Eating Disorder Measures in a Sample of Military Veterans: A Focus on Gender, Age, and Race/Ethnicity

Early detection of eating disorders (EDs) is crucial for both prevention and treatment; however, few ED measures have been validated among older adults, men, and racially/ethnically diverse individuals, who may have varying symptom presentations. We examined the psychometric quality of three self-report ED measures within a diverse sample of U.S. military veterans, a population that may have elevated rates of EDs. Participants (N = 1,187) completed the Eating Disorder Diagnostic Scale-5 (EDDS-5), the Eating Disorder Examination-Questionnaire (EDE-Q), the SCOFF (Sick, Control, One, Fat, and Food) questionnaire, and measures of associated mental health symptoms. We examined proportions of probable EDs and reliability estimates, associations among ED measures, and their relationship with mental health measures for the sample as a whole and based on age, gender, and race/ethnicity. Proportions of probable EDs ranged from 9.9% to 27.7% and were comparable for White, Black, and Latinx participants. Participants aged 40–49 had significantly higher proportions of EDs compared to other age groups, whereas participants aged ≥60 had significantly lower proportions of EDs. Participants with obesity had significantly higher proportions of probable EDs compared to participants with healthy weight or overweight. There was fair to moderate agreement between the ED measures, with varying evidence for psychometric quality across demographic subsamples. Overall, the EDDS-5 performed best in this sample and yielded estimates of probable EDs consistent with expectations.