Mind the Gaps: Revisiting the Validity, Consistency, and Scope of the Eating Disorder Examination. A Commentary on Reilly et al. (2025)

Abstract

This commentary responds to Reilly et al.'s (2025) forum article and focuses primarily on Area of Focus #2: ensuring group-specific validity and adaptability of eating disorder assessment tools. Using the Eating Disorder Examination (EDE) as a case example, it is argued that psychometric flexibility must be accompanied by empirical accountability. Specifically, the commentary highlights the importance of testing measurement invariance (MI) to evaluate whether tools like the EDE function equivalently across different populations and time points. This is particularly relevant as the EDE or its self-report version (EDE-Q) are increasingly being used in populations for which they were not originally designed, for example, individuals with avoidant/restrictive food intake disorder or people of diverse gender identities. Additionally, the commentary discusses the need for harmonization between different versions of the instrument (EDE vs. EDE-Q), and calls for greater transparency in reporting and applying scoring conventions. A further consideration is the consistency of application across raters and research contexts, suggesting that interrater reliability should be examined more systematically across sites. Drawing on the metaphor of a long-serving but evolving vehicle, the commentary argues that modernization is necessary, but must not come at the cost of clinical depth or training relevance. Knowing how to drive remains essential, even when upgrading the vehicle.