No online quiz can diagnose an eating disorder, but validated screening tools used by clinicians can tell you whether your relationship with food warrants professional evaluation. The most widely used is the SCOFF questionnaire: five yes-or-no questions that take under a minute. If you answer “yes” to two or more, the screening has 100% sensitivity for detecting anorexia and bulimia, meaning it catches virtually every case. Below are the questions themselves, what different eating disorders actually look like, and how to read the signs that something has crossed the line from dieting into disorder.
The SCOFF Screening Questions
The SCOFF questionnaire was developed as a quick, reliable way to flag eating disorders. Each question targets a core feature of disordered eating, and the name is an acronym built from a key word in each one:
- S – Do you make yourself Sick because you feel uncomfortably full?
- C – Do you worry that you have lost Control over how much you eat?
- O – Have you recently lost more than One stone (14 pounds) in a 3-month period?
- F – Do you believe yourself to be Fat when others say you are too thin?
- F – Would you say that Food dominates your life?
Each “yes” is one point. A score of 2 or higher suggests a likely eating disorder and is a strong reason to seek a professional evaluation. This is a screening tool, not a diagnosis. It’s designed to catch problems early, which means it casts a wide net. Some people who score 2 won’t ultimately have a diagnosable disorder, but the screen is telling you something worth paying attention to.
The EAT-26: A More Detailed Self-Assessment
If you want something more thorough, the Eating Attitudes Test (EAT-26) is a 26-item questionnaire that explores three dimensions of your eating behavior: dieting habits (how much you scrutinize calories, carbs, and food choices in pursuit of thinness), binge-purge tendencies (whether you purge after meals or think about food excessively), and oral control (the degree to which you restrict eating through sheer willpower). The EAT-26 is freely available online.
The traditional cutoff score is 20 or higher, which flags you for further evaluation. However, more recent research suggests a cutoff of 11 may be more accurate for detecting binge eating disorder and other eating disorders that don’t involve extreme thinness. If your score falls in that range, it’s worth taking seriously even if it feels “not high enough.”
What Each Eating Disorder Looks Like
Eating disorders aren’t one thing. They show up in very different patterns, and some don’t match the stereotype most people carry in their heads.
Anorexia Nervosa
The defining pattern is restricting food intake to the point of significantly low body weight, combined with intense fear of gaining weight and a distorted perception of your own body. You might look in the mirror and see yourself as overweight when others see the opposite. What makes this a disorder rather than a diet is that the restriction is persistent, the fear of weight gain doesn’t respond to logic, and you may not recognize how serious the weight loss has become. Clinical severity is graded by BMI, ranging from mild (BMI of 17 or above) to extreme (below 15).
Bulimia Nervosa
Bulimia involves recurring episodes of eating a large amount of food in a short window, feeling out of control during the episode, and then compensating. Compensation can mean self-induced vomiting, but it also includes fasting, excessive exercise, or laxative use. The current diagnostic threshold is at least once per week for three months. Many people with bulimia maintain a normal weight, which is one reason it often goes undetected.
Binge Eating Disorder
This is the most common eating disorder and often the least recognized. The binge episodes look similar to bulimia: eating much more than normal in a short period, eating rapidly, eating past the point of discomfort, eating when not hungry, eating alone out of embarrassment, and feeling disgusted or deeply guilty afterward. The key difference from bulimia is that there’s no purging, fasting, or compensatory behavior. To meet the diagnostic threshold, episodes occur at least once a week for three months. Mild cases involve one to three episodes per week. Extreme cases involve two or more episodes per day.
ARFID
Avoidant/Restrictive Food Intake Disorder looks nothing like the other three. There’s no fear of weight gain and no body image distortion. Instead, the person avoids foods based on texture, taste, smell, or a fear of choking or vomiting, and the avoidance is severe enough to cause real consequences: significant weight loss, nutritional deficiencies like iron-deficiency anemia, dependence on supplements to meet basic energy needs, or serious interference with social functioning (refusing to eat with others, avoiding events that involve food). This is what separates ARFID from picky eating. Picky eaters tend to maintain a normal weight. People with ARFID cannot reliably meet their own nutritional needs.
When “Healthy Eating” Becomes a Problem
Orthorexia isn’t yet an official diagnosis, but it describes a pattern clinicians increasingly recognize: an obsessive fixation on eating “pure,” “clean,” or “correct” food that takes over your life. The preoccupation goes beyond preference. You spend excessive time planning, buying, and preparing food. You label foods as safe or toxic, natural or contaminated. Eating something outside your rules triggers genuine anxiety or guilt. Your diet becomes so rigid and restrictive that it’s nutritionally unbalanced, and the time you devote to it crowds out relationships, work, and daily functioning. The distinction from simply caring about nutrition is that orthorexia erodes your health and quality of life rather than improving it, and your self-worth becomes tied to how well you follow your dietary rules.
Disordered Eating vs. an Eating Disorder
Not every unhealthy relationship with food is a clinical eating disorder, but that doesn’t mean it’s fine. Disordered eating sits on a spectrum between normal eating and a full eating disorder. It includes many of the same behaviors, like chronic restrictive dieting, binge episodes, guilt-driven exercise, or obsessive calorie counting, just at a lower frequency or intensity. Think of it as a yellow light. You may not meet every diagnostic criterion, but the patterns are there and they tend to intensify over time without intervention.
A few questions can help you gauge where you fall. Does thinking about food, weight, or your body take up a significant portion of your day? Have you changed how you socialize to avoid eating situations? Do you feel panicked or ashamed after eating certain foods? Have other people expressed concern? The more “yes” answers, the further along the spectrum you likely are.
Physical Signs Your Body May Be Affected
Eating disorders produce physical changes that are sometimes easier to spot than the psychological ones. Hair that thins, breaks, or falls out is common with prolonged restriction. Some people develop lanugo, a soft downy hair that grows on the face and body as the body tries to insulate itself. Dental erosion and calluses on the knuckles point to repeated vomiting. Persistent constipation, bloating, and nausea signal that the digestive system is under stress.
The more dangerous signs are internal. Irregular heart rhythms, low blood pressure, dehydration, and electrolyte imbalances (sodium, potassium, calcium) can develop quietly and become life-threatening. Bone loss, anemia, muscle wasting, and kidney problems are also well-documented consequences. These aren’t limited to people who look visibly underweight. People with bulimia and binge eating disorder experience serious medical complications at any body size.
What a Professional Evaluation Involves
If a screening tool flags you, or if you recognize yourself in the patterns above, the next step is evaluation by a mental health professional with experience in eating disorders. The process typically involves a conversation about your thoughts, feelings, eating habits, and behaviors around food and body image. You may be asked to complete additional questionnaires. Medical tests are often ordered to check for complications: bloodwork to assess electrolytes, kidney function, and nutritional status, along with cardiac monitoring if restriction or purging has been significant. The goal isn’t to catch you doing something wrong. It’s to understand what’s happening and figure out how to help.