Background: Preliminary research suggests that eating disorders (ED) are common among overweight teenagers. Missing the diagnosis is a poor prognostic factor. Aim: To quantify the risk of ED and the effects of age, sex and severity of obesity in obese adolescents. Patients and methods: We studied 99 obese adolescents with a body mass index (BMI) > percentile 95 of CDC-NCHS, 51% females, aged between 11 and 19 years, attending an obesity clinic. The Eating Disorders Inventory-2 (EDI-2) was used to evaluate the risk of ED. A score equal or higher than 110, corresponding to the 85th percentile, was considered as risky. Results: Sixteen percent of studied adolescents had EDI scores > 110. No statistically significant differences were observed by age, sex or severity of obesity. EDI-2 scores in participants with a BMI z score over and under 4 were 93.6 ± 33.9 and 78.2 ± 38.8 respectively (p=0.02). A high percentage of participants had body dissatisfaction (BD) and drive for thinness. Bulimic symptoms, inefficacy, fear of maturity, and impulsivity scores were significantly higher among participants with a high risk of developing ED. Conclusions: Obese adolescents have a high risk for ED, regardless of their age and sex. The risk increases along with higher BMI. The routine use of screening tests is fundamental for an early detection of ED.Background: Preliminary research suggests that eating disorders (ED) are common among overweight teenagers. Missing the diagnosis is a poor prognostic factor. Aim: To quantify the risk of ED and the effects of age, sex and severity of obesity in obese adolescents. Patients and methods: We studied 99 obese adolescents with a body mass index (BMI) > percentile 95 of CDC-NCHS, 51% females, aged between 11 and 19 years, attending an obesity clinic. The Eating Disorders Inventory-2 (EDI-2) was used to evaluate the risk of ED. A score equal or higher than 110, corresponding to the 85th percentile, was considered as risky. Results: Sixteen percent of studied adolescents had EDI scores > 110. No statistically significant differences were observed by age, sex or severity of obesity. EDI-2 scores in participants with a BMI z score over and under 4 were 93.6 ± 33.9 and 78.2 ± 38.8 respectively (p=0.02). A high percentage of participants had body dissatisfaction (BD) and drive for thinness. Bulimic symptoms, inefficacy, fear of maturity, and impulsivity scores were significantly higher among participants with a high risk of developing ED. Conclusions: Obese adolescents have a high risk for ED, regardless of their age and sex. The risk increases along with higher BMI. The routine use of screening tests is fundamental for an early detection of ED.