Use our readymade template to create your Binge Eating Scale (BES) assessment tool for diagnosing and assessing the severity of binge eating disorder
Create your care assessments
BES score | Binge Eating Problem | Proposed treatment |
---|---|---|
0-17 | Minimal | May not need treatment |
18-26 | Moderate | Consider counseling |
27-48 | Severe | Active treatment |
- Prebuilt template with BES scoring to assess the presence of binge eating disorder and measure its severity
- 16-item questionnaire that scores each item from “0” to “3” based on the severity of the behavior
- Real-time calculation of BES Score and binge eating problem based on the form responses
- Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
- Compare the scores from the initial screening with that of the followup to track the progression of the disorder
- Easily create responsive forms that allow patients to complete their assessments on any device at any time
Collect responses from your patients
Patient ID | 1004 |
Patient Name | John W |
Patient Email | johnw@ymail.com |
Patient Phone Number | 0987654321 |
Doctor's Name | Dr. Smith |
Location | New York |
1. | I frequently think about my weight and feel great shame and disgust. |
2. | Usually I swallow my food almost without chewing, then feel as if I ate too much. |
3. | Because I feel so helpless about controlling my eating I have become very desperate about trying to get in control. |
4. | I have a strong habit of eating when I’m bored. Nothing seems to help me break the habit. |
5. | Although I’m not physically hungry, I get a hungry feeling in my mouth that only seems to be satisfied when I eat a food, like a sandwich, that fills my mouth. Sometimes, when I eat the food to satisfy my mouth hunger, I then spit the food out so I won’t gain weight. |
6. | Almost all the time I experience strong guilt or self-hate after I overeat. |
7. | I have a regular habit of starting strict diets for myself, but I break the diets by going on an eating binge. My life seems to be either a “feast” or “famine.” |
8. | I eat so much food that I regularly feel quite uncomfortable after eating and sometimes a bit nauseous. |
9. | In my adult years, I have had week-long periods where I practically starve myself. This follows periods when I overeat. It seems I live a life of either “feast or famine.” |
10. | I feel incapable of controlling urges to eat. I have a fear of not being able to stop eating voluntarily. |
11. | Because I have a problem not being able to stop eating when I want, I sometimes have to induce vomiting to relieve my stuffed feeling. |
12. | I feel so ashamed about overeating that I pick times to overeat when I know no one will see me. I feel like a “closet eater.” |
13. | There are regular periods when I seem to be continually eating, with no planned meals. |
14. | It seems to me that most of my waking hours are pre-occupied by thoughts about eating or not eating. I feel like I’m constantly struggling not to eat. |
15. | Most of my days seem to be pre-occupied with thoughts about food. I feel like I live to eat. |
16. | Even though I might know how many calories I should eat, I don’t have any idea what is a “normal” amount of food for me. |
BES Score | 45 |
Binge Eating Problem | Severe |
- Pre-populate patient details such as patient id, name, email etc in the BES assessment form before sharing it with the patients
- Send an email invitation with a secure link for patients to complete their BES assessment form prior to their visit
- Allow patients to save their progress and complete their BES assessment form at a later time without losing any responses
- Set up an email template for your BES assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their BES score, diagnosis, next steps when they submit their BES assessment
Track patient responses in Google Sheets
A | B | C | D | E | |
---|---|---|---|---|---|
1 | Name | Question | Answer | Score | Total Score |
2 | John W | 1. | I frequently think about my weight and feel great shame and disgust. | 3 | 45 |
3 | John W | 2. | Usually I swallow my food almost without chewing, then feel as if I ate too much. | 3 | 45 |
4 | John W | 3. | Because I feel so helpless about controlling my eating I have become very desperate about trying to get in control. | 3 | 45 |
5 | John W | 4. | I have a strong habit of eating when I’m bored. Nothing seems to help me break the habit. | 3 | 45 |
6 | John W | 5. | Although I’m not physically hungry, I get a hungry feeling in my mouth that only seems to be satisfied when I eat a food, like a sandwich, that fills my mouth. Sometimes, when I eat the food to satisfy my mouth hunger, I then spit the food out so I won’t gain weight. | 3 | 45 |
7 | John W | 6. | Almost all the time I experience strong guilt or self-hate after I overeat. | 2 | 45 |
8 | John W | 7. | I have a regular habit of starting strict diets for myself, but I break the diets by going on an eating binge. My life seems to be either a “feast” or “famine.” | 3 | 45 |
