What Is the SCOFF Questionnaire?

The SCOFF questionnaire is a brief five‑item screening tool designed to identify potential eating disorder symptoms. Its name is an acronym formed from key words in each question: Sick, Control, One Stone, Fat, and Food. Developed in the United Kingdom, it is widely used in primary care and university settings because it takes only a minute to administer and has been shown to detect anorexia and bulimia with reasonable accuracy.

How to Use This Screener

Tick each statement that resonates with your recent experiences around eating and body image. When you press Calculate, the script counts how many boxes are checked. Two or more positive responses suggest a possible eating disorder and warrant further evaluation by a healthcare professional. The SCOFF is not a diagnostic tool—it simply helps highlight potential concerns so you can seek advice if needed.

Importance of Early Detection

Eating disorders often hide in plain sight. Many individuals appear to maintain a normal weight yet struggle secretly with unhealthy behaviors. Early detection leads to more successful treatment outcomes. The SCOFF questionnaire offers a confidential way to reflect on your relationship with food. If the score indicates risk, sharing the result with a doctor, therapist, or dietitian can be a crucial first step toward recovery.

Limitations and Considerations

Although simple, the SCOFF does not capture every nuance of disordered eating. It tends to focus on classic symptoms of anorexia and bulimia, so other conditions like binge-eating disorder may not trigger a high score even when professional help would be beneficial. Cultural differences in language and attitudes can also affect how questions are interpreted. Consider the SCOFF a conversation starter rather than a definitive measure.

Next Steps After Scoring

If you score two or higher, reach out to a qualified medical or mental health provider who specializes in eating disorders. They can conduct a comprehensive assessment that looks at physical health, nutritional intake, and psychological factors. Early intervention often includes counseling, nutrition education, and sometimes medication. Friends and family who express concern about your eating habits or self-image can be valuable allies in seeking help.

Encouraging a Supportive Environment

Whether you are taking this screener for yourself or someone you care about, fostering a supportive environment is key. Avoid negative comments about body shape or weight, and emphasize healthy eating in a positive, nonjudgmental manner. Recovery from an eating disorder typically requires both medical guidance and emotional support. Use the SCOFF score as a prompt to open honest discussions and encourage compassionate help-seeking.

Understanding Each Question in Detail

Each line of the acronym points to a behavior or belief that often accompanies disordered eating. The first item asks about self-induced vomiting after meals. While occasional stomach upset happens to everyone, purposely vomiting to relieve fullness or anxiety is a red flag. It may signal bulimia nervosa or other purging disorders. The second question addresses the feeling of losing control when eating. People with binge‑eating tendencies often describe entering a trance-like state around food, consuming large quantities faster than normal and feeling unable to stop. The third question references losing “one stone,” a British unit equal to fourteen pounds. Rapid weight loss in a short period can endanger organs and is characteristic of restrictive eating patterns. The fourth question explores distorted body image—seeing yourself as fat despite being underweight. This distortion is a hallmark of anorexia nervosa. The final question measures how much mental space food and weight occupy in your life. If planning meals, counting calories, or worrying about appearance crowd out other interests and responsibilities, professional support may be warranted. Understanding why each question matters helps users reflect more honestly and recognize patterns they may have normalized.

Recognizing Physical and Emotional Symptoms

Beyond the SCOFF questions, numerous physical and emotional signs can indicate developing problems. Physical symptoms might include constant fatigue, dizziness, gastrointestinal issues, brittle nails, hair loss, or frequent sore throats from vomiting. Some individuals experience irregular or absent menstruation, low heart rate, or unexplained injuries due to weakened bones. Emotionally, people might withdraw from social events involving food, become irritable when eating schedules are disrupted, or obsess over perceived body flaws. Tracking these patterns over time provides context to the questionnaire score. If you note any combination of these symptoms alongside a SCOFF score of two or higher, seeking a medical evaluation becomes especially important.

Why Early Intervention Matters

Eating disorders are serious mental health conditions with the highest mortality rate of any psychiatric illness. However, recovery is achievable, particularly when treatment starts early. Early intervention reduces the risk of long-term health complications such as heart damage, infertility, or severe depression. It also shortens the duration of disordered behaviors, making it easier to relearn balanced eating habits. The SCOFF questionnaire offers a low-barrier entry point for recognizing warning signs before they escalate. Clinicians often use the screener during routine checkups or when a patient exhibits unexplained weight changes. By acting on early signals, individuals can access therapy, nutritional counseling, and support groups that steer them toward healthier coping strategies.

