This week, I've a thought-provoking questionnaire for you. British researchers have demonstrated that a simple 5 question screening tool can identify patients at risk for eating disorders with a very high degree of reliability. (Study reported in the prestigious British Medical Journal 1999;319: 1467-1468)

In the study 116 women from referrals to a specialist clinic with confirmed diagnosis of either anorexia nervosa or bulimia were compared with 96 women recruited through local college advertising. The responses from both groups were compared. Statistically, a score of at least two positives from these 5 questions had a sensitivity of 100% (95% CI 97-100%) and a specificity of 87.5% (79.2% - 93.4%) for a diagnosis of eating disorder.

I believe it's impossible to live amid the crazymaking media hype prevalent in our culture today without having (at least) disordered eating attitudes. We see messages that tell us " nothin' says lovin' like somethin' from the oven" followed immediately by an ad for Slim Fast then one for Wendy's latest creation followed by an ad for a Lean Cuisine meal or an ad for Jenny Craig weight loss services. We're told a too lean body can predispose us to osteoporosis and, if the lean look is acquired from too few calories, that we are compromising our immune system, yet skinny models, t. v. personalities and movie stars are featured as fashion icons and role models for impressionable youngsters and adults.

There is also a very strong social, emotional and spiritual connection with food in our culture. In addition to the relationship created in the first year of life if we are fed every time we cry, many of us also grew up hearing, "there are children starving in _____ (you fill in the blank)," or "Is that all you're going to eat?" We bribe and reward children (and ourselves) with food and many of us eat to feel better when we are sad, tired, angry, bored or just because we "see" food. We eat before and after weddings, funerals, birthdays, graduations--in fact any celebration without food is deemed by many as paltry.

And, because the shame of being less than perfect ruins too many lives, too few seek the help that can remove the despair of a life filled with dysfunctional and self-defeating behaviors.

Saying "we have everything we need," is a cliché'. Nevertheless, until we are happy with the resources we can muster within it's important to make use of the resources we can muster externally to ballast us while we grow strong.

Here's the questionnaire.

The 5 questions (abbreviated as "SCOFF") are:

• S: Do you make yourself Sick because you feel uncomfortably full?
• C: Do you worry you have lost Control over how much you eat?
• O: Have you recently lost more than 15 pounds in a 3 month period?
• F: Do you believe yourself to be Fat when others say you are too thin?
• F: Would you say that Food dominates your life?

IF you respond "yes" to two or more questions, use your results as a benchmark for finding resources to avoid the inevitable downward spiral to poor health. There is recovery.