9 | John W | 8. | I eat so much food that I regularly feel quite uncomfortable after eating and sometimes a bit nauseous. | 3 | 45 |
10 | John W | 9. | In my adult years, I have had week-long periods where I practically starve myself. This follows periods when I overeat. It seems I live a life of either “feast or famine.” | 3 | 45 |
11 | John W | 10. | I feel incapable of controlling urges to eat. I have a fear of not being able to stop eating voluntarily. | 3 | 45 |
12 | John W | 11. | Because I have a problem not being able to stop eating when I want, I sometimes have to induce vomiting to relieve my stuffed feeling. | 3 | 45 |
13 | John W | 12. | I feel so ashamed about overeating that I pick times to overeat when I know no one will see me. I feel like a “closet eater.” | 3 | 45 |
14 | John W | 13. | There are regular periods when I seem to be continually eating, with no planned meals. | 3 | 45 |
15 | John W | 14. | It seems to me that most of my waking hours are pre-occupied by thoughts about eating or not eating. I feel like I’m constantly struggling not to eat. | 3 | 45 |
16 | John W | 15. | Most of my days seem to be pre-occupied with thoughts about food. I feel like I live to eat. | 3 | 45 |
17 | John W | 16. | Even though I might know how many calories I should eat, I don’t have any idea what is a “normal” amount of food for me. | 2 | 45 |
- Export patient responses including the calculated BES score and binge eating problem to Google Sheets for easy record-keeping
- Export individual points for each item to Google Sheets for data manipulation and analysis for comprehensive insights
- Use pre-built reports to easily keep track of patient progress over time and monitor changes in their eating behaviors
- Receive a copy of the response and the calculated BES score by email whenever a patient submits their BES assessment
- Use data in Google Sheets to integrate with external EHR systems for seamless data transfer
HIPAA compliance
Patient ID: | 1004 |
Patient Name: | ****** |
Patient Email: | ****** |
Patient Phone Number: | ****** |
Doctor's Name: | Dr. Smith |
Location: | New York |
1.: | I frequently think about my weight and feel great shame and disgust. |
2.: | Usually I swallow my food almost without chewing, then feel as if I ate too much. |
3.: | Because I feel so helpless about controlling my eating I have become very desperate about trying to get in control. |
4.: | I have a strong habit of eating when I’m bored. Nothing seems to help me break the habit. |
5.: | Although I’m not physically hungry, I get a hungry feeling in my mouth that only seems to be satisfied when I eat a food, like a sandwich, that fills my mouth. Sometimes, when I eat the food to satisfy my mouth hunger, I then spit the food out so I won’t gain weight. |
6.: | Almost all the time I experience strong guilt or self-hate after I overeat. |
7.: | I have a regular habit of starting strict diets for myself, but I break the diets by going on an eating binge. My life seems to be either a “feast” or “famine.” |
8.: | I eat so much food that I regularly feel quite uncomfortable after eating and sometimes a bit nauseous. |
9.: | In my adult years, I have had week-long periods where I practically starve myself. This follows periods when I overeat. It seems I live a life of either “feast or famine.” |
10.: | I feel incapable of controlling urges to eat. I have a fear of not being able to stop eating voluntarily. |
11.: | Because I have a problem not being able to stop eating when I want, I sometimes have to induce vomiting to relieve my stuffed feeling. |
12.: | I feel so ashamed about overeating that I pick times to overeat when I know no one will see me. I feel like a “closet eater.” |
13.: | There are regular periods when I seem to be continually eating, with no planned meals. |
14.: | It seems to me that most of my waking hours are pre-occupied by thoughts about eating or not eating. I feel like I’m constantly struggling not to eat. |
15.: | Most of my days seem to be pre-occupied with thoughts about food. I feel like I live to eat. |
16.: | Even though I might know how many calories I should eat, I don’t have any idea what is a “normal” amount of food for me. |
BES Score: | 45 |
Binge Eating Problem: | Severe |
BES Score: | 45 |
Binge Eating Problem: | Severe |
- Create a HIPAA compliant BES assessment form to safely collect, store and access patient responses
- Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
- Automatically mask PHI fields when exporting BES form responses to Google Sheets and sending them on email
- Prepopulate patient details in BES assessments by creating secure prefill links without exposing PHI
- Limit access to patient data only for authorized personnel and minimize the risk of data breaches
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