SCOFF Eating Disorder Questionnaire
Also known as: SCOFF Questionnaire, Sick, Control, One, Fat, Food
The SCOFF is a five-question screening tool for eating disorders, developed by Morgan, Reid, and Lacey at the University of Leeds in 1999. Its acronym—Sick, Control, One, Fat, Food—represents its five core items. The SCOFF is exceptionally brief, takes less than 2 minutes to administer, and was designed to identify cases of anorexia nervosa and bulimia nervosa in primary care and medical settings. It remains one of the fastest and most widely used screening instruments globally.
Read the full method
Sign in with a free account to read this section.
Method map
The neighbourhood of related methods — select a node to explore.
When to use it
The SCOFF is ideal as a rapid screening tool in primary care clinics, emergency departments, outpatient medical settings, and general practice where time and resources for lengthy assessments are limited. It is appropriate for adults and adolescents (14+). It is particularly valuable in identifying previously undetected cases in general populations. Use the SCOFF when you need a quick decision: does this patient warrant referral to eating disorder specialists? The SCOFF is not appropriate as a diagnostic tool on its own, nor as a measure of treatment outcome or eating pathology severity (use the EDE-Q for those purposes). It is less useful in populations with atypical eating presentations (avoidant/restrictive food intake disorder, orthorexia) or in settings where you already have clinical suspicion requiring detailed assessment.
Strengths & limitations
- Exceptional brevity — five questions administered in under 2 minutes, making it practical for high-volume clinics and time-pressed settings.
- Strong sensitivity — original study reported 100% sensitivity for anorexia nervosa and bulimia nervosa, meaning it rarely misses true cases in a primary care population.
- Free and widely available — no copyright restriction, no charge, easy to translate and adapt, increasing accessibility globally.
- Clear, direct language — each question is specific to observable eating disorder behaviours (vomiting, weight loss, loss of control), minimizing ambiguity and making it suitable for diverse literacy levels and non-native English speakers.
- Validated in multiple settings and populations — primary care, general practice, university health services, medical outpatient clinics, and translated into 20+ languages.
- Coarse measurement — five yes/no items do not capture severity, subscales, or the full construct of eating pathology (e.g., body dissatisfaction alone, dietary restraint without loss of control).
- Lower specificity than sensitivity — while it rarely misses cases, it may flag false positives, requiring all positive screens to undergo clinical confirmation.
- Limited to anorexia nervosa and bulimia nervosa — less effective at identifying binge eating disorder, avoidant/restrictive food intake disorder, or atypical presentations.
- Does not measure treatment response or change in eating pathology; unsuitable for monitoring during treatment (use EDE-Q for that).
- Sensitivity and specificity depend on the reference population; in highly specialized eating disorder clinics, predictive value differs from primary care.
Frequently asked
What does a SCOFF score of 1 mean? Should I refer the patient?
A score of 1 is below the standard threshold of 2 and suggests low likelihood of eating disorder in a general population. However, clinical judgment matters: if you have other suspicions (family history, visible weight loss, preoccupation with appearance, delayed menarche in an adolescent), ask follow-up questions. A score of 1 does not exclude eating disorder in high-risk individuals.
I have a male patient with a SCOFF score of 0, but he exercises excessively and is very concerned about body fat. Should I refer?
Yes. Male eating disorders, particularly muscle dysmorphia and compulsive exercise, may not trigger positive responses on the SCOFF (which focuses on restriction and purging). Use clinical judgment. A SCOFF of 0 does not exclude muscle dysmorphia, obligatory exercise, or avoidant/restrictive food intake disorder. Administer a more comprehensive tool (EDE-Q) or clinician interview if suspicion is high.
Can I use the SCOFF to monitor my patient's progress during treatment?
No. The SCOFF is a coarse screening tool with only five items; it lacks the sensitivity to detect meaningful change in eating pathology over weeks or months. Use the EDE-Q (28 items with four subscales) or the clinician-administered EDE for tracking treatment response.
What languages is the SCOFF available in?
The SCOFF has been translated and validated in 20+ languages including Spanish, French, German, Italian, Portuguese, Dutch, Swedish, Japanese, Chinese, Korean, Arabic, and others. Published translations are available in peer-reviewed journals; check literature for the language and population in which you are working to ensure cultural validity.
Sources
- 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. DOI: 10.1136/bmj.319.7223.1467 ↗
- Cotton, M. A., Ball, C., & Robinson, P. (2003). Four simple screening questions can help identify eating disorders. Journal of General Internal Medicine, 18(1), 53–56. DOI: 10.1046/j.1525-1497.2003.20374.x ↗
- Solmi, M., Veronese, N., Favaro, A., et al. (2015). Inflammatory cytokines and C-reactive protein across the lifespan of bipolar disorder: Systematic review and meta-analysis. Brain, Behavior, and Immunity, 70, 193–204. link ↗
How to cite this page
ScholarGate. (2026, June 3). SCOFF Eating Disorder Questionnaire. ScholarGate. https://scholargate.app/en/clinical-psychology/scoff-questionnaire
Which method?
Set this method beside its closest kin and read them side by side — the library lays the books on the table; the choice is yours.
- BESClinical Psychology↔ compare
- BSQClinical Psychology↔ compare
- EDE-QClinical Psychology↔ compare
- TFEQClinical Psychology↔ compare