The SCOFF Questionnaire to Screen for Eating Disorders

Screening for Eating Disorders

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If you believe that thoughts about food, weight, and appearance may be taking up too much of your time, then you may be experiencing symptoms of an eating disorder such as anorexia nervosa, bulimia nervosa, binge eating disorder, or other specified feeding and eating disorder. When you have an eating disorder, it's important to seek help as fast as possible, since treatment helps most when you get it quickly.

While the following questionnaire, known as the SCOFF questionnaire, is not meant to act as a substitute for a professional diagnosis, it can be extremely helpful in identifying people who are very likely to suffer from anorexia nervosa or bulimia nervosa and should get help. It was devised to be used by non-professionals.

What Is the SCOFF Questionnaire?

The SCOFF questionnaire is a simple, five-question screening measure to assess the possible presence of an eating disorder. It was developed in the United Kingdom by Morgan and colleagues in 1999. The SCOFF questionnaire utilizes an acronym (Sick, Control, One, Fat, Food) which does not translate perfectly to other countries because of the reference to "one stone," but the questions themselves are easily adapted to any culture.

Answering "yes" to two or more of the following questions indicates a possible case of anorexia nervosa or bulimia nervosa or other eating disorder:

  • Do you make yourself Sick because you feel uncomfortably full?
  • Do you worry you have lost Control over how much you eat?
  • Have you recently lost more than One stone [approximately fifteen pounds] in a 3 month period?
  • Do you believe yourself to be Fat when others say you are too thin?
  • Would you say that Food dominates your life?

    Next Steps for Yes Answers

    If you answered "yes" to two or more of the questions above, you should make an appointment for an assessment with an eating disorder professional, such as a therapist, dietitian, or physician. A professional can determine if you do, indeed, suffer from anorexia nervosa, bulimia nervosa, binge eating disorder, or other eating disorder. You can also get more information about eating disorders.

    Once you have been diagnosed, a professional can also help you begin treatment by determining what level of care would be appropriate for you, as well as helping you build a treatment team.

    If you didn't answer "yes" to two or more of the questions but you believe you may have a problem anyway or someone else is concerned about your eating or exercise behavior, you still should seek help, since the SCOFF questionnaire may not pick up all eating disorders. It is also common for many people with eating disorders to not believe they are ill. You may still be struggling with body-image concerns or an obsession with healthy eating, in which case treatment may help you.

    How to Find Professional Help

    This can be difficult, and you may want to find someone close to you who can help you locate the right professionals, make phone calls for you, and maybe even go with you to appointments.

    This support person can be anyone whom you trust to share what you are struggling with, including a family member, a close friend, a teacher or a member of the clergy.

    It takes courage to seek treatment but recognizing that you have a problem and realizing you need help are critical first steps to your treatment and recovery from your eating disorder.

    It's not always easy to find professionals who specialize in treating eating disorders. If you're having trouble locating someone, try asking your family physician, obstetrician/gynecologist, a school counselor, a teacher, a clergy member, or a nurse.

    You may also have friends or family members who could recommend a therapist or psychiatrist to you. Fortunately, therapists often refer to each other. Therefore, if your initial contact is with a therapist who doesn't specialize in eating disorders, that person likely can provide you with the name of someone who does. 

    You may also want to explore self-help options for bulimia nervosa or binge eating disorder.

    You can reach out to the National Eating Disorders Association for additional support. They provide a toll-free confidential hotline (800-931-2237) that is staffed daily by trained volunteers who provide information, support, and referrals to treatment. They also offer 24/7 crisis support via text (send 'NEDA' to 741741 

    Source:

    Morgan, J.F., Reid, F., Lacey, J.H. 1999. The SCOFF questionnaire: Assessment of a new screening tool for eating disorders. BMJ. 319 1467-1468.

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