Validation of the Eating Disorders-15 (ED-15) in Mexican patients across levels of care: Psychometric properties in a clinical sample

Objective: This study aimed to validate the Eating Disorders-15 (ED-15) in a clinically diverse sample of Mexican patients with eating disorders (EDs). Given the increasing prevalence of EDs in Latin America and the need for validated assessment tools, this study evaluated the psychometric properties of the ED-15 in this specific cultural and clinical context. Method: A total of 286 individuals diagnosed with EDs were recruited from a specialized treatment center in Mexico. Participants completed the ED-15, alongside the Eating Disorder Examination-Questionnaire 7, the Body Shape Questionnaire-8, the Body Appreciation Scale-2, the Patient Health Questionnaire-9, and the Clinical Impairment Assessment. Confirmatory factor analyses tested four models, including the original two-factor model, a higher-order model, and a bi-factor model. Internal consistency, as well as convergent validity, were assessed. Results: The original two-factor model showed excellent fit and was retained as the final solution based on model parsimony, goodness-of-fit indices, and theoretical considerations. The ED-15 demonstrated high internal consistency (ω > 0.80), strong positive associations with ED psychopathology, body dissatisfaction, depressive symptoms, and clinical impairment, and strong negative associations with body appreciation. Discussion: These findings support the reliability and validity of the ED-15 in a Mexican clinical sample. The study provides robust psychometric evidence for the use of the ED-15 in clinical and research settings in Latin America and highlights the importance of culturally validated brief instruments for assessing eating disorder symptoms.