Maladaptive movement in eating disorders: clinical correlates and cross-cultural adaptation of the Czech exercise and eating disorders questionnaire

Abstract Purpose This study examines the role of maladaptive movement (MM) in individuals with eating disorders (EDs) receiving specialised treatment. It compares findings from a Czech population with the original Norwegian data, focusing on global and subscale outcomes. The research utilises the cross-culturally adapted Czech version of the Exercise and Eating Disorders (EED) questionnaire to assess whether EED scores predict treatment outcomes, vary across diagnostic groups and treatment settings, and relate to specific MM behavioural parameters and patient age. Methods We assessed 226 female participants, comprising 181 ED patients and 45 healthy controls, using the Czech version of the EED. Patients were recruited from inpatient and day care programmes at a specialised ED centre. Analyses examined group differences, clinical correlates, and the predictive value of baseline EED scores for treatment outcomes. Results The EED demonstrated strong discriminative capacity, differentiating ED patients from controls with large effect sizes. Patients with Anorexia Nervosa scored highest, followed by those with Bulimia Nervosa, whereas those with Binge Eating Disorder and controls had lower global EED scores. A higher total EED score was significantly associated with longer inpatient treatment duration ( ρ = 0.25, p < 0.001), whereas the relationship with weight gain was not significant. Total EED scores also correlated strongly with the self-reported frequency, intensity, and duration of physical activity ( ρ = 0.48–0.61, all p < 0.001). Conclusions The EED is a reliable and clinically meaningful tool in a European context. MM features predict treatment outcomes and illness severity, underscoring the importance of assessing these behaviours for screening, individualised treatment planning, and relapse prevention in ED care. Level of evidence This study represents Level 3 evidence according to the Oxford Centre for Evidence-Based Medicine (CEBM) classification. It is a prospective cohort study with clinical and control groups, conducted without randomisation. Patients with EDs were assessed at treatment intake and at discharge, and their outcomes were compared with those of a healthy control sample.