Introduction
The Eating Disorder Examination (EDE) is a semi-structured interview that assesses the full range of the specific psychopathology of eating disorders, including extreme concerns about shape and weight. Zafra Cooper and Christopher Fairburn published it in 1987, and it has received more than 1,900 citations.
A trained clinician conducts the EDE, which is considered a "gold standard" for assessing eating disorder psychopathology. This guide explains its subscales, rating rules, versions and evidence on reliability and validity.
Key Features of the Eating Disorder Examination (EDE)
Purpose and Use
The EDE was developed for detailed psychopathological studies and for investigations into the effects of treatment. It assesses both:
Attitudes: restraint, eating concern, shape concern and weight concernBehaviors: how often specific eating disorder behaviors occurTarget Population
The EDE is intended for adults aged 18 and older. A child version, the ChEDE, is available for children and adolescents aged 8 and older.
Structure
The EDE uses a flexible, investigator-based format. Instead of a fixed set of questions, the clinician probes to gather full information, and the interview is commonly described as having 62 items, although the count varies with the clinician's probes. It covers thoughts and behaviors over the preceding 28 days.
Four subscales capture the core psychopathology:
Subscale
What it covers
Dietary Restraint
Restraint over eating, avoidance of eating, food avoidance, dietary rules and desire for an empty stomach
Eating Concern
Preoccupation with food, eating or calories, fear of losing control, eating in secret, guilt about eating and discomfort eating in social situations
Shape Concern
Preoccupation with shape or weight, fear of weight gain, feelings of fatness, dissatisfaction with shape, discomfort seeing one's body and avoidance of exposing it
Weight Concern
Preoccupation with shape or weight, strong desire to lose weight, importance of weight, reaction to prescribed weighing and dissatisfaction with weight
The EDE also records the frequency of behavioral symptoms, including objective and subjective binge-eating episodes, purging (such as self-induced vomiting and laxative misuse), fasting and excessive exercise.
Scoring Method
Most items are rated on a 7-point scale (0 to 6) with at least four clearly defined anchor points. Items are rated either for severity or for how often they occurred at a defined level of severity. Frequency anchors are:
Rating
Days in the past 28 days
0
No days / not at all
1
1–5 days
2
6–12 days
3
13–15 days
4
16–22 days
5
23–27 days
6
Every day
Subscale scores: the mean of the relevant itemsGlobal score: the mean of the four subscale scoresBehavior frequencies: specific items, such as the number of days, are recorded directlyThe EDE has no single, universally accepted cut-off score.
Administration Format
The EDE is a clinician-administered interview. The developers recommend interviewer training so that all the concepts being assessed are well understood.
Applications of the Eating Disorder Examination (EDE)
The EDE supports several uses:
Psychopathology research: detailed study of the specific features of eating disorders.Treatment research: measuring the effects of treatment.Diagnosis: the current version (17.0D) generates DSM-5 eating disorder diagnoses.Languages and availability
The original 1987 article is published in the International Journal of Eating Disorders, and the instrument is listed in PsycTESTS. Wiley holds the copyright for the original publication.
A Spanish-language version of the EDE has been compared with the Spanish EDE-Q, and a cultural adaptation of the EDE-Q 6.0 has been published in Russian.
For commercial use of the EDE or EDE-Q, contact the Centre for Research on Eating Disorders at Oxford (CREDO).
Reliability and Validity
The EDE showed excellent inter-rater reliability in its original development. A later study examined the validity of the EDE and its subscales, and a systematic review has evaluated the psychometric properties of the EDE and EDE-Q.
Validation studies:
The Eating Disorder Examination: a semi-structured interview for the assessment of the specific psychopathology of eating disorders (1987): study linkThe validity of the Eating Disorder Examination and its subscales (1989): study linkThe Spanish language version of the EDE-Q: comparison with the Spanish EDE and test–retest reliability (2007): study linkLimitations and Considerations
Keep these points in mind:
Training: interviewers need training to administer the EDE well.No fixed cut-off: there is no universally accepted cut-off score.Research focus: the EDE was designed for research purposes, not as a standalone diagnostic tool.Variable length: the item count varies with the clinician's probes.Other Versions And Related Questionnaires
The EDE has several versions:
Version
Year
Notes
Original EDE
1987
The original semi-structured interview by Cooper and Fairburn
12th edition
1993
Published in Binge Eating: Nature, Assessment and Treatment
16.0D
2008
Published in Cognitive Behavior Therapy and Eating Disorders
17.0D
2014
Current version; generates DSM-5 diagnoses and data compatible with 16.0D
Child EDE (ChEDE) 17.0D/C.1
–
Adapted for ages 8 and older by Rachel Bryant-Waugh and Beth Watkins
The Eating Disorder Examination Questionnaire (EDE-Q) is a self-report version adapted from the interview. It is not a diagnostic instrument. The current EDE-Q 6.0 has 28 items and keeps the four subscales and global score. Youth (YEDE-Q) and child (ChEDE-Q) questionnaires are also available.
