ARFID - Understanding Avoidant/Restrictive Food Intake Disorder (ARFID) - 27/Feb/2024

ARFID – Understanding Avoidant/Restrictive Food Intake Disorder (ARFID) – 27/Feb/2024

Understanding Avoidant/Restrictive Food Intake Disorder (ARFID)

Avoidant/Restrictive Food Intake Disorder (ARFID) is a relatively new diagnosis, but it describes a long-recognized condition that goes beyond what many people think of as “picky eating” in children or adults. ARFID presents serious and persistent disturbances in eating related to the intake of certain foods, which can significantly impact health and functioning. This article offers an in-depth look at the definition, symptoms, causes, and treatment options for ARFID.

Defining ARFID

Avoidant/Restrictive Food Intake Disorder is detailed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as an eating or feeding disturbance characterized by persistent failure to meet appropriate nutritional and/or energy needs leading to one or more of the following: significant weight loss (or failure to achieve expected weight gain or faltering growth in children), significant nutritional deficiency, dependence on enteral feeding or oral nutritional supplements, or marked interference with psychosocial functioning.

Symptoms and Diagnosis

Individuals with ARFID may show distinct symptoms that differentiate it from other eating disorders like anorexia nervosa or bulimia nervosa. These symptoms primarily involve an avoidance or restriction of food intake but do not manifest from concerns over body weight or shape. Diagnosing ARFID requires a comprehensive evaluation by healthcare professionals as it can sometimes be confused with other disorders.

Common symptoms may include:

– Avoidance based on the sensory characteristics of food (e.g., texture, color, smell, taste)
– Lack of interest in food or eating
– Fear of aversive consequences from eating, such as choking or vomiting
– Being unaffected by appetite stimulants
– Nutritional deficiencies that may not match their visible eating patterns
– For children, the potential for a stalled growth curve or failure to gain weight appropriately

Etiology: The Causes Behind ARFID

The causes of ARFID are multifactorial and can be a composite of biological, psychological, and social elements. Some individuals may have had negative experiences with food, such as choking or a traumatic event involving food which leads to avoidance behaviors. Sensory sensitivities often play a role; for some people with ARFID, certain textures or tastes of food can be intolerable. In addition, psychological traits such as anxiety or an unwillingness to try new foods can contribute to the development of this disorder.

Treatment and Management

Effective treatment is necessary to address the issues ARFID presents. Multidisciplinary approaches often yield the best outcomes — these can involve nutritionists, therapists, and medical providers.


Nutritional Rehabilitation

: Assessment and planning by a dietician to address deficiencies and promote balanced eating habits.


: Cognitive Behavioral Therapy can help individuals identify and challenge the thought patterns related to their restrictive eating behaviors. Exposure therapy is also common, helping individuals become desensitized to the sensory aspects of foods that cause them anxiety or discomfort.

Family-Based Treatment

: For children and adolescents, parents can play a crucial role in normalized feeding routines.


: While not a central aspect of treating ARFID typically medication might be used to help manage related symptoms like anxiety.

Researchers are also investigating newer therapeutic approaches including Occupational Therapy (OT) that focuses on desensitizing individuals to various textures and smells associated with different foods.


  • ARFID was officially added to the DSM-5 as a diagnosis in 2013.
  • It can occur in as many as 5% of children; recent studies suggest it’s also present in adults, but prevalences there are less clear.
  • Unlike anorexia nervosa or bulimia nervosa, ARFID doesn’t involve distress about body shape or size nor behaviours like purging after meals.
  • People with ARFID often experience coexisting conditions such as anxiety disorders or autism spectrum conditions.
  • Image Description

    An image of organized rows of distinctly different foods representing various textures and colors that might be used for exposure therapy during treatment sessions for patients with ARFID.