Systematic Review and Meta-Analysis: Examining the Psychometric Evaluations of Disordered Eating Scales in Adults Living With Gastrointestinal Conditions

Background The scales used to assess disordered eating are often not validated in adults living with gastrointestinal conditions (i.e., gastrointestinal populations). This systematic review and meta-analysis aimed to examine the psychometric evaluations (i.e., assessments of reliability and validity) of disordered eating scales in adult gastrointestinal populations and quantify the prevalence of disordered eating in both gastrointestinal and non-gastrointestinal populations. Methods We conducted a search of observational studies up to May 2024 that measured disordered eating using a scale in adults with a gastrointestinal condition. Psychometric evaluations of the scales were narratively reviewed. Prevalence rates of disordered eating were pooled using a random-effects meta-analysis, and risk of bias was assessed using an adapted Newcastle Ottawa Scale. Key Results Among 29 studies (overall medium risk of bias), 23 reported prevalences of disordered eating in gastrointestinal populations, and eight of these studies also reported prevalences in non-gastrointestinal populations. Only one out of 10 scales was developed and psychometrically evaluated in gastrointestinal populations, and 11 studies reported internal consistency (range alpha = 0.63 to alpha = 0.95). The prevalence of disordered eating was 33.2% (p < 0.001; 95% confidence interval: 0.25-0.41; I-2 = 97.34%) in gastrointestinal populations and 21.0% (p < 0.001; 95% confidence interval: 0.09-0.32; I-2 = 97.41%) in non-gastrointestinal populations. Subgroup analyses showed consistently high heterogeneity. Conclusions and Inferences The utilisation of current disordered eating scales for adults living with gastrointestinal conditions should be undertaken with caution, and there is a need for disordered eating scales to be developed and validated in this population.