Establishing General and Context‐Specific Eating Disorder Examination Questionnaire (EDE‐Q) Cut‐Off Scores for Anorexia Nervosa

OBJECTIVE: Our aim was to evaluate the diagnostic accuracy of the Eating Disorder Examination Questionnaire (EDE-Q) scores and establish general and context-specific cut-off points for anorexia nervosa (AN) in Australian women. METHODS: The sample included 67 women with AN, 41 women with a history of AN and restored weight, 100 women with self-reported AN, 27 sisters of individuals with AN, 73 healthy controls, and 597 community controls. ROC analysis assessed the EDE-Q's accuracy and determined cut-off scores in different contexts. RESULTS: The EDE-Q showed varying discriminative ability, with cut-off scores differing by context. In the most realistic scenario-diagnosed AN versus community controls drawn from the general population, reflecting typical screening contexts-, the Area Under the Curve (AUC) was 0.88, and a cut-off score of 2.775 yielded sensitivity of 0.91 and specificity of 0.71, recommended as the general cut-off for AN in Australian women. CONCLUSION: These findings indicate the EDE-Q is useful for identifying individuals at risk of AN but has limited diagnostic capacity due to moderate specificity. While the EDE-Q can guide initial screening using a 2.775 cut-off on the Global score, it is primarily a screening tool and should be complemented by further assessment to confirm diagnosis. Overall, our study provides evidence-based guidance for establishing a general EDE-Q cut-off for AN and informs the definition of context-specific thresholds.