Box 9 Mental health assessment for eating disorders

Core cognitive features.

Overvaluation of weight and shape.

Eating-related cognitions (e.g., guilt, control).

Preoccupations (e.g., with food preparation, eating, body image/appearance).

Body dissatisfaction.

Body checking.

Fear of fatness, fear of weight gain, internalised weight bias.

Perfectionism.

Food intake.

Nutritional adequacy (malnutrition is possible; nutritional status greatly impacts mood and anxiety).

Fluid intake.

Typical eating patterns/usual day.

Eating behaviours.

Past and current, and motivation to change these.

Food rituals.

Avoided foods and food sensitivities.

Triggers to eat or avoid eating (i.e ., emotional eating, binge eating, perceived restriction, rewarding oneself, sensation seeking).

Food restriction and restraint.

Weight history.

Current height and weight.

Weight changes and rate of change.

Weight-loss treatment history (especially but not only surgical interventions).

Current desire for weight loss/target weight.

Binge eating, purging or compensatory behaviour.

Type of compensatory behaviour (e.g ., laxative use, excessive exercise, diet pills, steroid use).

Frequency.

Amount.

Types of food.

Triggers to binge.

History of Medical co-occurring conditions.

Especially (but not only) metabolic syndrome, type 1 diabetes, type 2 diabetes, cardiovascular disease, sleep apnoea, musculoskeletal, polycystic ovary syndrome.

Psychosexual and interpersonal functioning.

Including important domains of functioning such as work/studies/home duties.

Eating disorder treatment history.

Psychological co-occurring conditions.

Anxiety, depression, post-traumatic stress, substance misuse all commonly co-occur with eating disorder presentations.

Personality disorders or obsessive–compulsive disorder may also be present.

Family of origin and support system.

Formative years and trauma history, especially (but not only) experiences of weight stigma and weight discrimination (i.e ., teasing, bullying and harassment or denial of access or social exclusion on the basis of weight).

Mental state assessment.

Mental health risk factor history (including self-harm and suicidality).

Psychometric assessment.