Screening
The SCOFF questionnaire
There is no evidence for screening people with no signs or symptoms of an eating disorder. There is evidence that screening tools are accurate for detecting eating disorders in symptomatic adults.[83] The SCOFF (Sick, Control, One stone, Fat, Food) questionnaire is a screening tool for eating disorders and is particularly appropriate in a nonspecialist setting. It is appropriate in patients considered at risk for eating disorders. It is designed to raise suspicion of an eating disorder rather than to make a specific diagnosis. It consists of 5 short questions, as follows:
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 >1 stone (14 pounds or 6 kg) 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?
One point is scored for every positive answer. A score ≥2 indicates a likely diagnosis of anorexia nervosa or bulimia.[84] Lack of awareness of the treatment and outcome of bulimia nervosa among young adult women may prevent them from seeking help. Health promotion may be needed in some populations.[85]
The American Academy of Child and Adolescent Psychiatry recommends that mental health clinicians screen all preteen and adolescent patients for eating disorders by asking about body satisfaction and eating patterns. Height and weight should be plotted on a growth curve. Concerns about faltering growth should be evaluated further. The Eating Attitudes Test, Eating Disorder Inventory, and Eating Disorder Examination-Questionnaire are validated questionnaires which can be used for screening.[11]
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