OBJECTIVE: This study aimed to evaluate the reliability and validity of the Binge Eating Disorder Screener-7 (BEDS-7) across 42 countries and 26 languages, assessing its reliability and validity as a screening tool for binge-eating disorder (BED) in diverse cultural contexts. Specifically, it sought to enhance early recognition of BED symptoms in primary care settings globally, contributing to a standardized framework for assessing BED. METHOD: The International Sex Survey, a cross-sectional online study, was conducted in 42 countries and 26 languages. A diverse community sample of 82,243 participants, aged 18 years or older, completed the BEDS-7 and measures of sexuality, mental health, substance use, and sociodemographic characteristics. Confirmatory factor analyses and tests of measurement invariance were employed to evaluate the reliability and validity of the BEDS-7 across languages, countries, genders, and sexual orientations. RESULTS: The BEDS-7 demonstrated scalar factorial invariance across languages and countries, indicating consistent factor loadings and item intercepts. In contrast, the screener showed residual invariance across gender and sexual orientation groups, supporting its robustness across these demographics. Kruskal-Wallis tests revealed significant differences in BED symptoms across languages, countries, genders, and sexual orientations, with the highest BED scores observed among queer, pansexual, and gender-diverse individuals. The BEDS-7 also demonstrated adequate reliability (Cronbach's alpha > 0.80) and moderate criterion validity. DISCUSSION: The findings provide further evidence of the reliability and validity of the BEDS-7 as a potential screening tool for identifying probable cases of BED globally, facilitating early intervention in primary care settings.

Artois University Arras France

Austrian Public Health Institute Vienna Austria

Biostatistics Consulting Center National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan

Center for Excessive Gambling Addiction Medicine Lausanne University Hospitals Lausanne Switzerland

Center on Alcohol Substance Use and Addictions University of New Mexico Albuquerque New Mexico USA

Centre de Recherche Interdisciplinaire Sur les problèmes Conjugaux et les Agressions Sexuelles Université de Montréal Montréal Canada

Centre for Advanced Research Excellence in Public Health Savar Dhaka Bangladesh

Centre of Excellence in Responsible Gaming University of Gibraltar Gibraltar Gibraltar

Chuncheon Addiction Management Center Chuncheon South Korea

College of Healthcare Sciences James Cook University Townsville Queensland Australia

Compassionate Inquiry Canada

Connecticut Council on Problem Gambling Hartford Connecticut USA

Decentralized Big Data Team RIKEN Center for Advanced Intelligence Project Tokyo Japan

Departamento de Psicología y Filosofía Facultad de Ciencias Sociales Universidad de Tarapacá Arica y Parinacota Chile

Département de Psychologie Université de Montréal Montréal Canada

Département de Psychologie Université du Québec à Trois Rivières Trois Rivières Canada

Department of Addictology Charles University 1st Faculty of Medicine Prague Czech Republic

Department of Addictology General University Hospital Prague Prague Czech Republic

Department of Clinical Pharmaceutical and Biological Sciences University of Hertfordshire Hatfield UK

Department of Educational Psychology and Psychology of Health Pavol Jozef Safarik University in Kosice Košice Slovakia

Department of Family Medicine National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan

Department of Health Services Srinagar India

Department of Neuropsychiatry Graduate School of Medicine Kyoto University Kyoto Japan

Department of Personality Assessment and Psychological Treatments University of Valencia Valencia Spain

Department of Psychiatry All India Institute of Medical Sciences New Delhi India

Department of Psychiatry Faculdade de Medicina Universidade de São Paulo Hospital das Clinicas Instituto de Psiquiatria Excessive Sexual Drive and Prevention of Negative Outcomes Associated to Sexual Behavior Outpatient Unit São Paulo Brazil

Department of Psychiatry Hallym University Chuncheon Sacred Heart Hospital Chuncheon South Korea

Department of Psychiatry Schulich School of Medicine and Dentistry Western University London Health Sciences Centre and St Joseph's Health Care London London Ontario Canada

