Eating Disorder Questionnaire
Issue this Eating Disorder Questionnaire to your patient in order to assess the severity of their eating disorder. Have them fill it out and use their answers as the basis for your care plan to put a stop to their eating disorder and help them reach a state where they have healthy eating habits.
What is an Eating Disorder Questionnaire?
The (sometimes labeled as the Eating Disorder Examination Questionnaire) is a self-report assessment that acts like an on-paper interview, but instead of coming up with elaborate answers for each prompt, patients who have eating disorders simply need to rate themselves based on the questions.
The questionnaire has four categories that it seeks to assess: restraint, eating concerns, shape concerns, and weight concerns. The patient has to rate the items on the questionnaire based on how they felt and acted in relation to eating food for the past four weeks (twenty-eight days).
Printable Eating Disorder Questionnaire
Download this Eating Disorder Questionnaire and assess the likelihood of your client having an eating disorder.
How to use the Eating Disorder Questionnaire
Issue this questionnaire to the patient and have them answer it.
If you’ve reached the point in your sessions with your patient where you are now going to have to properly assess the severity of their eating disorder, then it’s best to issue this assessment to them.
Instruct them on how to answer and simply wait for them to give it back.
The questionnaire is easy. They simply need to follow the instructions per section, which is mostly rating themselves based on the past four weeks (twenty-eight days). The ratings go from 0 to 6. These ratings stand for different things per section, so make sure they carefully read what each number stands for per section.
That’s mostly what they need to do. Toward the end of the questionnaire, they simply have to indicate their weight at the moment and their height. If they’re not sure about those, they can give their best estimate. If they’re seeing you face-to-face, then it’s best that you have the equipment to measure them in your clinic.
There’s also a section only meant for females, which asks them if they have missed any menstrual periods over the past three to four months, how many they have missed, and if they take birth control pills.
Tally the scores.
This version of the Eating Disorder Questionnaire has a simplified scoring system. You simply have to tally the scores per category (Restraint, Eating Concern, Shape Concern, and Weight Concern), then do the following:
- For each category, calculate its total score by dividing its respective sum by the respective number of items it has
- Then, combine all the total scores and divide by the total number of categories (always 4) to get the global score.
- If they get a score of 4 or higher, whether it’s for a category or global score, that means that it’s a cause for concern and should be looked into as soon as possible.
- There is no clear designation for whatever score they get. You just have to know that the higher the score, the higher the concern. If they score below 4, that doesn’t mean they don’t have an eating disorder. You’re going to have to base your interpretations on the ratings themselves.
Develop a care plan.
After tallying all the scores, you can indicate if they have a severe eating disorder based on what they got per category and what they got as a global score.
Just to reiterate, there is no specific designation for each score, except that 4 or higher means that their eating disorder severity is at the point where there should be cause for concern.
Whether they scored higher or lower than 4, your plan will be based on their specific ratings and whatever you have discussed with them. Make sure to tailor-fit the plan to their needs.
Eating Disorder Questionnaire Example
Here’s a filled-out Eating Disorder Questionnaire sample so that you have an idea of what it looks like, especially when it has been fully accomplished by the patient. If you need this questionnaire for your practice, feel free to download a printable Eating Disorder Questionnaire PDF. You may even fill this out digitally as well! Do note that this is for non-commercial use only. If you need to use this for commercial use, please contact the copyright holders: Christopher G Fairburn and Sarah Beglin.
Download this Eating Disorder Questionnaire Example (Sample) here:

When is it best to use this Eating Disorder Questionnaire?
It’s best to issue this questionnaire to your patient when you need to assess the severity of their disorder and want to examine how they exercise restraint, what their concerns are when it comes to eating (like feeling guilty for eating or fear of eating too much), and how preoccupied are they with their weight and body shape.
You may have them answer it on the spot or you may have them take the questionnaire home. It would be best to come to an agreement with your patient so you don’t unnecessarily give them any stress given that you are discussing what is highly likely to be a sensitive topic for them.
