Key Eating Disorder Assessment Questions Every Australian Psychologist Should Ask
Eating disorder assessments can become complicated quickly. Key information is often spread across multiple sessions, and small differences in behaviours, family involvement, or motivation can change clinical priorities. I’ve found that using a structured assessment approach helps me develop a clear formulation earlier and keeps sessions focused.
Here are five key questions I make sure to cover in every eating disorder assessment. These are practical, evidence-informed, and directly inform treatment planning.
1. What does a typical day of eating look like for you?
This may sound simple, but it often uncovers patterns of restriction, bingeing, or purging that clients may not otherwise volunteer. Ask gently and openly: “Can you run me through a typical day of meals and snacks?” Make sure to clarify the timing of each eating episode. If a client has difficulty recalling their eating or gives vague answers, you may explore with them whether tracking a day or two of eating may be a useful exercise to gain clarify about what is going on. Understanding routines and triggers early on is critical for formulating a treatment plan.
2. How do you feel about your body and weight?
Body image disturbance is a core feature of most eating disorders. Rather than asking yes/no questions, explore feelings and behaviours: “How do you feel when looking in the mirror?”, “Do your thoughts about your body affect how you plan your day?”, “Is there anything about your body you wish you could change?”
3. Are there any behaviours you use to compensate for eating?
Compensatory behaviours (e.g., vomiting, excessive exercise, laxative or diuretic use) can have significant medical implications, so it is important to obtain these detail from clients. You can start by asking broad questions: “Do you ever feel the need to ‘make up for’ what you’ve eaten?” Then, if the client is engaging in compensatory behaviours, it is important to understand these behaviours in more detail. For example, “How do you make yourself vomit?”, “Have you ever seen blood in your vomit?, “How do you decide when to stop vomiting?”, “What brand of laxatives do you use?” The responses inform risk assessment, treatment priorities, and safety planning.
4. How does this affect your day-to-day life?
Eating disorders often disrupt school, work, social relationships, and family life. Asking: “How does your eating or body image affect your day-to-day activities?” provides a holistic view and highlights areas where support may be needed beyond the eating disorder itself.
5. How ready are you to make changes?
Motivation is a strong predictor of engagement and outcome. Open questions such as “How do you feel about changing your eating patterns?” or “What are your goals for therapy?” give insight into where clients sit in terms of readiness and highlight potential barriers. Motivational interviewing techniques can be useful here.
Making Assessment Practical
It’s one thing to ask the right questions, but documenting and using that information efficiently can save a lot of time when you are working in private practice. I use an intake assessment template for eating disorders after the initial session and progress note templates systematically after each subsequent session. Using templates reduces the amount of time spend doing administrative tasks when working in private practice, and also ensures no important information is missed.
When referrals are needed having a ready-made referral acceptance letter template dedicated to Eating Disorder Plans also makes the process smooth and professional. It ensures all necessary information is included and reduces administrative stress, letting you focus on clinical work rather than paperwork.