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The SCOFF is the briefest validated eating-disorder screen in clinical practice. Five yes/no items, published by Morgan and colleagues in the BMJ in 1999, designed to surface a flag in a single question block. The acronym names the five items: Sick, Control, One stone, Fat, Food.

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What it measures

Five behavioural and cognitive markers of eating disorders:
  • Sick — making yourself sick because uncomfortably full (purging)
  • Control — worry that you’ve lost control over how much you eat
  • One stone — recently lost more than one stone (14 lb / 6.35 kg) in three months
  • Fat — believing yourself fat when others say you’re thin
  • Food — food dominates your life
Each item is yes/no. Items 1 (purging) and 4 (body-image distortion) are flagged sensitive in the template so the intake panel handles them with the same trauma-informed presentation as other sensitive items.

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When to send it

  • Adult intake when you want a brief eating-disorder signal
  • Primary-care embedded mental-health practice
  • As the first pass before sending the longer EDE-Q
  • When weight or body-image concerns surface in initial conversations
Under a minute to administer. Works well in-session or async.

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How Rivet scores it

Sum of yes-scored items, range 0–5.
TotalBand
0–1Below cutoff
2–5Positive screen
Cutoff ≥2 is the standard threshold (Morgan 1999: sensitivity 100%, specificity 87.5% in an eating-disorder unit; specificity around 80% in primary-care populations). A positive SCOFF warrants follow-up — the EDE-Q for symptom dimensions and severity, or a clinical interview structured around the eating disorder.

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Citation

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. Free clinical use.

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When not to use it

The SCOFF is a flag, not a severity instrument. It tells you to look more closely; it doesn’t tell you which symptom dimensions are involved or how severe the picture is. For symptom-dimension profiling and treatment-response tracking, use the EDE-Q. The “one stone” framing is from the original UK validation — recent weight loss may not be the primary marker in long-standing eating-disorder presentations or in atypical anorexia. Treat the question literally and weight context appropriately.

EDE-Q

The 28-item Eating Disorder Examination Questionnaire — symptom dimensions and severity.

Administering measures in session

How to give a screen in-session or between sessions.