Screening Questionnaires for Eating Disorders: Tools for Early Identification
Early detection of eating disorders can significantly improve outcomes, yet many cases go unrecognized due to stigma, secrecy, or lack of routine screening. Screening questionnaires are simple, evidence-based tools that can help clinicians, educators, and even caregivers identify individuals who may need further assessment or intervention.
This guide outlines the most commonly used eating disorder screening questionnaires, what they measure, how they’re used, and where they’re most effective.
Why Use Screening Tools?
Eating disorders are often hidden—symptoms may not be obvious on the surface.
Early screening improves access to care and reduces long-term medical and psychological complications.
Screening tools are non-invasive, cost-effective, and widely validated for different settings (primary care, schools, mental health clinics).
Top Screening Questionnaires for Eating Disorders
1. SCOFF Questionnaire
Purpose: Rapid screening for possible anorexia nervosa or bulimia nervosa
Format: 5 yes/no questions
Population: Adolescents and adults
Scoring: ≥2 “yes” answers = positive screen
Sample Questions:
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 (14 pounds) 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?
Strengths:
Fast (under 1 minute)
Validated in multiple populations
Easy to remember
Limitations:
May miss ARFID or binge eating disorder
Less sensitive in children under 12
2. EDE-Q (Eating Disorder Examination Questionnaire)
Purpose: Measures severity and symptom patterns of eating disorders
Format: 28 items on a 7-point scale
Population: Adolescents and adults
Domains:
Restraint
Eating concern
Shape concern
Weight concern
Strengths:
In-depth symptom tracking
Useful for baseline and follow-up
Aligned with DSM criteria
Limitations:
Longer to administer
May require clinical interpretation
3. EAT-26 (Eating Attitudes Test)
Purpose: Identifies symptomatic eating behaviors and attitudes
Format: 26 questions + behavioral frequency questions
Population: Age 13+
Scoring: ≥20 suggests need for further evaluation
Sample Statements:
I am terrified about being overweight.
I am preoccupied with a desire to be thinner.
I eat diet foods.
Strengths:
Widely used and validated
Captures attitudinal risk factors
Limitations:
May miss newer diagnoses like ARFID
Risk of false negatives in individuals who minimize symptoms
4. ESP (Eating Disorder Screen for Primary Care)
Purpose: Quick screen for primary care settings
Format: 5 yes/no questions
Sample Questions:
Are you dissatisfied with your eating patterns?
Do you ever eat in secret?
Does your weight affect how you feel about yourself?
Strengths:
Simple and easy to use in medical settings
Good for routine adolescent screening
Limitations:
May lack nuance or depth
Does not differentiate between specific ED diagnoses
5. NIH-PROMIS Measures (ARFID-Specific Screeners)
Purpose: Screening for Avoidant/Restrictive Food Intake Disorder (ARFID)
Population: Pediatric and adolescent patients
Domains:
Sensory sensitivity
Fear of aversive consequences (e.g., choking)
Lack of interest in eating
Strengths:
One of the only tools validated for ARFID
Helps distinguish between ARFID and other restrictive EDs
Limitations:
May require clinician interpretation
Not yet widely used in primary care
Other Noteworthy Tools
BEDS-7 (Binge Eating Disorder Screener) – For adults with suspected BED
ChEDE-Q (Child EDE-Q) – Modified for ages 7–13
PEDE-Q – Pediatric version of the EDE-Q
Kids’ Eating Disorder Survey (KEDS) – For school settings
Where and How to Use These Tools
Setting: Recommended Tool
Primary care: SCOFF, ESP, BEDS-7
Eating disorder clinics: EDE-Q, EAT-26, NIH PROMIS
School/college health: SCOFF, ChEDE-Q, KEDS
Pediatric practices: ARFID screeners, EAT-26 (modified)
Community mental health: EDE-Q, EAT-26
Screening should always be followed by a clinical interview and assessment when results are positive or concerning.
Limitations of Screening Tools
They are not diagnostic on their own
May miss atypical presentations (e.g., individuals at higher weight or males)
Can be influenced by shame, denial, or lack of insight
Require provider training and follow-up planning
Final Thoughts
Screening tools are not about labeling—they are about opening the door to help. When used thoughtfully, these questionnaires can reveal distress that might otherwise remain hidden, giving providers and families the chance to intervene early and compassionately.
Eating disorders don’t have a “look”—but they do have signs. And screening helps us find them.
References
Morgan, J. F., Reid, F., & Lacey, J. H. (1999). The SCOFF questionnaire: A new screening tool for eating disorders. BMJ, 319(7223), 1467–1468.
Fairburn, C. G., & Beglin, S. J. (2008). Eating Disorder Examination Questionnaire (EDE-Q). Cognitive Behavior Therapy and Eating Disorders.
Garner, D. M., & Garfinkel, P. E. (1979). The Eating Attitudes Test: An index of the symptoms of anorexia nervosa. Psychological Medicine, 9(2), 273–279.
Becker, K. R., et al. (2019). Initial validation of the child eating disorder examination questionnaire (ChEDE-Q) in a pediatric sample. International Journal of Eating Disorders, 52(6), 702–707.
NIH PROMIS Pediatric Measures (2022). ARFID-specific screening tools.
