Disordered eating behaviours
============================

* Jennifer M. Jones
* Marion P. Olmsted
* Gary Rodin

We appreciate Frank Elgar's recent letter to the editor drawing attention to our study of disordered eating attitudes and behaviours in a large school-based sample of teenaged girls in Ontario.1 We agree that self-report screening measures should not be used to diagnose eating disorders, and we did not use them for this purpose in our study. In the presentation of our findings, we have not suggested that the percentage of girls who scored above the cut-off on a self-report measure, specifically the Eating Attitudes Test-26 (EAT-26),2 be equated with the prevalence estimate of a psychiatric disorder in our sample. Nor did we use our other self-report screening measures (i.e., the Eating Disorder Inventory3 or the Diagnostic Survey for Eating Disorders4) as diagnostic instruments. 

As Elgar correctly notes, many girls who scored above cut-off on the EAT-26 in our sample would likely not meet the criteria for a clinical eating disorder, based on a diagnostic assessment.5 However, self-report screening instruments can provide valuable information regarding the presence of disturbed attitudes and behaviours that may put some young women at increased risk for the development of clinical eating disorders.6,7 The alarmingly high frequency of disordered attitudes about weight and food and of unhealthy weight loss behaviours (as reported in our sample) highlights the importance of routine screening and the need for primary and secondary preventive interventions.

**Jennifer M. Jones** Research Scientist Toronto General Hospital Research Institute University Health Network Toronto, Ont. **Marion P. Olmsted** Director Ambulatory Care for Eating Disorders Toronto General Hospital University Health Network Toronto, Ont. **Gary Rodin** Head, Behavioural Sciences and Health Research Division Toronto General Hospital University Health Network Toronto, Ont.

## References

1.  1. Jones JM, Bennett S, Olmsted MP, Lawson ML, Rodin G. Disordered eating attitudes and behaviours in teenaged girls: a school-based study. CMAJ 2001;165(5):547-52.
    
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2.  2. Garner DM, Olmsted MP, Bohr Y, Garfinkel PE. The eating attitudes test: psychometric features and clinical correlates. Psychol Med 1982; 12: 871-8.
    
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3.  3. Garner DM, Olmsted MP.* Eating Disorder Inventory (EDI) Manual*. Florida: Psychological Assessment Resources; 1984.
    
    

4.  4. Johnson C. Initial consultation for patients with bulimia and anorexia nervosa. In: Garner DM, Garfinkel PE, editors. *Handbook of Psychotherapy for Anorexia and Bulimia*. New York: Guilford Press; 1985. p. 19-51.
    
    

5.  5. Garfinkel PE, Newman A. The eating attitudes test: twenty-five years later. Eat Weight Disord 2001; 6 (1):1-24.
    
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6.  6. Polivy J, Herman CP. Dieting and bingeing: a causal analysis. Am Psychol 1985;40:193-201.
    
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7.  7. Patton GC, Selzer R, Coffet C, Carlin JB, Wolfe R. Onset of adolescent eating disorders: population based cohort study over 3 years. BMJ 1999; 318: 765–8.
    
    [Abstract/FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6MzoiYm1qIjtzOjU6InJlc2lkIjtzOjEyOiIzMTgvNzE4Ni83NjUiO3M6NDoiYXRvbSI7czoyNDoiL2NtYWovMTY2LzExLzEzOTYuMy5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=)