Researchers cross-culturally adapted the Exercise and Eating Disorders (EED) questionnaire into Czech and tested it in 226 female participants: 181 patients receiving specialised eating disorder treatment and 45 healthy controls.
The patients were recruited from inpatient and day care programmes at a specialised eating disorder centre. Each completed the Czech version of the EED, a questionnaire originally developed in Norway, allowing the team to compare their findings with the original Norwegian data at both the global score and subscale level. The study also asked whether baseline EED scores could predict treatment outcomes, whether scores differed across diagnostic groups and treatment settings, and how they related to specific behavioural parameters of physical activity and patient age.
The questionnaire showed strong discriminative capacity, separating eating disorder patients from healthy controls with large effect sizes. Within the patient group, diagnostic differences followed a clear pattern: patients with anorexia nervosa scored highest on the EED, followed by those with bulimia nervosa, while patients with binge eating disorder and the healthy controls recorded lower global scores.
The total EED score was significantly associated with longer inpatient treatment duration, with a Spearman correlation of ρ = 0.25 (p < 0.001). By contrast, the relationship between EED scores and weight gain during treatment was not statistically significant, a distinction the authors report explicitly rather than treating exercise-related cognition as a simple predictor of every clinical outcome.
Where the questionnaire aligned most strongly with patient experience was in self-reported activity behaviour. Total EED scores correlated strongly with the frequency, intensity and duration of physical activity as reported by patients, with correlations ranging from ρ = 0.48 to 0.61, all significant at p < 0.001. This suggests the instrument captures not only attitudes but also the practical dimensions of maladaptive exercise habits.
The authors conclude that the EED is a reliable and clinically meaningful tool in a European context, and that maladaptive movement features predict treatment outcomes and illness severity. They argue this supports routine assessment of these behaviours for screening, individualised treatment planning and relapse prevention in eating disorder care.
The study is classified as Level 3 evidence under the Oxford Centre for Evidence-Based Medicine system. It was a prospective cohort study with clinical and control groups conducted without randomisation. Patients were assessed at treatment intake and again at discharge, and their outcomes were compared with those of a healthy control sample — a design that supports association and prediction but not causal claims about how maladaptive movement influences recovery.
The sample was restricted to female participants, leaving questions about male patients and the generalisability of the Czech adaptation beyond this population open for further work. The comparison with the original Norwegian data nonetheless suggests the questionnaire's core structure travels across cultural settings.
For clinicians, the authors argue that a validated questionnaire may help identify patients whose maladaptive movement features are relevant to treatment, supporting screening, individualised treatment planning and relapse prevention.
Subject of Research: Cross-cultural adaptation and clinical validation of the Czech Exercise and Eating Disorders questionnaire measuring maladaptive movement in eating disorder patients
Article Title: Maladaptive movement in eating disorders: clinical correlates and cross-cultural adaptation of the Czech exercise and eating disorders questionnaire
Article References: Minařík, P., Dostálová, V., Suchý, J., & Papežová, H. (2026). Maladaptive movement in eating disorders: clinical correlates and cross-cultural adaptation of the Czech exercise and eating disorders questionnaire. Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity. https://doi.org/10.1007/s40519-026-01902-z
Image Credits: AI Generated
DOI: 10.1007/s40519-026-01902-z
Keywords: eating disorders, maladaptive exercise, questionnaire validation, anorexia nervosa, bulimia nervosa, binge eating disorder, Czech adaptation, treatment outcomes, prospective cohort, clinical assessment, Maladaptive, movement
News Source: Ophelia Keating. (October 30, 2026). Czech Version of Exercise Questionnaire Flags Maladaptive Movement in Eating Disorders. Scienmag.
