What Tool Most Effectively Measures Symptoms of Bulimia?

Bulimia nervosa is an eating issue that can be assessed using a variety of diagnostic tools. Because there are many different measures to evaluate bulimia, some researchers believe that overestimation or underestimation of bulimia exists. To cloud the issue further, a large majority of people who have symptoms of bulimia often have comorbid psychological conditions, including mood problems, anxiety, depression, and drug or alcohol use.

Less than half of the individuals who demonstrate bulimic symptoms seek treatment for them. Although many do enter treatment for comorbid issues, the bulimia is often discovered secondarily and does not always receive the attention it deserves. Bulimia can lead to serious negative health outcomes and even suicide. For clinicians to identify those most at risk and intervene at the earliest point possible, it is imperative that consistency in symptom assessment and diagnosis be achieved.

Katie Sandberg of the Department of Education Specialties at Loyola University in Maryland wanted to test the reliability, consistency and validity of the six most commonly used tools for assessing bulimia. She conducted an analysis of existing research involving studies using the Eating Disorder Examination (EDE), the Eating Attitudes Test (EAT), the Eating Disorder Inventory-3 (EDI-3), the Body Shape Questionnaire (BSQ), the Bulimic Investigatory Test, Edinburgh (BITE), and the Three-Factor Eating Questionnaire (TFEQ).

Sandberg found that all six measures were able to assess bulimic symptoms with relative accuracy, but in unique ways. Based on symptoms of purging, binging, laxative use, and overall body dissatisfaction, she found that the EDI and the EAT were the most reliable at assessing bulimia. When she looked at body dissatisfaction, the BSQ and the EDE emerged as the most reliable tools.

In sum, Sandberg believes these findings show the importance of utilizing multiple screening tools when evaluating clients for bulimia. She said, “The best way for clinicians and researchers to document treatment effects is to use a multitude of high-quality instruments to achieve triangulation.” Further, she believes implementing screening tools before and during treatment can provide clinicians with accurate measures of progress and can help clients and clinicians identify persistent symptoms that need further attention.

Sandberg, Katie, and Bradley T. Erford. “Choosing Assessment Instruments for Bulimia Practice and Outcome Research.” Journal of Counseling and Development : JCD 91.3 (2013): 367-79. ProQuest. Web. 26 July 2013.

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  • Shane R

    August 16th, 2013 at 11:52 PM

    These methods are mostly tests or questionnaires so I think using multiple techniques is completely fine.with something like this there is no chance of a side effect so its okay to go with more than one method.and if using two or more would give better accuracy then they should go ahead with someing like this by default.

  • Natalia

    August 17th, 2013 at 5:26 AM

    There are going to be different ways to get different patients to open up about the problems they have going on in their lives and different tools will always meet the needs of different people. I think that particularly in the case of eating disorders you will find a lot of hesitation for women and men to seek treatment because it not only is about issues that they are experiencing internally alot of it has to do with how they are seeing themsel ves on the outside too. A variety of tools will always be the most effective approach to reaching the most patients and making the greatest impact on the biggets numbers of sufferers.

  • vanessa

    August 18th, 2013 at 8:24 PM

    sounds good.not only does it address the lack of a 100% accuracy in any one method but also counters any chances of inconsistency.any catch here though?would using more than one method be detrimental in any way?if so then how?all good but proceed with caution we should.

  • carson

    August 19th, 2013 at 5:43 AM

    I know that when we found out that my sister had an eating disorder it took the doctors months to get that out of her because there was nothing that they were doing for her or saying to her that was reaching her in a way that allowed her to feel safe enough to open up and be honest about what was going on with her. Come to find out this was something that she had been struggling with for years but she knew how much it ended up burdening her so she did not want to place that same kind of burden on the family as well. This has been such a learning experience for all of us trying to get her help while also learning what we could be ndoing to trigger her behavior and how we could contribute in a more meaningful way to her recovery.

  • Tim

    August 20th, 2013 at 5:48 AM

    I suppose after reading this I can see that I have been in the dark when it comes to this subject because I thought that the only symptoms of bulimia would be the traditional bingeing and purging.
    Of course there would be mood issues to go along with that but my first inclination when thinking of this is not to go to that but to only think of what you do with the food and not how that manifests in other ways.

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