Eating Disorder Examination Questionnaire (EDE-Q) Short Form
Eating Disorder Examination Questionnaire (EDE-Q) Short Form
Self-report severity screener for eating disorders measuring dietary restraint, shape/weight concerns, and episode frequency.
Please answer based on the past 28 days. Responses help your clinician gauge severity and tailor care.
Patient name *
Your answer
Date of birth
Current weight (lbs)
Current height (inches)
Have you been deliberately trying to restrict food (to influence shape/weight)?
Have you gone for long periods (8 waking hours) without eating?
Have you tried to exclude specific foods to influence shape/weight?
+ 10 more questions
About this template
Self-report severity screener for eating disorders measuring dietary restraint, shape/weight concerns, and episode frequency.
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