, three‐factor EDE‐Q in diverse gender minority samples across race, ethnicity, socioeconomic status, and age ranges.Public Significance StatementAlthough transgender individuals have greater risk of developing an eating disorder, the factor structure of the Eating Disorder Examination‐Questionnaire, one of the most widely used eating disorder assessment measures, has not been explored in transgender adults. We found that a seven‐item model including three factors of dietary restraint, shape and weight overvaluation, and body dissatisfaction had the best fit among transgender and nonbinary adults.

Eating Disorders in Sexual and Gender Minority Adolescents

“…EDE-Q norms have been published for a variety of adult sexual and gender minority populations [40,[42][43][44][45][46]. However, numerous studies of adult sexual and gender minority individuals have failed to replicate the original four factors of the EDE-Q (i.e., restraint, eating concern, shape concern, weight concern) [47,48]. Although there have been fewer studies, recent findings in sexual and gender minority adolescents have been similar.…”

Empirical Investigation of Different Factor Structures for the Eating Disorder Examination–Questionnaire in Adult Women With Anorexia Nervosa

“…When higher-order factor structures of the EDE-Q have been tested (i.e., with subscales loading onto a ''Global'' scale), results have indicated worse fit than first-order models (e.g., Rand-Giovannetti et al, 2020). A bifactor model (where four factors exist alongside an uncorrelated general latent factor) demonstrated good fit in a community sample of 3,000 Norwegian women (Friborg et al, 2013; see also Nagata et al, 2023).…”