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Age: _____
pregnancy): _____
Sex: _____
Height: _____
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Score
Total Score =
Behavioral Questions:
In the past 6 months have you:
Gone on eating binges where you feel that you may not be able to stop? (Eating
A.
much more than most people would eat under the same circumstances)
If you answered yes, how often during the worst week: ____________________
Ever made yourself sick (vomited) to control your weight or shape?
B.
If you answered yes, how often during the worst week: ____________________
Ever used laxatives, diet pills or diuretics (water pills) to control your weight or shape?
C.
If you answered yes, how often during the worst week? ____________________
Ever been treated for an eating disorder? When: ___________________________
D.
EAT-26 From: Garner et al. 1982, Psychological Medicine, 12, 871-878); adapted by D. Garner with permission.
Yes
No
Items # 1-25:
Always
Usually
Often
Sometimes
Rarely
Never
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Total =
Add item scores together
for a Total EAT-26 score:
Step 3: Behavioral Questions
Yes
Did you score Yes on
Questions A, B, C or D?
Step 4: Underweight
Step 5: Referral
No Yes
Weight
(pounds)
86
88
89
90
91
93
95
96
99
100
101
103
105
106
108
109
112
113
114
117
Height
(inches)
68
68 _
69
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70 _
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72 _
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77 _
Weight
(pounds)
118
120
121
124
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131
132
134
135
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144
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149
152
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Always
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Never
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Score
Total Score=
1) Have you gone on eating binges where you feel that you may not be able to stop?
(Eating much more than most people would eat under the same circumstances)
_ No _ Yes
2) Have you ever made yourself sick (vomited) to control your weight or shape?
_ No _ Yes
3) Have you ever used laxatives, diet pills or diuretics (water pills) to control your weight or shape?
_ No _ Yes How many times in the last 6 months? _________
4) Have you ever been treated for an eating disorder? _ No _ Yes When? ____________________
EAT-26 ' David M. Garner (1982) Note: The EAT-26 has been made available with permission of the authors.
Step 1
EAT-26 ITEM SCORING:
Score each item as indicated below
and put score in box to the right of
each item
Item #26 only:
Items # 1-25:
Always
Usually
Often
Sometimes
Rarely
Never
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Step 2
Total =
Add item scores together
for a Total EAT-26 score:
Step 3
Determine if you are significantly
underweight according to the table to
the right
Step 4
If your EAT-26 score is 20 or more or
if your weight is below the number on
the weight chart to the right, we
suggest that you discuss your results
with your physician or therapist
Significantly Underweight
According to Height
Height
(inches)
58
58 _
59
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60
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