The SCOFF 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 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

*One point for every "yes"; a score of 2 indicates a likely case of anorexia nervosa or bulimia

Specific recommendations for counselling and supporting obese and overweight patients

Educate patients about the hazards of obesity and the overall health benefits of modest weight loss (5-10% of body weight)
Assess readiness to change with the following questions27:
Are you currently involved in any effort to lose weight?
(If not currently involved in any effort to lose weight) Are you considering trying to lose weight?
Have you made any attempts to lose weight? If so, what happened?

For patients who are ready to change, help patients set realistic goals for change in behaviour

Emphasise gradual change in behaviour over time
Encourage patients to give up the short term "diet mentality" and stress the need for long term lifestyle change
Recommend increased physical activity, both planned exercise (for example, walking 30 minutes three times a week) and incorporating activity into daily routine (for example, using stairs instead of lifts or escalators)
Recommend some level of caloric restriction
Provide self help materials or referrals
Help patients overcome barriers
Acknowledge the difficulty of losing weight, given the easy availability and widespread marketing of large amounts of high fat, high caloric food, but emphasise that behavioural change is possible
Praise success in changing behaviour as well as in losing weight

Be aware of professional cynicism and prejudice against obese individuals that might compromise support for patients and disrupt their efforts at changing their lifestyle