Development and validation of the Ottawa disordered eating screen (ODES): a brief screening tool for service and surveillance

Abstract

Abstract Background Brief, accessible screening tools are needed to identify disordered eating and eating disorder (ED) risk across clinical settings and population health surveillance. The Ottawa Disordered Eating Screen (ODES) was developed as a 4-item self-report measure using language applicable across the lifespan. This study describes the development and psychometric evaluation of the ODES, including its scoring guidelines, measurement properties, and applications in both service and surveillance contexts. Methods The tool was developed through multidisciplinary expert consultation and refined using clinical vignettes to capture a range of eating- and body-related concerns. Psychometric testing used retrospective data from 278 participants aged 26–33 years in the Research on Eating and Adolescent Lifestyles 2.0 study. Convergent validity, internal consistency, and classification accuracy were evaluated. To assess utility as a surveillance tool, the ODES was implemented in two Canadian surveillance efforts: the 2024 Mental Health Research Canada (MHRC) Poll 21 (n = 3,213; ages 16–65) and the 2023 Ontario Student Drug Use and Health Survey (OSDUHS; n = 10,145; ages 11–20). Results A dual scoring approach was supported: a domain-based “traffic light” model for clinical triage that assigns a risk level and recommended next step, employing a communimetric design, and a total score cutoff (≥ 7) for identifying at-risk individuals in surveillance and outcomes monitoring. The ODES demonstrated strong convergent validity with measures of restrained and emotional eating, appearance and weight satisfaction, and internalizing symptoms, alongside acceptable internal consistency and classification accuracy. In population surveillance, elevated disordered eating symptomatology was observed across demographic groups, with higher levels among adolescent girls, racialized individuals, and 2SLGBTQ+ groups. Conclusions The ODES is a brief, valid, inclusive, and scalable tool suitable for use across age groups in clinical, community, and public health settings. Its dual scoring framework supports both service-level triage and population-level surveillance, facilitating screening efforts, monitoring, public health initiatives, and informed resource planning.