Eating attitudes test (EAT-26)

The EAT-26 is a 26-item self-report instrument that utilizes a 6-point Likert scale ranging from 1 (never) to 6 (always). The EAT-26 is an abbreviated version of a 40-item scale developed by Garner et al. and is a validated psychometric measure that identifies risk for EDs in the general population [21]. The criterion validity of the EAT-26 was evaluated and found to have an overall accuracy of 0.90 [22]. Additionally, the EAT-26 has a high degree of internal reliability with an alpha coefficient of 0.79 in patients with AN and an alpha coefficient of 0.94 comparing patients with AN and normal controls [21].

Although the EAT-26 was validated in the general population and not athletes [21], it was chosen as the external validity comparison because it is a well-accepted tool for detecting EDs and is a relatively brief measure for use in the field. A score of 20 or greater on the EAT-26 indicates risk for ED [22, 23]; however, the purpose of the DESA-6 is to detect DE and not ED, so a different scoring system was needed. A study of female athletes found a mean EAT-26 score of 12.66 was associated with DE [24]; therefore, a score of 12 was chosen for this study to indicate someone being “at risk” for DE. was agreed upon with expert opinion from two sports psychiatrists.