SCOFF Questionnaire

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The SCOFF is a five-item screening tool designed to identify possible cases of anorexia nervosa and bulimia nervosa. It is brief, easy to administer, and widely used in primary care and mental health settings to flag disordered eating behaviours.

Recommended Frequency: Administer at intake or when eating concerns are suspected; repeat only as clinically indicated during treatment or reassessment.

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.

Copyright

© Morgan, Reid & Lacey, 1999. Originally published in BMJ. Freely distributed for non-commercial clinical use with attribution.

References

  1. Morgan, J. F., Reid, F., & Lacey, J. H. (1999). The SCOFF questionnaire: Assessment of a new screening tool for eating disorders. BMJ, 319(7223), 1467–1468. https://doi.org/10.1136/bmj.319.7223.1467

Disclaimer

This summary is for informational purposes only. HiBoop does not interpret results or provide diagnostic guidance. The SCOFF should be administered and evaluated by qualified health professionals.

Permissions

The SCOFF is available for non-commercial clinical and academic use with appropriate citation. It may be reproduced without modification but may not be sold or altered without permission.

Frequently Asked Questions

  • Is it triggering?

    It can be for some clients. Introduce it gently and follow with a supportive conversation.

  • How often should I re-administer it?

    Only if there’s a significant change in behaviour or concern about relapse.

  • Can it detect binge eating disorder or ARFID?

    Not reliably. The SCOFF is more sensitive to restrictive or purging patterns. Use additional tools for broader screening.

  • Is this tool appropriate for all genders?

    Yes. While originally validated in women, it is now widely used across genders and identities.

  • Can the SCOFF diagnose eating disorders?

    No. It flags risk, but a full clinical assessment is needed for diagnosis.