Eating Disorders Online Test

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), the authoritative guide used by clinicians to diagnose, classify, and treat mental health conditions, eating disorders are serious mental health conditions involving disturbances in eating, with associated distressing thoughts and emotions. These patterns are typically severe and persistent, and can significantly impair both physical health and psychosocial functioning.

Disordered eating and eating disorders both focus on disturbances in eating patterns. However, disordered eating refers to a range of problematic eating behaviour, attitudes towards food and preoccupation with physical appearance that may lead to skipping meals, fasting, restricting or avoiding food, etc.
Eating disorders on the other hand are complex mental illnesses with specific criteria as outlined by the DSM-5-TR. Disordered eating does not meet the severity and duration criteria outlined in the DSM-5-TR for eating disorders.

Common symptoms of eating disorders include food avoidance or restriction, binge eating, which may be followed by compensatory behaviours such as self-induced vomiting, using laxatives or diuretics. Sufferers commonly have distorted body image, engage in frequent weight checking, wear baggy clothes, and experience distressing thoughts and emotions related to food.

Other psychological and physical signs can include increased anxiety and depression, increased irritability without a clear cause, fainting or lightheadedness and dramatic weight fluctuations. Eating disorders are often comorbid with conditions such as depression, anxiety disorders, obsessive-compulsive disorder, substance use disorders, and post-traumatic stress disorder, reflecting shared underlying vulnerabilities in emotion regulation, cognition, and neurobiology.

According to the DSM-5-TR, eating disorders include:
Anorexia Nervosa (AN)
Bulimia Nervosa (BN)
Binge Eating Disorder (BED)
Avoidant/Restrictive Food Intake Disorder (ARFID)
Pica
Rumination Disorder
Other Specified Feeding or Eating Disorder (OSFED)

The SCOFF questionnaire uses 5 yes/no questions to screen for risk of eating disorders. These questions focus on Sick, Control, One, Fat, Food as a means of screening for eating disorder risk. Each response is scored as 1 or 0.

Each of the 5 questions is dichotomous with a yes or no response. A yes response is scored 1, while a no is scored 0.

Your score determines the severity of your symptoms:
0 — None
1 — Minimal
2-5 — Severe
Your score would determine your next step. Scores of 2 and above (widely used cutoff) indicate a risk of eating disorders and may require expert evaluation.

While the SCOFF questionnaire is sensitive for Anorexia Nervosa and Bulimia Nervosa in young women, it may be less sensitive for BED, ARFID, and atypical presentations of eating disorders. Hence, it is a screening tool, and not a diagnostic tool.

The SCOFF questionnaire has a high level of sensitivity and specificity. The initial sensitivity test done in 1999 revealed 100% sensitivity especially for Anorexia Nervosa and Bulimia Nervosa. Subsequent tests still reveal high sensitivity and specificity of 84.6% and 89.6% respectively, making it a good screening tool especially for Anorexia Nervosa and Bulimia Nervosa in young women.

This screening is modeled on the SCOFF 5-questions eating disorder self-test developed by Prof. John Morgan and team. It is widely used as a screening tool in primary care and clinical settings. It has a high level of sensitivity and specificity especially for Anorexia Nervosa and Bulimia Nervosa.

While the SCOFF questionnaire shows great sensitivity for Anorexia Nervosa and Bulimia Nervosa in young women, evidence reveals that it is not as sensitive for the full spectrum of eating disorders covered by the DSM-5-TR, especially in more varied populations of ages, genders and ethnicity.
Because of this, you should still seek medical advice for an eating disorder if you suspect that you are at risk, or offer support and encouragement to seek medical advice to a loved one if they are showing signs.

If you've been experiencing loss of control around food, restricting your food intake, binge eating followed by compensatory behaviours (e.g., vomiting, laxative use, excessive exercise), having distressing thoughts and emotions around food, feeling fat when others say otherwise, or you've lost more than one stone (6.35 kg) in the last three months, you may consider taking this eating disorder test to help determine your risk for an eating disorder. Eating disorders can affect people of all genders, including men and women, though they may present differently and are often under-recognized in some groups.

It is recommended that you should seek professional help if you score 2 and above, as this indicates a risk for eating disorders, requiring professional evaluation by a doctor or psychologist. Also, if your eating patterns are affecting your quality of life, or you are distressed about food, weight and body image, you should consider seeking professional help.