Who can use the Eating Disorder Questionnaire for their practice?
The following healthcare practitioners may use this for their practice:
- Dietitians
- Nutritionists
- Pediatricians
- Psychologists
- Psychiatrists
- Occupational therapists
- Rehabilitation therapists and workers
- Mental health therapists
- Nurses
So long as the practitioner specializes and is a certified expert when it comes to eating disorders and mental health-related issues, they can definitely use this.

What are the benefits of using this Eating Disorder Questionnaire?
It can help you determine if a patient is at risk of developing an eating disorder.
This nifty questionnaire can be used as a screening tool. In the event that your patient hasn’t been diagnosed with an eating disorder yet, this should help you see if they are at risk of developing one. If they are at risk of developing one, you can work to curb it so it doesn’t get any worse.
This version streamlines the scoring part for you.
This particular version of the Eating Disorder Questionnaire has a section that’s meant for the practitioner, which has tally boxes and a mini-guide that tells them how to go about their calculations. This makes attempting to organize and calculate the scores less of a hassle.
It may help the patient realize what they do and how they actually feel about themselves.
Given that this questionnaire asks specific questions in relation to their restraint, their eating concerns, as well as their weight and shape concerns, this will create the opportunity for the patient to mull over their eating habits and possible disorders they might (or do) have. They may not want to act on it immediately, but acknowledging their (possible) eating disorder(s) is half the battle.
Their ratings can serve as the basis for discussion for your next sessions and your treatment plan
In relation to nudging them to get to talk, the items in the questionnaire and the patient’s ratings should become talking points in order to better assess their problems. Yes, the scores should serve as indicators as well, but it’s also important to get them to elaborate so the practitioner can have a better understanding. Their ratings and whatever you discuss moving forward after receiving a fully-accomplished questionnaire should also give you ideas on what to include in the treatment plan.
It can be used to monitor the patient over time.
Just because you already used it before, it doesn’t mean that you can reuse the questionnaire. One great way to track your patient in terms of progress is to reissue this questionnaire. You’ll be able to see if they are getting better based on their new ratings. Reusing this questionnaire may also help you determine if your treatment plan is working and should be maintained, or if it needs some tweaking to become more effective in the long run.
Commonly asked questions
The calculations are more or less the same per category. You simply need to add up a category’s score, then divide it by the number of items that the category has.
For the final score, you have to add up the total scores for all categories, then divide by 4.
We simplified things for you by creating a scoring section with the calculation instructions.
There are no specific designations for the scores, save for the broad definition of 4 and above, meaning the patient’s (potential) eating disorder is a cause for concern.
Also, if they score below 4, that doesn’t mean they don’t have (potential) eating disorders. How you should approach this will be based on their ratings because you should be able to identify (potential) problems based on the patient’s answers on the questionnaire and during your sessions.
The Eating Disorder Questionnaire is helpful because, no matter the scores, you will be able to screen if the patient is at risk of developing eating disorders or determine if they already have one. Their self-ratings should also serve as the basis on what your treatment plan should focus on.
Why use Carepatron for psychology and mental health software?
If you are looking for worksheets, assessments, and even plans to help aid you with your psychology, mental health, and/or counseling practice, Carepatron is the best source for all of that. Our platform houses a wide variety of clinical documents that cover a wide range of topics and fields. One such assessment that you can find is this Eating Disorder Questionnaire!
Not only do we have a range of documents and templates you can use, but we also offer the storage of clinical documents! If you use this Eating Disorder Questionnaire for your practice, you can store fully-accomplished ones via our platform and you’ll be able to do so in a HIPAA-compliant manner! You can even set who can access these documents besides you!
Storing them on our platform also makes it easily accessible, meaning you can access your documents via your desktop, laptop, or even a phone!
Convenience. Accessibility. Security. You get all three with Carepatron.
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