Clinical Medicine & Physiology
SCOFF Questionnaire Calculator: 5-Item Anorexia & Bulimia Primary-Care Screen
Score John F. Morgan et al.’s (1999, BMJ) 5-question SCOFF eating-disorder screening tool (0–5 Yes responses; >= 2 cutoff flags likely anorexia nervosa or bulimia nervosa for diagnostic evaluation).
Five memorable binary questions screen for anorexia and bulimia nervosa in under 60 seconds!
Designed by John F. Morgan, Fiona Reid, and J. Hubert Lacey (1999, BMJ) as an Eating-Disorder analogue to alcohol screening’s CAGE questionnaire, the SCOFF acronym awards 1 point for each "Yes" answer across five core psychopathology items: S — Do you make yourself Sick because you feel uncomfortably full? C — Do you worry you have lost Control over how much you eat? O — Have you recently lost more than One stone (~14 lb / 6.35 kg) in a 3-month period? F — Do you believe yourself to be Fat when others say you are too thin? F — Would you say that Food dominates your life?
Endorsed by USPSTF evidence reviews and NICE NG69 primary-care awareness pathways, a threshold of SCOFF >= 2 "Yes" answers achieves ~86% pooled sensitivity and ~83% pooled specificity across meta-analyses — prompting empathetic clinical interview, vitals/orthostatics, electrolytes, and specialist referral (remembering SCOFF is a case-finding screen, never a standalone diagnosis).
| SCOFF Acronym Item (0 = No, 1 = Yes) | Core Eating-Disorder Construct |
|---|---|
| S — Make yourself Sick when uncomfortably full? | Compensatory purging behavior |
| C — Worry you lost Control over how much you eat? | Objective/subjective binge-eating loss of control |
| O — Recently lost > One stone (6.35 kg / 14 lb) in 3 mo? | Rapid restrictive weight loss |
| F — Believe yourself Fat when others say too thin? | Body-image distortion |
| F — Would you say Food dominates your life? | Cognitive preoccupation (>= 2 Total = Positive Screen) |
Total 5-Item SCOFF Score (0 to 5 Points)
Verifies that all five items B2:B6 equal 0 or 1 and returns SUM(B2:B6).
=IF(OR(MIN(B2:B6) < 0, MAX(B2:B6) > 1, INT(B2) <> B2, INT(B3) <> B3, INT(B4) <> B4, INT(B5) <> B5, INT(B6) <> B6), "Each SCOFF Item Must Be 0 (No) or 1 (Yes)", SUM(B2:B6))SCOFF Screening Interpretation (>= 2 Positive Threshold)
Flags SCOFF >= 2 for comprehensive eating-disorder clinical assessment.
=IF(OR(MIN(B2:B6) < 0, MAX(B2:B6) > 1, INT(B2) <> B2, INT(B3) <> B3, INT(B4) <> B4, INT(B5) <> B5, INT(B6) <> B6), "Each SCOFF Item Must Be 0 (No) or 1 (Yes)", IF(SUM(B2:B6) >= 2, "SCOFF >= 2: Positive Eating-Disorder Screen — Perform Comprehensive Clinical Evaluation", "SCOFF 0–1: Negative Screen — Assess Clinically if Symptoms Persist"))Try the example
Use the original values or change them to test your understanding.