Screening Tools: Eating Disorders

In the present day, eating disorders may be regarded as one of the most serious and even life-threatening mental conditions. According to recent estimations, approximately 10 million men and 20 million women all over the world “will experience an eating disorder at some point in their lives” (American Psychological Association, 2020, para. 1). There are three main types of eating disorders:

• Anorexia nervosa (It is connected with a distorted body image when even extremely thin people see themselves as overweight (American Psychological Association, 2020). As a result, they refuse to eat and may starve to death.);
• Bulimia nervosa (This disorder related to a lack of control implies eating excessive quantities and subsequent purging with the use of vomiting, diuretics, or exercising.);
• Binge eating disorder (It is similar to bulimia nervosa with frequent episodes of out-of-control eating, however, without purging of excess calories (American Psychological Association, 2020).).

According to the data from the National Institute of Mental Health, although eating disorders are most common in adolescents or young adults, they may affect almost anyone regardless of body weight, age, ethnicity, and background (American Psychological Association, 2020). People frequently have eating disorders, and their families and friends do not even suspect the existence of this problem. At the same time, individuals with eating disorders may reduce social contact, deny the abnormality of their eating patterns, and hide their behavior. In this case, screening tools help medical professionals identify people who may be asymptomatic though vulnerable to specific diseases, conditions, or disorders (Department of Mental Health & Substance Abuse Services, 2016). The results of screening traditionally determine whether additional tests are required to confirm or reject specialists’ hypotheses. Finally, a diagnostic test may be applied to support these results.

In general, the SCOFF questionnaire is currently regarded as one of the most acceptable and effective screening tools for people with eating disorders. Developed in 1999 by Morgan, Reid, and Lacey, it includes only the following five questions that presuppose only “yes” or “no” answers, and two positive answers have already indicated the potential existence of eating disorders:

• Do you make yourself Sick because you feel uncomfortably full?
• Do you worry you have lost control over how much you eat?
• Have you recently lost more than One stone in 3 months?
• Do you believe yourself to be Fat when others say you are too thin?
• Would you say that Food dominates your life? (Morgan et al., 1999, p. 1467)

Multiple experiments and comparative studies were conducted to evaluate the validity of the SCOFF questionnaire as a screening tool for the detection of eating disorders, especially anorexia nervosa and bulimia nervosa. In general, its sensitivity, specificity, positive predictive value, and negative predictive value are 72-85%, 73-90%, 24-35%, and 99% respectively, depending on the characteristics of the participants (Seferovic et al., 2019). However, predominantly women aged 18-50 and 28 years old on average, with a mean body mass index of almost 30kg/m² participated in the studies (Seferovic et al., 2019).

From a personal perspective, even though the sample size should be enlarged in the future and a more diverse population should be involved, the SCOFF questionnaire may be regarded as an efficient screening tool, especially in the setting of primary care. I will integrate it into my advanced practice due to its considerable benefits. It is simple and non-invasive, provides reliable results, and contributes to the prevention of health issues or time-sensitive health care delivery to people with a serious eating disorders.

References

American Psychological Association. (2020). Eating disorders. Web.

Department of Mental Health & Substance Abuse Services. (2016). Substance use best practice tool guide: Screening tools [PDF document]. Web.

Morgan, J. F., Reid, F., Lacey, J. H. (1999). The SCOFF questionnaire: Assessment of a new screening tool for eating disorders. BMJ, 319, 1467-1468. Web.

Seferovic, A., Dianes, G. N., Juan, B., Larsen, D., Oyler, V., Ragoza, Y. (2019). What is the best screening tool for eating disorders in the primary care setting? Evidence-Based Practice, 22(3), 12. Web.