Self-check · Eating & body image
ARFID Test: avoidant and restrictive eating, screened in nine questions
The nine-item NIAS screen, scored as its authors published it — with the three sub-scores that matter more than the total. Free, private, and nothing about weight or body shape.
A screening questionnaire, not a diagnosis. Its authors recommend using it alongside a screen for other eating disorders rather than on its own.
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THE NIAS SCREEN9 questionsOn texture, appetite and fear of choking.
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NOT ABOUT WEIGHTNothing to do with body imageThis is what separates ARFID from anorexia and bulimia, and it is the most misunderstood part.
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PRIVATENothing is saved or sentFree, no account, no sign-up. Your result stays in your browser.
A screening tool
Take the ARFID test
Nine statements about how eating actually works for you. Answer for how you generally are. About two minutes, and the result appears only in your browser.
Your result
What the ranges mean
- 0–10 Few patterns overall — still read your three sub-scores
- 11–20 Some patterns — worth attention, especially if one sub-score is high
- 21–30 Notable patterns — may be affecting nutrition or daily life
- 31–45 Strong patterns — please arrange an assessment soon
Each statement scores 0 (Strongly disagree) to 5 (Strongly agree) across nine items, for a total of 0–45. The total matters less than the pattern: ARFID can involve just one of the three, so a modest total with one high sub-score is a more meaningful result than a middling total spread evenly.
Picky eating, appetite and fear are scored separately, with cut-offs of 10, 9 and 10. One high sub-score can matter more than the total.
The short answer
What is ARFID?
An eating disorder in which someone avoids or restricts food enough to cause nutritional, medical or psychosocial problems — but not because of concerns about weight or shape. It entered the DSM-5 in 2013. Clinicians describe three presentations, and a person may have one or a mix: avoidance based on the sensory properties of food, where texture, smell or appearance feel intolerable and the range of safe foods narrows; genuinely low appetite or interest, where eating is forgettable rather than wanted; and restriction driven by fear of an aversive consequence such as choking, vomiting or pain, often after a frightening episode.
It affects children and adults alike, and it commonly occurs alongside autism, ADHD, anxiety and sensory sensitivities. None of that makes it less real or less treatable — it mostly means that a clinician who understands those overlaps will be more useful than one who does not.
Restriction without a weight or body-image motive is the definition. If body image is driving it, that points to a different diagnosis, not a milder one.
Zickgraf and Ellis (2018) developed this nine-item screen across large samples and showed it measures three distinct factors rather than one. That structure is the point: the three sub-scales map onto the three ARFID presentations, which is why reading them separately tells you more than the total does.
View sourceSigns
What does ARFID look like?
These cluster around the three presentations. Having some does not mean you have ARFID — what matters is whether they are affecting your health, growth or daily life.
A very narrow range of safe foods
You eat a small set of foods and cannot easily add to it, often down to specific brands or preparations. Trying something unfamiliar feels genuinely distressing rather than merely unappealing.
Texture, smell or appearance are intolerable
Slimy, mushy or mixed textures, certain smells, or how something looks can trigger gagging or nausea. This is a sensory response, not stubbornness, and it is not under voluntary control.
Low appetite, or forgetting to eat
Hunger rarely arrives, you fill up very quickly, lose interest partway through, or simply forget until you feel unwell. Eating is a task to manage rather than something your body asks for.
Fear of choking, vomiting or getting sick
You avoid foods because of what might happen — choking, being sick, pain — often after one frightening episode. You may take tiny bites, eat very slowly, or stay with foods that feel safe.
Mealtimes are stressful, especially with others
Eating in company, at someone else’s home or somewhere new produces real anxiety, and social situations involving food get avoided. The social cost is often what people notice first.
Physical effects of under-eating
Unintended weight loss or faltering growth, fatigue, feeling cold, dizziness, poor concentration, digestive problems, or signs of nutritional deficiency. These are the signs that make it urgent rather than merely difficult.
ARFID, picky eating and anorexia
Three things that involve a narrow diet and are not the same.
| Pattern | What drives it | What settles it |
|---|---|---|
| Picky eating | Preference. A limited range of liked foods. | Health, growth and daily life are basically fine. |
| ARFID | Sensory response, low appetite, or fear. | Restriction is causing real nutritional or life impact. |
| Anorexia | Concern about weight, shape or body image. | The motive is the distinction, not the amount eaten. |
| So where exactly is the line? | Impairment, not fussiness. ARFID is diagnosed when restriction causes nutritional deficiency, weight loss or faltering growth, dependence on supplements or tube feeding, or marked interference with daily life and relationships. A narrow diet without those consequences is selective eating, not a disorder. | |
Reading your sub-scores
The three blocks, and what each cut-off means
The nine questions run in blocks of three. Burton Murray and colleagues derived a cut-off for each from clinically diagnosed cases.
