Developed by Garner, Olmstedt, Bohr and Garfinkel (1982), The Eating Attitudes Test (EAT-26) is a widely used standardised self-report measure of disordered eating behaviours and attitudes toward food. The EAT-26 is a refinement of the original EAT-40 that was first published in 1979, following the low factorial loadings of 14 items which were subsequently removed to create the EAT-26. Designed as a screening tool to be used with at-risk populations (as well as non-clinical populations), the EAT-26 does not provide a specific diagnoses for an eating disorder, but rather, an instrument to help identify individuals who might be at risk for an eating disorder (Garner et al., 2009).
The EAT-26 can be used in both clinical and non-clinical settings, with both adolescents and adults. The ch-EAT (Mahoney, McGuire & Daniels, 1988) has been developed for children aged 8 to 13.
The EAT-26 is useful as a screening tool to assess ‘eating disorder risk’ in school, college, athlete populations (Garner et al., 1983). It has also been used in non-clinical samples to detect characteristics and concerns related to anorexia and bulimia (Garner et al., 1983). The EAT-26 contains the same three factors as the EAT-40, which include: dieting, bulimia and food preoccupation and oral control (pertains to self-control of eating and perceived pressure from others to gain weight; Garner et al., 1982). 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. Any screening process should be accompanied with an interview to obtain a comprehensive assessment of the individual (Garner et al., 2009).
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) Responses to the behavioural 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 on one or more sections.
EAT-26 correlates highly with the original EAT-40 scale (r = 0-98).The reliability (internal consistency) of the EAT-26 is high (alpha = 0-90 for the AN group), even though this scale is much shorter than the original EAT-40 (Garner, et al., 1982). Test-retest reliability for EAT-26 ranged from .84 to .89 (Banasiak et al., 2001). Other studies have noted the low reliability in studies conducted from 2005 onward, which might reflect changing attitudes toward food and exercise since the establishment of the EAT. There have also been some issues around the factorial structure of the EAT. The original three factor structure established by Garner et al., (1983) has been replicated inconsistently, with some studies noting three factors and four factors in others (Periera et al., 2008; Ocker et al., 2007). In non-clinical populations, some studies have found four factors that differ from Garner’s original factor structure. As such, a notable concern in nonclinical populations is that the EAT factors represent multiple theoretical constructs within one dimension (Ocker, Lam, Jensen & Zhang, 2007).
However, the EAT-26 has been extensively validated across other clinical and non-clinical subgroups from various cultural backgrounds (Eastern/Western Europe, South America, Middle East, Asia; Garfinkel and Newman, 2001).
You can access the EAT-40 and the EAT-26 by following this link: http://www.eat-26.com/. Information regarding scoring, interpretation and screening information.
Garner DM & Garfinkel PE. The eating attitudes test: An index of the symptoms of anorexia nervosa. Psychological Medicine. 1979; 9: 273-279.
Garfinkel, P. & Newman, A. (2001). The Eating Attitudes Test: Twenty-five years later. Eating and Weight Disorders — Studies on Anorexia, Bulimia and Obesity, 6(1), 1–21. http://dx.doi.org/10.1007/BF03339747.
Garner, D., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The Eating Attitudes Test: Psychometric features and clinical correlates. Psychological Medicine, 12(4), 871-878.
Garner, D. (2009). EAT-26 Self-Test. Retrieved from http://www.eat-26.com/index.php
Gleaves, D. H., Pearson, C. A., Ambwani, S., &Morey, L. C. (2014). Measuring eating disorder attitudes and behaviors: A reliability generalization study. Journal of Eating Disorders, 2(6), 1-12. doi: 10.1186/2050-2974-2-6.
Maloney, M.J., McGuire, J.B., Daniels, S.R. (1988). Reliability testing of a children’s version of the Eating Attitude Test. Journal of the American Academy of Children and Adolescent Psychiatry, 27, 541–543.
Ocker, L.B., Lam, E., Jensen, B. E., Zhang, J.J. (2007). Psychometric properties of the Eating Attitudes Test. Measurement in Physical Education and Exercise Science, 11(1), 25-48.
Pereira, A. T., Maia, B., Bos, S., Soares, M. J., Macques, M., & Macedo, A., et al. (2008). The Portuguese short form of the Eating Attitudes Test-40. European Eating Disorders Review,16, 319-325.
Rivas, T., Bersabe, R., Jimenez, M., & Berrocal, C. (2010). The Eating Attitudes Test (EAT-26): Reliability and validity in Spanish Female Samples. The Spanish Journal of Psychology, 13(2), 1044-1056.