Preliminary Validation of Two Brief Screening Measures for Eating Disorders in Adults with Chronic Pain

TL;DR

This study tested two short questionnaires to detect eating disorders in adults with chronic pain, finding them reliable but possibly incomplete for this specific group.

Contribution

The study provides preliminary validation of the EAT-8 and EDE-Q8 as screening tools for eating disorders in chronic pain patients.

Findings

Both EAT-8 and EDE-Q8 showed acceptable reliability and strong validity in chronic pain patients.

Scores varied by BMI and eating disorder history, with higher scores in obese individuals or those with prior eating disorders.

Less than 20% of participants felt the measures fully captured their eating problems related to chronic pain.

Abstract

Chronic pain and eating problems frequently co-occur, with disordered eating behaviors such as emotional eating, food restriction, and appetite fluctuation contributing to adverse outcomes. However, there are no validated screening tools specifically designed for assessing eating problems in chronic pain populations. This study aimed to validate two brief eating disorder measures, the Eating Attitudes Test-8 (EAT-8) and Eating Disorder Examination-Questionnaire-8 (EDE-Q8), for English-speaking adults presenting for chronic pain treatment. Participants included 173 adults seeking treatment at a pain evaluation service. Participants completed the EAT-8 and EDE-Q8 alongside self-report clinical measures. Demographic and clinical data were extracted from medical records. Statistical analyses assessed internal reliability, construct validity, and differences in eating disorder measures by BMI and eating disorder history. Both the EAT-8 and EDE-Q8 demonstrated acceptable internal reliability (McDonald’s omega ≥ 0.7) and strong construct validity, with significant correlation between the two measures (r = 0.77). Scores varied significantly by BMI and eating disorder history, with higher scores observed among participants with obese BMI or a history of eating disorders. However, less than 20% of participants felt the measures fully captured their experiences, suggesting potential gaps in assessing eating problems specific to chronic pain. The EAT-8 and EDE-Q8 are valid and reliable tools for identifying disordered eating behaviors in chronic pain patients. However, these measures may not capture the full spectrum of eating problems unique to this population. Future research should refine screening tools to better assess eating behaviors as they relate to chronic pain.

The online version contains supplementary material available at 10.1007/s10880-025-10111-2.