SCOFF Questionnaire

About the SCOFF

The SCOFF was developed in the UK to support rapid screening for eating disorders in general medical and psychiatric settings. Each item is phrased as a yes/no question targeting key symptoms of anorexia and bulimia, including food restriction, purging, and distorted body image.

The acronym “SCOFF” represents elements of the questions: Sick, Control, One stone (weight loss), Fat, Food.

Psychometric Properties

The SCOFF has shown strong sensitivity (~86%) and moderate specificity (~87%) in detecting probable eating disorders when using a cutoff of two or more “yes” answers.

Though originally developed for anorexia and bulimia, it may also flag disordered eating behaviours relevant to other diagnoses, including OSFED and binge eating disorder.

Source: Morgan et al., 1999

The Scale

Each of the five yes/no questions corresponds to a hallmark behaviour or symptom of eating disorders. The acronym “SCOFF” comes from keywords in the questions:

1. S – Do you make yourself Sick because you feel uncomfortably full?
2. C – Do you worry you have lost Control over how much you eat?
3. O – Have you recently lost more than One stone (≈6.35 kg / 14 lb) in a 3-month period?
4. F – Do you believe yourself to be Fat when others say you are too thin?
5. F – Would you say that Food dominates your life?

Each “yes” response scores 1 point. A total score of 2 or more suggests the need for further assessment.

Score Range

• 0–1: Low likelihood of clinically significant eating disorder
• 2–5: Elevated risk; further clinical evaluation recommended

The SCOFF is a screening tool only and does not provide diagnostic information.

Can the SCOFF diagnose eating disorders?

References