These questionnaires are related:
Eating Attitudes Test; see the ResRef EAT-26 guideEating Disorder InventoryBinge Eating Scale and Bulimia TestRevised Restraint Scale and Three Factor Eating QuestionnaireAdditional Resources
A critique of the EDE (Thomas, Berg and Roberto, 2014): linkMind the Gaps: revisiting the validity, consistency and scope of the EDE (2025): linkThe EDE and EDE-Q in the Australian comorbidity guidelines: linkCBT-E measures for professionals: linkFor commercial use of the EDE or EDE-Q, contact CREDO at credo@medsci.ox.ac.uk.Browse more psychiatry questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What does the Eating Disorder Examination measure?The EDE assesses the specific psychopathology of eating disorders over the past 28 days across four subscales: dietary restraint, eating concern, shape concern and weight concern. It also records binge eating, purging, fasting and excessive exercise.
How is the EDE scored?Most items are rated from 0 to 6. Each subscale score is the mean of its items, and the global score is the mean of the four subscales. Behavior frequencies, such as the number of days, are recorded directly.
What is the difference between the EDE and the EDE-Q?The EDE is a clinician-administered semi-structured interview. The EDE-Q is a 28-item self-report questionnaire adapted from it, which keeps the four subscales and global score but is not a diagnostic instrument.
Does the EDE have a cut-off score?No. The EDE does not have a single, universally accepted cut-off score. Higher subscale and global scores reflect more severe eating disorder psychopathology over the past 28 days.
A Word from ResRef About the Eating Disorder Examination (EDE)
The Eating Disorder Examination is a comprehensive, semi-structured interview considered a gold standard for assessing the specific psychopathology of eating disorders. It demonstrated excellent inter-rater reliability in its original development. Its administration requires interviewer training, and it is designed for research purposes, not as a standalone diagnostic tool.
References
Cooper, Z., & Fairburn, C. (1987). The eating disorder examination: A semi-structured interview for the assessment of the specific psychopathology of eating disorders. International Journal of Eating Disorders, 6(1), 1–8. https://doi.org/10.1002/1098-108X(198701)6:1%3C1::AID-EAT2260060102%3E3.0.CO;2-9Cooper, Z., Cooper, P. J., & Fairburn, C. G. (1989). The Validity of the Eating Disorder Examination and its Subscales. British Journal of Psychiatry, 154(6), 807–812. https://doi.org/10.1192/bjp.154.6.807Elder, K. A., & Grilo, C. M. (2007). The Spanish language version of the Eating Disorder Examination Questionnaire: comparison with the Spanish language version of the eating disorder examination and test-retest reliability. Behaviour Research and Therapy, 45(6), 1369–77. https://doi.org/10.1016/j.brat.2006.08.012Schmidt, R. (2025). Mind the Gaps: Revisiting the Validity, Consistency, and Scope of the Eating Disorder Examination. A Commentary on Reilly et al. (2025). International Journal of Eating Disorders, 58(10), 1911–1914. https://doi.org/10.1002/eat.24509Berg, K. C., Peterson, C. B., Frazier, P., & Crow, S. J. (2011). Psychometric evaluation of the eating disorder examination and eating disorder examination‐questionnaire: A systematic review of the literature. International Journal of Eating Disorders, 45(3), 428–438. https://doi.org/10.1002/eat.20931Aslanova, M. S., Chernov, N. V., Kostyuk, G. P., & Sgonnik, E. S. (2026). [Cultural adaptation of the Eating Disorder Examination Questionnaire (EDE-Q 6.0)]. Zhurnal Nevrologii I Psikhiatrii Imeni S.S. Korsakova, 126(2), 97–108. https://doi.org/10.17116/jnevro202612602197