There are several screening tools useful for detecting disordered eating behaviors in patients. These tools are not designed to make a diagnosis; however, they can be helpful in identifying those who could benefit from a referral to a specialist for an eating disorder evaluation. Patients may not always bring up these issues on their own, so it is important to ask specific questions about this subject.
The National Eating Disorder Association (NEDA) recommends asking patients about:
- History of weight fluctuations
- Actions taken to maintain, control, or alter weight
- Laxatives, enemas, diuretics, appetite suppressants, supplements
- Excessive exercise
- Periods of binge eating or feeling a lack of control over food intake
- Comfort with current weight/shape
- Report of typical daily food and water intake
- Exercise habits (How much? How often? Why?)
- Menstrual history
- Family history of eating disorders, depression, obesity, and chemical obedience
Below are three examples of eating disorder screeners that healthcare providers can incorporate into your practice.
- Five question screener, with sensitivity of 100% and specificity of 90% for anorexia nervosa
- Do you make yourself Sick because you feel uncomfortably full?
- Do you worry that you have lost Control over how much you eat?
- Have you recently lost more than One stone (14lbs) in a 3-month period?
- Do you believe yourself to be Fat when others say you are too thin?
- Would you say that Food dominates your life?
Eating Attitudes Test (EAT-26)
- Screener divided into Part A, B, and C designed to measure symptoms characteristic of eating disorders
- If patient is underweight, scored 20 or more on Part B, or marked specific boxes in Part C, then a referral to a specialist is suggested
- Screener can be found at: http://www.eat-26.com/Docs/EAT-26Test-3-20-10.pdf
Binge Eating Disorder Screener-7 (BEDS-7)
- Seven question screener designed to quickly assess if an adult might have binge eating disorder
- First question: “During the last 3 months, did you have any episode of excessive overeating (i.e. eating significantly more than what most people would eat in a similar period of time)?”
- Second question: “Do you feel distressed about your episodes of excessive overeating?”
- If the patient answers yes to the first two questions and checks one of the shaded boxes for questions 3 through 7, then consider further discussion with the patient regarding eating behaviors and associated feelings
- Screener can be found at: http://www.vyvansepro.com/documents/Adult-Binge-Eating-Disorder-Patient-Screener.pdf