EAT-26 (eating attitudes test): Free questionnaire template & scoring guide

Key takeaways

The EAT-26 is a 26-item self-report questionnaire that screens for eating disorder symptoms in people aged 14 and older.

Scores run from 0 to 78, and a total of 20 or higher calls for further clinical evaluation.

Three subscales cover dieting, bulimia and food preoccupation, and oral control, so you can see which pattern is driving the score.

Only item 26 is reverse-scored, so check that step before you total the responses.

Practice management software like Pabau can send the questionnaire out, score it automatically, and file the result in the patient record.

The EAT-26 is the questionnaire most practices reach for when a patient’s relationship with food starts to look like a clinical concern.

A total score of 20 or higher is the point at which you arrange a full eating disorder assessment.

It takes five to ten minutes to complete. This guide covers what the 26 items measure, how to total and interpret them, and what each score band asks you to do next.

What the EAT-26 measures

The EAT-26 (Eating Attitudes Test, 26-item version) is the most widely used self-report screen for disordered eating attitudes. Garner and colleagues developed it in 1982, and it is still the standard first-line screen in both practice and research.

The questionnaire flags risk rather than confirming a diagnosis. A score of 20 or higher marks a patient who needs a clinical interview, not a patient who has an eating disorder. It is validated in community samples, clinical populations, and both male and female respondents.

You can hand the questionnaire to a patient on paper, or send it ahead of the visit as one of your digital intake forms. Sending it early means the score is already in the record when the patient sits down.

What the questionnaire asks

Each of the 26 questions uses the same six-point response scale: always, usually, often, sometimes, rarely, or never. The full set of items sits in the downloadable template, grouped by subscale. Here is a sample from each group, to show what the instrument covers.

• Dieting: “I am terrified about being overweight,” “I feel extremely guilty after eating,” “I am preoccupied with a desire to be thinner”
• Bulimia and food preoccupation: “I vomit after I have eaten,” “I think about purging after meals”
• Oral control: “I feel satisfied with my eating,” “I am able to control my eating urges,” “I display self-control around food”

The binge item is the bluntest of the 26. It asks whether the patient has “gone on eating binges where I feel that I may not be able to stop.” The template gives you all 26 items in their published order, so you can run the complete questionnaire at intake or at a review appointment.

How to score and interpret results

Responses are coded numerically: always is 3, usually is 2, often is 1, and sometimes, rarely and never all score 0. One item (item 26) is reverse-scored. Add the 26 item scores together for a total between 0 and 78.

What the table cannot show is where 20 actually sits. The cutoff falls a quarter of the way up a 0 to 78 scale. A fairly modest total already puts a patient in the clinical range.

The cutoff of 20 or higher is the standard clinical threshold across published validation studies and professional guidelines. Meeting it means the patient needs further evaluation, not that the patient has an eating disorder.

The three subscales: Dieting, bulimia, and oral control

The EAT-26 yields three subscale scores, and each one points at a different pattern of eating pathology. Reading them separately tells you what to ask about in the interview that follows.

A high dieting score suggests the restrictive pattern typical of anorexia nervosa. Elevation on bulimia and food preoccupation points instead to binge and purge behavior. Low oral control scores often reflect difficulty managing eating impulses.

What a score of 20 means

A score of 20 or higher means an eating disorder may be present and a professional evaluation is warranted. It is a screening threshold, not a diagnosis. False positives happen, particularly in patients with high health anxiety, perfectionism, or subclinical body image concerns.

The reverse also happens. A total below 20 does not clear a patient, because someone who is minimizing or hiding symptoms can score in the typical range. Weigh the number against what you observe in the room.

Important clinical note: the EAT-26 cannot diagnose an eating disorder. Follow a positive screen with a full clinical interview and a medical history review. A psychiatric evaluation template gives you a structure for that conversation, and a specialist referral follows where it is clinically indicated.

Who it is validated for

The EAT-26 is validated for adolescents aged 14 and older and for adults of all ages. It has been translated into more than 20 languages and used across a wide range of cultural settings.

