Original Articles
Rapid screening for disordered eating in college-aged females in the primary care setting

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Abstract

Purpose: To identify an efficient, valid, and reliable instrument for use by primary care physicians during clinical encounters to screen female adolescents at risk for eating disorders.

Methods: We created a survey of 36 questions, including the Eating Attitude Test-26 (EAT-26) and additional test questions identified through focus groups and literature review. The EAT-26 is a valid and reliable tool to identify individuals with eating disorders (1). We randomly distributed the survey to 865 college freshman women residing in dormitories at the University of Florida. The EAT-26 portion of the survey was scored according to established protocol. A score of ≥20 identified individuals likely to have an eating disorder, including anorexia nervosa and bulimia nervosa.

Results: 402 women completed surveys for a response rate of 47%. Based on the EAT-26 scores greater than 20, 17% of our population had scores predictive of an eating disorder. Four test questions correlated with positive EAT-26 scores: “How many diets have you been on in the past year?”; “Do you feel you should be dieting?”; “Do you feel dissatisfied with your body size?”; and “Does your weight affect the way you feel about yourself?”

Conclusions: These four test questions in written format screen for disordered eating among female college students in primary care settings.

Section snippets

Methods

We conducted a survey of college freshman women at the University of Florida using a self-report questionnaire. Subjects resided in three dormitories. Surveys were sent to every third name on a roster provided by the dormitory director. The dormitories housed socioeconomically and racially diverse groups of college women. The surveys were distributed via campus mail and returned voluntarily by respondents. Their ages ranged from 18 to 22 years. In our pilot study in the spring of 1996, we sent

Results

Demographic information showed a population consisting primarily of white families with annual household incomes between $50,000 and $100,000 (Table 1). The mean age was 18.3 years (SD ± 1.3 years). The mean self-reported weight was 127 pounds (SD ± 21 pounds) and height was 65 inches (SD ± 4.3 inches). In our population, 91% of our respondents desired weight loss, with a mean desired weight loss of 11.4 pounds.

Seventeen percent of EAT scores were greater than 20, consistent with a high risk

Discussion

Eating disorders have serious health consequences. Most physicians recognize the importance of screening for these disorders and ask adolescents questions about their weight, diet, and dieting behavior to determine the need for further evaluation. The “gold standard” for the diagnosis of eating disorders remains the clinical interview. Many excellent structured interviews exist such as the Eating Disorders Examination, the Diagnostic Interview Schedule, the Diagnostic Interview for Children and

Conclusion

The results indicate a significant correlation between high-risk scores on the EAT-26 and four of the hypothesized questions. These questions in written format screen for disordered eating behaviors in a college-aged population comparably to the more lengthy EAT-26. These questions may find great utility and ease in primary care settings in which time is limited.

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