Eating Attitudes (EAT-26) Test

The Eating Attitudes Test (EAT-26) is one of the most widely used self-report instruments for screening symptoms and attitudes associated with eating disorders. Developed in the late 1970s and early 1980s by David M. Garner, Mary P. Olmsted, Yvonne Bohr, and Peter E. Garfinkel, the test was designed to provide a brief, psychometrically robust tool for identifying individuals at risk for anorexia nervosa and other disordered eating behaviors. Garner and Olmsted, both clinical psychologists with extensive experience in eating disorder research, together with Garfinkel, a psychiatrist with a focus on clinical assessment, sought to create a standardized instrument that could be applied in both clinical and research settings.

The EAT-26 originated as a shortened form of the original 40-item Eating Attitudes Test (EAT-40). The reduction to 26 items was guided by psychometric analyses aimed at maximizing internal consistency, discriminative power, and construct validity while reducing respondent burden. Items were selected to capture core symptoms and attitudinal patterns associated with eating disorders, including preoccupation with food and body weight, restrictive eating practices, and behaviors indicative of bulimic tendencies. Each item is scored on a six-point Likert scale, and responses are assigned numeric values ranging from 0 to 3, with higher scores reflecting greater risk for disordered eating. A total score of 20 or greater is conventionally used as a cutoff to identify individuals warranting further evaluation. While the EAT-26 provides a screening indication, it is not a diagnostic tool and must be interpreted in conjunction with clinical assessment and structured interviews.

Psychometric evaluation of the EAT-26 has consistently demonstrated strong reliability and validity. Internal consistency coefficients (Cronbach’s alpha) typically range from 0.85 to 0.90 across diverse populations, indicating high homogeneity among items. Test-retest reliability over short intervals is also robust, reflecting the stability of measured attitudes over time. Factor-analytic studies have confirmed the presence of three conceptually coherent subscales—Dieting, Bulimia/Food Preoccupation, and Oral Control—though the instrument is often used primarily as a single global measure of eating disorder risk. Convergent validity has been supported through correlations with clinical diagnoses, other self-report measures of eating pathology, and behavioral indicators such as body mass index and reported compensatory behaviors.

The EAT-26 has been translated and validated in numerous languages and across a wide range of cultural contexts, making it one of the most widely cited tools in the field of eating disorder research. Its applications include large-scale epidemiological studies, screening in school and university populations, and monitoring of treatment outcomes in clinical settings. Importantly, while it effectively identifies individuals at elevated risk, it cannot substitute for a comprehensive clinical evaluation, and its sensitivity may vary depending on age, sex, and cultural background.

In summary, the EAT-26 is a scientifically validated, reliable, and efficient screening instrument for detecting attitudes and behaviors associated with eating disorders. Developed by recognized experts in psychology and psychiatry, it combines brevity with psychometric rigor, supporting its widespread use in both research and applied clinical contexts. Its continued prominence in the literature reflects its utility in identifying at-risk populations, informing intervention strategies, and advancing the understanding of disordered eating across diverse populations.

References

• Garner, D.M., & Garfinkel, P.E. (1979). The Eating Attitudes Test: An index of the symptoms of anorexia nervosa. Psychological Medicine, 9(2), 273–279. https://doi.org/10.1017/S0033291700030762
• Garner, D.M., 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.M. (1991). Eating Disorder Inventory2 and Eating Attitudes Test (EAT26): Professional manual. Odessa, FL: Psychological Assessment Resources.