Screening for eating disorders can help a person get the right diagnosis and treatment. Learn about the different screening options for detecting eating disorders.
With so many different health trends and dietary requirements, it can be hard to tell what is healthy and what may signal a more serious problem. It’s not always easy to spot an eating disorder since they’re not always associated with low weight and certain behaviors can seem like a normal part of dieting.
Eating disorder screening tools and questionnaires can help identify signs and symptoms that indicate a person has an eating disorder. Tools that screen for eating disorders can help identify a person who is struggling and allow them to get appropriate treatment.
The SCOFF Questionnaire
The SCOFF questionnaire is a short and easy-to-use tool for assessing the presence of anorexia and bulimia. The questionnaire includes five questions related to self-control, weight loss, body image and the role of food in a person’s life.
The questions included in the SCOFF questionnaire are scored one for “yes” answers and zero points are given for answering “no” to a question. A cut-off point of two points or greater out of five suggests an eating disorder. The SCOFF Questionnaire is helpful for identifying potential cases of eating disorders, but shouldn’t be used on its own to formally diagnose a condition.
Eating Disorder Screening for Primary Care
Eating disorder screening for primary care (ESP) is a set of five questions taken from other questionnaires. It is a quick-and-easy tool that doctors can use in their general practice to get a sense of whether an eating disorder may be present.
The ESP asks about eating behaviors and the patient’s family and personal history of eating disorders. While this tool can be a helpful first step, it should be followed up by a full psychological test if an eating disorder is suspected. If an eating disorder seems likely after completing an ESP, a doctor will often refer a patient onwards to a psychiatrist for more complete testing and diagnosis.
Eating Attitudes Test
The Eating Attitudes Test (EAT-26) is a 26-question screening tool that asks questions that fall into three general categories. These categories include distorted body image, body weight, bulimic behavior and self-control. This questionnaire allows for a complete picture of symptoms and behaviors.
A score of 11 is considered to suggest the presence of an eating disorder.
Questionnaire for Eating Disorder Diagnosis
The Questionnaire for Eating Disorder Diagnosis (Q-EDD) was designed to capture the diagnostic criteria for eating disorders included in the Diagnostic and Statistical Manual of Mental Disorders (DSM), 4th edition.
Initial testing of this questionnaire showed that it is a reliable test, and compares well against a diagnostic interview by a clinician. However, since the update to the DSM-5 in 2013, the questionnaire does not necessarily reflect the most current diagnostic criteria.
For example, the DSM-5 includes revised new eating disorders like binge eating disorder or eating disorder not otherwise specified (EDNOS). Using the Q-EDD for eating disorder screening may fail to capture all of the currently recognized eating disorders, so it’s best to use a questionnaire that reflects the recent diagnostic changes.
Eating Disorder Examination
The Eating Disorder Examination (EDE) is a diagnostic interview that reflects the current DSM-5 diagnostic criteria for eating disorders. It is also available in The Eating Disorder Examination Questionnaire (EDE-Q). Both are considered gold-standard screening tools.
The examination and questionnaires are delivered slightly differently. The EDE is delivered by a clinician, like a psychiatrist, in an interview. The EDE-Q can be completed by a patient on their own, but having a clinician nearby to explain concepts or answer questions can be helpful.
Both the interview and questionnaire include four subscales or categories related to symptoms of eating disorders. These categories include restraint, eating concern, shape concern and weight concern. This screening tool also asks questions about eating disorder behaviors, like using laxatives, how often binge eating occurs or whether a patient exercises excessively. This information can help clinicians provide a more specific and accurate diagnosis.
The EDE and EDE-Q are the best options for eating disorder screenings.
The Importance of Screening for Eating Disorders
Screening for eating disorders can help tell the difference between healthy behavior and a serious disorder that requires treatment.
Importantly, screening for eating disorders can help make sure a patient gets the right diagnosis. Getting the correct diagnosis is important for determining the best treatment and can improve a patient’s chances of recovery.
People who are worried about their eating behaviors or think they may have an eating disorder can complete a simple questionnaire. A questionnaire is a helpful first step in assessing whether or not your symptoms might suggest an eating disorder. However, it’s important to receive a full assessment from a trained professional. A formal diagnosis usually requires a combination of physical assessment and a psychological interview.
Screening for eating disorders is an important first step in identifying a problem and asking for help. If you are struggling with an eating disorder related to a substance use disorder, The Recovery Village can help. Reach out today to take the first step toward a healthier future.
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Orbitello, B. “The EAT-26 as screening instrument for clinical nutrition unit attenders.” International Journal of Obesity, 2006. Accessed September 23, 2019.
Morgan, J F; et al. “The SCOFF questionnaire: a new screening tool for eating disorders.” The Western Journal of Medicine, 2000. Accessed September 23, 2019.
Berg, Kelly C; et al. “Psychometric evaluation of the eating disorder examination and eating disorder examination-questionnaire: a systematic review of the literature.” The International Journal of Eating Disorders, 2012. Accessed September 24, 2019.
Cotton, Mary-Anne; et al. “Four simple questions can help screen for eating disorders.” Journal of General Internal Medicine, 2003. Accessed September 24, 2019.
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