- 01 Picky eating
Questions 1 to 3 — cut-off 10
Sensory-driven avoidance. This cut-off is the most sensitive of the three and the least specific, so it catches nearly everyone who fits the presentation while also flagging many people who do not have ARFID.
- 02 Appetite
Questions 4 to 6 — cut-off 9
Low hunger and limited interest in eating. This is the presentation people most often miss in themselves, because an appetite that never arrives is hard to notice as absent.
- 03 Fear
Questions 7 to 9 — cut-off 10
Avoidance driven by fear of choking, vomiting or pain. This cut-off is the most specific of the three, so crossing it is the strongest single signal on this screen.
The researchers who validated these cut-offs do not recommend using the NIAS on its own. Their conclusion was that it should be paired with a screen for other eating disorders, because the sub-scale cut-offs only distinguished ARFID from other eating disorders correctly when combined with one. A positive result here therefore means “this is worth assessing properly”, not “this is ARFID”. It also cannot see your nutrition, your weight history, or your medical state — and those are what determine how urgent this is.
Things people ask early
The questions that come up first
Three worth answering before the detail.
Is this just being a picky eater?
The difference is impairment, not the number of foods. If your eating is limited but your health, growth and life are fine, that is selective eating. ARFID is when the restriction is costing you one of those.
Can adults have ARFID?
Yes. It is often framed as a childhood condition and it affects adults too, including people who have eaten this way their whole lives and assumed it was simply who they are.
Is it treatable?
Yes, and that is worth saying plainly. There is a therapy developed specifically for it, CBT-AR, and treatment usually addresses both the eating and whatever is driving it rather than trying to force new foods.
Treatment
What helps, and who to ask
ARFID is recognised and treatable. The thing that most often delays help is the assumption that it is fussiness and ought to be outgrown.
- 01 / START HERE
A medical check first
Because restriction can affect the body, a doctor checking weight, growth and nutritional status is the sensible first step — and it is usually quick. This matters even if the eating itself feels manageable to you.
- 02 / THE SPECIFIC THERAPY
CBT-AR, and a clinician who knows ARFID
Cognitive behavioural therapy for ARFID was developed for this condition specifically. Ask whether a clinician has treated it before, and if autism or ADHD are part of your picture, whether they work with that too — the approach differs.
- 03 / FINDING SOMEONE
A free helpline that does the looking
The Alliance for Eating Disorders runs a free, confidential helpline on 1-866-662-1235, staffed by licensed eating-disorder clinicians who can point you toward appropriate care. You do not need a diagnosis to call, and you do not need to be in crisis.
Background: American Psychiatric Association, What are Eating Disorders?. This page is educational and is not medical advice.
What to do next
What should you do with your result?
Take the sub-scores rather than the total to whoever you speak to. That is the part with clinical meaning.
- 01
Write down which block scored highest
Picky eating, appetite or fear. That single fact shapes what kind of help is useful, and it is the thing a short appointment most needs from you.
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Note the physical signs, not just the eating
Weight change, fatigue, dizziness, feeling cold, concentration. Those are what make this urgent or not, and a questionnaire cannot see them.
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Say it plainly when you ask
Something like: “I struggle to eat enough, or a wide enough range, and it is affecting me. I would like help.” You do not have to use the word ARFID or be certain of anything.
Significant restriction has physical consequences, and some of them need attention the same day. If you feel faint, have chest pain or an irregular heartbeat, cannot keep fluids down, or are otherwise unwell, please seek medical care or call your emergency number — do not wait for an appointment. For finding ongoing care, the Alliance for Eating Disorders runs a free, confidential helpline on 1-866-662-1235, staffed by licensed eating-disorder clinicians who can point you toward treatment. You do not need a diagnosis to call. If you are in distress or thinking of harming yourself, call or text 988 in the US, or find a line at findahelpline.com. You deserve support with this, and asking for it is not an overreaction.
Good questions to ask
ARFID test — FAQs
What people actually ask about avoidant and restrictive eating.
No, though the phrase gets used and it undersells things badly. The distinction is impairment: ARFID is diagnosed when avoidance or restriction causes nutritional deficiency, weight loss or faltering growth, dependence on supplements or tube feeding, or marked interference with daily life and relationships. A narrow diet without those consequences is selective eating. The other difference is that ARFID is not a preference someone could override by trying harder — sensory responses, absent appetite and fear of choking are not under voluntary control.