Talking to a Professional

After a concerning score, scheduling an appointment with a healthcare provider is the next step. Primary care physicians can perform a physical exam, order lab tests to check for nutrient deficiencies or hormonal imbalances, and refer patients to specialists. Mental health professionals—such as psychologists, therapists, or psychiatrists—conduct a more detailed assessment of eating patterns, thoughts, and emotions. Treatment plans may include cognitive-behavioral therapy, family-based therapy, or medication. For adolescents, involving parents or guardians in treatment is often crucial. When reaching out, be honest about the behaviors and feelings that prompted you to take the SCOFF. Bringing a printed copy of your results or using the copy button above to share them electronically can facilitate the conversation.

Supporting Someone Else

If you are concerned about a friend or family member, approach the subject with empathy. Choose a private moment, express your care, and describe specific behaviors you have noticed without judging or blaming. You might say, “I’ve seen you skipping meals and I’m worried about you. Would you be open to talking to someone?” Encourage them to take the SCOFF questionnaire themselves or review the results if they already have. Offer to help them find professional support or accompany them to appointments. Avoid commenting on weight or appearance, as this can reinforce harmful obsessions. Instead, focus on overall well-being and your desire for them to feel healthy and supported.

Building a Recovery Toolkit

Recovery is a journey that often involves a combination of medical care, therapy, nutritional guidance, and community support. Many people benefit from creating a personal toolkit that includes a meal plan developed with a dietitian, coping strategies for stress, and a list of supportive contacts to reach out to during difficult moments. Journaling feelings and tracking triggers can reveal patterns and progress. Mindfulness practices, such as deep breathing or gentle yoga, may help reconnect the body and mind in a nonjudgmental way. Remember that setbacks are common; lapses do not erase progress. The SCOFF score is merely one snapshot—use it to observe changes over time and celebrate improvements, however small.

Myths and Facts

Misinformation can delay treatment. One common myth is that only underweight individuals have eating disorders. In reality, people of any size can struggle, and weight alone is not a reliable indicator of health. Another myth is that eating disorders are a choice or a phase. They are complex conditions influenced by genetics, environment, and psychological factors. Some believe that boys and men are unaffected, yet research shows that a significant portion of males experience disordered eating, often underreported due to stigma. Understanding these facts encourages more inclusive conversations and reduces shame.

Finding Resources and Support

Numerous organizations provide educational materials and helplines. In the United States, the National Eating Disorders Association (NEDA) offers a confidential chat and phone line. In the United Kingdom, Beat serves a similar role. Local hospitals and community centers may host support groups, both in-person and online. Schools and universities often have counseling services familiar with the SCOFF and related screenings. If immediate danger is present—such as severe malnutrition, dehydration, or suicidal thoughts—seek emergency medical care right away. Saving crisis numbers in your phone or sharing them with trusted friends ensures help is within reach.

Promoting Positive Body Image

Cultivating a healthy relationship with your body can reduce vulnerability to disordered eating. Limit exposure to media that promotes unrealistic ideals and curate social feeds to include diverse, body-positive content. Engage in activities that emphasize function over appearance, such as dancing, hiking, or sports you enjoy. Compliment yourself and others on qualities unrelated to weight or shape—creativity, kindness, intelligence. When negative thoughts arise, challenge them by listing things your body allows you to do. Body neutrality, focusing on respect rather than constant positivity, can also ease pressure. Incorporating these practices into daily life builds resilience against the cultural forces that often fuel eating disorders.

Maintaining Perspective on the Score

While a SCOFF score provides useful insight, it should not dominate your self‑perception. Some individuals might score low yet still feel distress around food or body image, while others may score high due to temporary stressors that resolve with support. Use the questionnaire as a springboard for broader reflection. Ask yourself how eating patterns affect energy levels, relationships, and mental health. Consider setting periodic reminders—perhaps every few months—to retake the screener and track changes. Improvement might appear as a lower score, but it can also manifest in healthier coping skills and greater self-compassion.

Disclaimer

This calculator is for educational purposes only and cannot substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified health provider with questions about a medical condition. If you believe you may harm yourself or someone else, seek emergency assistance immediately. The SCOFF questionnaire is one tool among many and should be interpreted in the context of a comprehensive assessment. By using this resource, you acknowledge that the developers are not liable for decisions made based on the results.