• Adolescents aged 14 and over: the primary validation population, used widely in school screening and at practice intake
• Young adults aged 18 to 30: the highest-risk group for onset, screened often in primary care and university health services
• Adults over 30: validated, and useful for picking up late-onset or long-standing symptoms
• Clinical populations: eating disorder treatment centers, mental health practices, and general medical practices
• Research use: established psychometric properties that support large-sample studies

Below age 14, a developmentally matched instrument usually fits better. The ChEAT, the children’s version of the test, uses adapted wording and examples. Consider reading level as well as age when you pick a screening tool.

Putting the questionnaire into your intake workflow

Five steps take the EAT-26 from a PDF in a folder to a documented part of routine care.

1. Screen at intake. Give the questionnaire out alongside your mood, substance use, and trauma screens. Sending it ahead of the appointment saves session time and gives you the score before the patient arrives.
2. Score during the visit. Total the 26 items and work out the three subscale scores during or straight after the session. Use the table above as a quick reference, or let your forms system total it for you.
3. Document the result. Record the total, the subscale breakdown, and your interpretation in the patient record. Note whether the score met the threshold of 20, and whether further assessment is warranted.
4. Decide what happens next. Above 20, take a focused eating and weight history and check for medical complications such as amenorrhea, cardiac symptoms, or gastrointestinal problems. An eating disorder worksheet gives the patient structured work to do while a specialist assessment is arranged.
5. Repeat it to track change. Readminister the questionnaire monthly or quarterly during treatment. A falling total is evidence that treatment is working, and patients find it motivating to see.

EAT-26 vs other eating disorder screening tools

Several validated alternatives exist, and the right pick depends on how much time you have and what you need to measure.

The EAT-26 is the most commonly cited of the group and the usual choice for a first screen. It gives you enough detail to guide an interview without taking up a whole appointment slot.

How Pabau scores screening questionnaires automatically

Most practices still run the EAT-26 on paper. Someone prints it and the patient fills it in at reception. A clinician totals the 26 items by hand, and the sheet gets scanned into a folder later. The reverse-scored item is easy to miss, and the number rarely ends up anywhere you can report on.

Digital forms in Pabau handle that whole sequence for you. You send the EAT-26 with the appointment confirmation and the patient completes it on their phone. With the scoring built into the form, the total and the three subscale scores are waiting in the record before the session starts.

The result is also reportable. You can pull every EAT-26 score across your caseload and check how many positive screens actually got a follow-up appointment. As software for therapy practices, Pabau keeps that screening history next to the notes, the consents, and the appointment record.

Score screening questionnaires without the paperwork

Send the EAT-26 before the appointment, let Pabau total the score, and keep the result in the patient record. Your clinicians read a number instead of adding one up.

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Conclusion

The EAT-26 earns its place because it is short enough to use on every intake and specific enough to act on. A total plus three subscale scores tells you whether to ask more questions, and which questions to ask.

The trade-off is that a number this easy to collect is also easy to over-read. Twenty is the threshold for a conversation, not a diagnosis, and a score below it does not close the question either.

Get the questionnaire into your intake pack this week, and decide in advance what happens when a score comes back at 20. Running it inside a mental health EMR removes the arithmetic and the filing, and keeps the result searchable a year later. Book a demo to see how Pabau delivers and scores the EAT-26 as part of your intake.

Continue your research

Need to keep working with a patient after a positive screen? Eating disorder worksheet gives them structured between-session work while a specialist assessment is arranged.

Want a measure focused on binge eating? Binge eating scale scores severity where the bulimia and food preoccupation subscale is elevated.

Screening a teenager for the first time? Adolescent intake questionnaire collects the history and consent detail an under-18 intake needs.

Need a structure for the interview that follows? Psychiatric evaluation template covers the diagnostic interview and the safety assessment.

Screening for substance use at the same visit? AUDIT alcohol screening test is a 10-item screen you can run alongside the EAT-26.

Frequently asked questions