Factor Structure of the EDE-Q in Inpatients With Anorexia Nervosa: Stability Over the Course of Inpatient Treatment

The Eating Disorder Examination-Questionnaire (EDE-Q) is one of the most widely used measures of eating disorder psychopathology; however, its original four-factor structure is not supported in data-driven investigations. This study examined the latent structure of the EDE-Q in a large sample of inpatients with anorexia nervosa (AN) at the beginning and end of hospitalization.

Inpatients with AN (ages 13-64 years) were included. Exploratory factor analysis (EFA) was conducted using EDE-Q data collected at admission (n = 320). Confirmatory factor analysis (CFA) was conducted using data collected just prior to discharge (n = 301). Reliability was assessed using internal consistency indices and construct validity of the proposed EDE-Q subscales was explored using correlational analyses with the eating disorder inventory (EDI) and the eating pathology symptoms inventory (EPSI).

The original four-factor structure was not supported. A three-factor model (Body Image Dissatisfaction, Discomfort with Body Exposure, and Restrictive Eating Concerns) emerged from the EFA and was supported in CFA with improved model fit (CFI = 0.928, TLI = 0.915, RMSEA = 0.087, SRMR = 0.055). The model showed acceptable internal consistency and convergent validity.

The EDE-Q was found to have a three-factor structure, comprising two body image-related domains and one domain assessing restriction and concern about eating. Findings support the emergence of a distinct factor capturing discomfort with body exposure, independent of body dissatisfaction. This highlights the need for empirically derived subscales that better disentangle overlapping eating disorder constructs.