By motive, not by amount eaten. In anorexia the restriction is driven by concerns about weight, shape or body image. In ARFID it is not — it is driven by sensory experience, low appetite, or fear of a consequence such as choking or vomiting, and many people with ARFID actively wish they could eat more or gain weight. Someone can be seriously underweight from either, so the amount of restriction does not distinguish them; the reason does.
That is a meaningful result, and it is exactly why the sub-scores exist. ARFID can involve only one of the three presentations, so a person can look unremarkable on the total and still screen positive in one area. The published cut-offs are 10 or more on picky eating, 9 or more on appetite, and 10 or more on fear. If you crossed one of those, it is worth raising regardless of what the total said.
No, and the researchers who derived these cut-offs are explicit about it. They recommend using the NIAS alongside a screen for other eating disorders, because the sub-scale cut-offs only distinguished ARFID from other eating disorders correctly in combination with one. The picky-eating cut-off in particular is highly sensitive and much less specific, meaning it flags many people who do not have ARFID. Read a positive result as a reason to get assessed, not as a diagnosis.
Adults absolutely have it. It is often discussed in children because that is where it is usually first noticed, but plenty of adults have eaten this way their whole lives and assumed it was simply a personality trait. Validation work on this screen included adults across a wide age range. If it has been lifelong, that is not a reason it cannot be treated now. Our Eating Disorder Test is the broader screen worth taking alongside this one.
They co-occur frequently. Sensory sensitivity is common in autism and maps closely onto the sensory presentation; interoception and forgetting to eat often feature in ADHD and map onto the appetite presentation. That overlap does not make the eating difficulty less real or less worth treating — it mainly means that finding a clinician who works with both will get you further than one who treats the eating alone.
Cognitive behavioural therapy for ARFID, usually shortened to CBT-AR, was developed specifically for this condition. Treatment generally combines a medical review of nutrition and weight with work on whatever drives the avoidance, which differs by presentation: graded exposure for fear-based restriction, structured eating for low appetite, systematic food introduction for sensory avoidance. The important point is that this is a recognised condition with recognised treatment, not a habit to be outgrown.
Trust that over the number. These nine statements cover specific patterns in particular wordings, and a screen cannot see your nutrition, your weight history or how much eating is costing you day to day. If something about your eating concerns you enough to look this up, that is worth raising with a doctor whatever this page returned.
Yes. The test is free, needs no account or sign-up, and your result appears only in your browser. Nothing is sent to us.
Editorial transparency
Sources and review information
This page uses the NIAS, a published screening instrument. Its nine statements are not our wording but the instrument’s own, reproduced unchanged with the scoring and cut-offs its authors published, and credited below. Surrounding content is written and reviewed by the PsyMed Editorial Team from the sources listed here. We are writers and researchers, not clinicians, and this page is educational rather than diagnostic. Read how we build our tests and who we are.
Research and editorial references
- Zickgraf, H.F., & Ellis, J.M. (2018). Initial validation of the Nine Item Avoidant/Restrictive Food Intake disorder screen (NIAS): a measure of three restrictive eating patterns. Appetite, 123, 32–42 — the instrument used on this page, and the source of its three-factor structure. doi.org/10.1016/j.appet.2017.11.111
- American Psychiatric Association. What are Eating Disorders? psychiatry.org — for the DSM-5 framing of ARFID as restriction without a weight or body-image motive. psychiatry.org/patients-families/eating-disorders
- Burton Murray, H., Dreier, M.J., Zickgraf, H.F., Becker, K.R., Breithaupt, L., Eddy, K.T., & Thomas, J.J. (2021). Validation of the nine item ARFID screen (NIAS) subscales for distinguishing ARFID presentations and screening for ARFID. International Journal of Eating Disorders, 54(10), 1782–1792. doi:10.1002/eat.23520 — the source of the sub-scale cut-offs used here (picky eating ≥10, sensitivity .97 and specificity .63; appetite ≥9, .86 and .70; fear ≥10, .68 and .89), and of the recommendation to pair the NIAS with a screen for other eating disorders. Cited as text because the publisher blocks automated access to the article page.
- The Alliance for Eating Disorders Awareness — free, confidential helpline on 1-866-662-1235 and a treatment directory, linked above. Number confirmed on the organisation’s own site; we do not reproduce hours or text keywords that could not be verified there, because wrong details on a support line are worse than none.
A screen, not a verdict
Read the sub-scores, and take them to someone.
ARFID is recognised and treatable, and eating this way is not fussiness or a failure of will. Whatever the total said, the block of questions you agreed with most is the part worth saying out loud to a doctor.
Take the test