Screening for anorexia nervosa

Target groups for screening for eating disorders such as bulimia and anorexia nervosa include (1):

• young women with low BMI compared with age norms
• patients consulting with weight concerns who are not overweight
• women with menstrual disturbances or amenorrhoea
• patients with gastro-intestinal symptoms
• patients with symptoms or signs of starvation or repeated vomiting
• children with poor growth
• young people with type 1 diabetes and poor treatment adherence

The SCOFF questionnaire aids in early detection of possible cases of eating disorders. A few additional questions may be helpful in detecting eating disorders and eliciting psychopathology in target groups (1,2):

• do you worry excessively about your weight?
• do you think that you have an eating problem?
• do you avoid eating with others?
• which foods feel 'safe' to you and what do you avoid?
• what would you say your ideal weight is?
• how would you feel if you were the normal weight for your height?
• do you have compulsions to binge or over exercise?
• do you ever vomit, abuse laxatives, and/or diuretics?
• do you ever get depressed, feel guilty or suicidal?
• has your life become more ritualised?

Reference:

• (1) NICE (2004). Eating disorders.
• (2) King's College London (2009) A General Practitioner's guide to eating disorders.