Restrictive Eating Test (ARFID)

Avoidant/restrictive food intake disorder (ARFID) became an official diagnosis in 2013, when the American Psychiatric Association added it to the DSM-5, the manual doctors use to diagnose mental disorders. Unlike anorexia nervosa or bulimia nervosa, ARFID is not about body shape, weight or wanting to be thin. Instead, people with ARFID eat far too little, or too few kinds of food, and this can lead to serious weight loss, missing nutrients, relying on nutrition drinks or supplements, or real problems in everyday social life. To help spot these patterns, Hana F. Zickgraf and Jordan M. Ellis (2018) developed the Nine Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS), a short questionnaire for adults that looks at the different forms restrictive eating takes.

The test breaks restrictive eating down into three parts, matching the three main forms doctors see. Picky Eating covers avoiding foods because of their taste, texture, smell or look, which often leaves a person with only a short list of foods they will eat. Appetite covers a general lack of interest in food; on this scale, a higher score means a smaller appetite and often having to push yourself to eat enough or to eat regular meals. Fear covers avoiding food because of worries about what eating might do, such as choking, vomiting or stomach discomfort. Together, these three scores give a full picture of how restrictive eating shows up in daily life. If you came looking for a picky eater test, the Picky Eating score is the part that measures it.

Research shows that these three parts capture real differences in how people relate to food. Zickgraf and Ellis (2018) showed that the NIAS scores are reliable and that each one is linked to its own problems, such as a low body mass index, eating fewer fruits and vegetables, and eating getting in the way of social life. Later research by Burton Murray et al. (2021) confirmed that the scores tell apart the different forms of ARFID seen in clinics. However, studies also show that high scores can come with other conditions too. For instance, Presseller et al. (2024) found that people with anorexia nervosa often score high on the NIAS, so while the screen picks up restrictive eating well, it cannot tell ARFID apart from other eating disorders without a fuller assessment by a professional.

Your results show a marker next to each score for comparison. These markers are rough averages, rescaled from data Presseller et al. (2024) collected from 795 Swedish adults who had never had an eating disorder; most of them were women. Because this site uses a five-point answer scale instead of the NIAS's original six-point one, the markers are estimates, not exact percentiles or official norms. They simply show how people without an eating disorder typically answer, to help you see where you stand.

This test is for education and self-reflection only. It is not medical advice or a diagnosis. A high score means you limit your eating more, but it cannot tell you whether you have an eating disorder. This test is based on the Nine Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS) but is independent and not affiliated with or endorsed by Hana F. Zickgraf, Jordan M. Ellis, or their universities. If the way you eat causes you real distress, leaves you short of nutrients, makes you lose weight, or gets in the way of daily life, please see a doctor, a registered dietitian or a mental health professional.

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.
• 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.
• Presseller, E. K., Cooper, G. E., Thornton, L. M., Birgegård, A., Abbaspour, A., Bulik, C. M., Forsén Mantilla, E., & Dinkler, L. (2024). Assessing Avoidant/Restrictive Food Intake Disorder (ARFID) Symptoms Using the Nine Item ARFID Screen in >9000 Swedish Adults With and Without Eating Disorders. International Journal of Eating Disorders, 57(11), 2143-2155.
• American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Association.

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