MAGENT

SCOFF questionnaire: scoring the five questions (Morgan 1999)

The SCOFF questionnaire is a five-question screen for eating disorders. Each question takes a yes or a no, each yes is worth one point, and two or more yes answers make the screen positive. The name is built from a key word in each question: Sick, Control, One stone, Fat and Food. This calculator adds the answers you've recorded and reports the score and whether it reaches 2.

Not a medical device. Not a diagnosis or dosing recommendation.

Use this calculator via API

What is the SCOFF questionnaire?

Morgan, Reid and Lacey designed SCOFF as a short screening tool that's easy to remember and quick to ask. It's meant to raise the question of an eating disorder, not to settle it. Magent doesn't interview anyone; each answer is recorded by the caller.

Each question is short and keyed to one letter of the name: Sick, Control, One stone, Fat and Food. The calculator takes the caller's yes or no for each; this page doesn't reproduce the questions.

The SCOFF formula

SCOFF = Sick + Control + One stone + Fat + Food

each answer: yes 1, no 0
total 0 to 5; 2 or more is a positive screen

Exact expression the calculator uses:

SCOFF = make_yourself_sick + lost_control_over_eating + lost_more_than_one_stone_3_months + believe_fat_when_others_say_thin + food_dominates_life; each 1 if true; max 5

Inputs

InputLetterPoints
make_yourself_sickS1 if true
lost_control_over_eatingC1 if true
lost_more_than_one_stone_3_monthsO1 if true
believe_fat_when_others_say_thinF1 if true
food_dominates_lifeF1 if true

How the calculation works

  1. Count the yes answers. Each is 1 point.
  2. Compare with 2. A score of 2 or more sets screen_positive to true; 0 or 1 leaves it false.

There's no weighting: every question counts the same.

Worked examples

These use Magent's own expected values for the calculator.

Example 1: yes to Sick and Control

  1. Sick 1, Control 1, the other three 0.
  2. 1 + 1 = 2.
  3. SCOFF 2, screen positive.

Example 2: yes to Sick alone

  1. Sick 1, the other four 0.
  2. SCOFF 1, screen not positive.

Example 3: no to every question

  1. All five answers are no.
  2. SCOFF 0, screen not positive.

History of the SCOFF questionnaire

Morgan, Reid and Lacey published "The SCOFF questionnaire: assessment of a new screening tool for eating disorders" in the BMJ in 1999. The five questions and the two-answer threshold the calculator uses come from that paper.

When it's used

When a quick screen is wanted to decide whether to ask more about eating, weight and body image.

Where it's used

Primary care, student health, mental health services and research.

Who uses it

GPs, nurses, mental health professionals and researchers. The calculator counts the answers.

Limits of the calculation

  • It's a screen. A positive result doesn't establish an eating disorder, and a negative one doesn't rule an eating disorder out.
  • The weight question uses stone and pounds; the calculator takes the answer as given and doesn't convert anything.
  • Answers depend on how openly the person responds.
  • This page doesn't say what a score means for a particular person.

Clinical decisions belong to a qualified clinician who knows the patient.

  • PHQ-9 totals nine items about mood and related problems, each scored 0 to 3.
  • CAGE questionnaire is a four-question alcohol screen.

Glossary

  • Screen positive: the result reaches the threshold for asking further questions.
  • Stone: a British unit of weight equal to 14 lb.
  • Screening tool: a short test used to decide who needs a fuller assessment.

Common mistakes

  • Treating 1 as positive. The threshold is 2.
  • Weighting the questions. Each yes is 1 point.
  • Reading a positive screen as a confirmed eating disorder. It's a screen.

Source

Morgan JF, et al. The SCOFF questionnaire: assessment of a new screening tool for eating disorders. BMJ. 1999;319(7223):1467-1468. DOI: 10.1136/bmj.319.7223.1467. PMID: 10582927

Frequently asked questions

How is the SCOFF questionnaire scored?

One point for each yes, out of five. Two or more is a positive screen.

What does SCOFF stand for?

Sick, Control, One stone, Fat and Food, one key word from each question.

Does a positive SCOFF mean someone has an eating disorder?

No. It means the screen threshold was reached, nothing more.

Does the calculator ask the questions?

No. The caller records each answer as true or false.