Department of Psychology and Cognitive Science University of Trento Trento Italy

Department of Psychology and Neuroscience Auckland University of Technology Auckland New Zealand

Department of Psychology Charles University Faculty of Education Prague Czech Republic

Department of Psychology College of Humanity and Social Science Fuzhou University Fuzhou China

Department of Psychology Humanities and Social Sciences University of Zagreb Zagreb Croatia

Department of Psychology Shardha University Greater Noida Uttar Pradesh India

Department of Psychology Sungkyunkwan University Seoul South Korea

Department of Psychology University of Nevada Las Vegas Nevada USA

Department of Psychology University of New Mexico Albuquerque New Mexico USA

Department of Public Health and Informatics Jahangirnagar University Savar Dhaka Bangladesh

Departmento de Psicología Básica Clínica y Psicobiología University Jaume 1 of Castellón Castellón Spain

Doctoral School of Psychology ELTE Eötvös Loránd University Budapest Hungary

Facultad de Ciencias de la Salud Universidad Privada del Norte Lima Peru

Facultad de Medicina Universidad Científica del Sur Lima Peru

Facultad de Psicología Universidad de Talca Talca Chile

Faculty of Philosophy Ss Cyril and Methodius University in Skopje Skopje Republic of North Macedonia

Faculty of Psychology University of Cuenca Cuenca Ecuador

Faculty of Social Work Max Stern Yezreel Valley College Yezreel Valley Israel

Florida State University Panama City Republic of Panama

Health Promotion Research Centre University of Galway Galway Ireland

HELP University Kuala Lumpur Malaysia

Institute for Behavioural Addictions Sigmund Freud University Vienna Austria

Institute for Neural Computations University of California San Diego California USA

Institute for Sex Research Sexual Medicine and Forensic Psychiatry; University Medical Centre Hamburg Eppendorf Hamburg Germany

Institute of Allied Health Sciences College of Medicine National Cheng Kung University Tainan Taiwan

Institute of Forensic Psychiatry and Sex Research Center for Translational Neuro and Behavioral Sciences University of Duisburg Essen Essen Germany

Institute of Forensic Psychiatry and Sex Research University of Duisburg Essen Essen Germany

Institute of Psychlogy Polish Academy of Sciences Warsaw Poland

Institute of Psychology Cardinal Stefan Wyszynski University Warsaw Poland

Institute of Psychology ELTE Eötvös Loránd University Budapest Hungary

Institute of Psychology University of Lausanne Lausanne Switzerland

Laboratory of Behavioral Medicine Neuroscience Institute Lithuanian University of Health Sciences Palanga Lithuania

Lawson Health Research Institute London Ontario Canada

Leuven School for Mass Communication KU Leuven Leuven Belgium

Macedonian Academy of Sciences and Arts Skopje Republic of North Macedonia

Nottingham Trent University Nottingham UK

Public Health Institute Faculty of Health Liverpool John Moores University Liverpool UK

SAMRC Unit on Risk and Resilience in Mental Disorders Department of Psychiatry and Neuroscience Institute University of Cape Town Cape Town South Africa

SAMRC Unit on Risk and Resilience in Mental Disorders Stellenbosch University Stellenbosch South Africa

School of Psychology University of Southampton Southampton UK

School of Social Work Faculty of Social Welfare and Health Sciences University of Haifa Haifa Israel

Section of Sexual Psychopathology Department of Dynamic and Clinical Psychology and Health Studies Sapienza University of Rome Rome Italy

Sistema Nacional de Investigación SENACYT Panama City Panama

Universidad Pedagógca y Tecnológica de Colombia Tunja Colombia

Universidad Privada de Santa Cruz de la Sierra Santa Cruz de la Sierra Bolivia

University of Baghdad College of Medicine Baghdad Iraq

University of Warith Al Anbiyaa College of Medicine Karbala Iraq

Virtual Teaching and Cyberpsychology Laboratory School of Psychology National Autonomous University of Mexico Mexico City Mexico

William James Center for Research Departamento de Educação e Psicologia Universidade de Aveiro Aveiro Portugal

Yale University School of Medicine New Haven Connecticut USA

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