Validation of the exercise and eating disorders questionnaire

Abstract

ObjectiveCompulsive exercise is a well‐known feature in eating disorders. The Exercise and Eating Disorder (EED) self‐report questionnaire was developed to assess aspects of compulsive exercise not adequately captured by existing instruments. This study aimed to test psychometric properties and the factor structure of the EED among women with eating disorders and a control group.MethodThe study included 449 female participants, including 244 eating disorders patients and 205 healthy controls. The patient group consisted of 32.4% (n = 79) AN patients, 23.4% (n = 57) BN, 34.4% (n = 84) EDNOS and 9.8% (n = 24) with BED diagnosis.ResultsThe analyses confirmed adequate psychometric properties of the EED, with a four‐factor solution: (1) compulsive exercise, (2) positive and healthy exercise, (3) awareness of bodily signals, and (4) weight and shape exercise. The EED discriminated significantly (p < .001) between patients and controls on the global score, subscales, and individual items. Test‐retest reliability was satisfactory (r = 0.86). Convergent validity was demonstrated by high correlations between the EED and the Eating Disorder Examination Questionnaire (EDE‐Q; r = 0.79).DiscussionThe EED is the first clinically derived, self‐report questionnaire to assess compulsive exercise among ED patients. The EED offers assessment that has broader clinical utility than existing instruments because it identifies treatment targets and treatment priorities. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:983–993).

Validation of the exercise and eating disorder questionnaire in males with and without eating disorders

“…These results, which are listed in Table , were not affected by age and BMI as covariates. Since the item (“I listen to my body”) changed the factor‐loading scale in males (Table ) and this was in contrast to our previous findings for females (Danielsen et al, ), it was left out of analyses of the actual subscales (i.e., “compulsive exercise and awareness of bodily signals”).…”

“…Low numbers in groups in males restricted investigations of compulsive exercise in our study. However, no significant differences between AN, BN, and unspecified eating disorders were found in the female validation study (Danielsen et al, ). This may indicate that the EED questionnaire covers more shared attitudes and thoughts toward compulsive exercise, thus supporting the clinical utility of the scale among ED patients.…”

“…This factor also showed a negative loading of 0.44 in the third factor. However, for reasons of clinical relevance, corresponding results to the female validation study (Danielsen et al, ), and a positive loading value close to 0.4 (Field, ), the item was retained in the fourth factor: “exercise for weight and shape reasons”.…”

“…The questionnaire yields clinically relevant information about attitudes toward compulsive exercise in EDs. The EED questionnaire has been validated in females and shown good psychometric properties, and a four‐factor structure (Danielsen et al, ). Significant discriminant validity between patients and controls, satisfactory test–retest stability, convergent validity between EED scales and ED pathology, and good internal consistency with Cronbach's alpha coefficients ranging from 0.80 to 0.93 (global score and subscales) were found.…”

“…The EED questionnaire is meant for use in clinical settings and for identifying treatment targets and priorities (Danielsen, Bjornelv, & Ro, ; Danielsen, Bratberg, & Ro, ). It has been validated in female ED patients and shown good psychometric properties (Danielsen et al, ). Other questionnaires that have been tested in clinical ED samples are the commitment to exercise scale (CES) (Davis et al, ; Zeeck et al, ) and the compulsive exercise test (CET) (Meyer et al, ; Taranis, Touyz, & Meyer, ).…”