Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder characterized by a seeming lack of interest in food or eating. A person with this disorder often avoids situations where food is eating, such as at regular mealtimes, especially if other people are going to be present. Some people call this “food avoidance” or simply, “picky eating.”
People who are diagnosed with this disorder often experience it in one of three different ways: lack of interest in food or eating; avoiding food because of its different tastes, textures, smells, and temperatures; and fear of some sort of aversive event connected to eating (such as choking or nausea).
While researchers don’t know of the specific causes of ARFID, some theories have suggested it is likely related to biological, social (family), and psychological factors in the person. Children who are exposed to ARFID behaviors within their family or their every day environment may be more prone to mimicking those behaviors, because they don’t understand what healthy versus unhealthy eating entails.
Specific Symptoms of Avoidant/Restrictive Food Intake Disorder (ARFID)
ARFID is an eating disorder that is characterized by avoiding or restricting their food intake for a number of reasons. One reason is because the person appears to have a lack of interest in eating or food in general. Eating holds no interest to them, and while they may outwardly say they recognize the value of eating, they mistakenly underestimate the amount of food needed in order to meet their nutritional needs.
Some people with this disorder can’t stand the way various foods taste differently, especially when the food is in their mouth. They are engaging in sensory avoidance — avoiding everything related to food because it is distasteful or feels uncomfortable to one or more senses. This may include the way the food smells, the way it tastes, its texture, or the temperature of the food.
A person with this disorder may also be overly concerned about some sort of negative consequence associated with eating. This could involve a fear of choking, getting some sort of food-related illness, coming down with nausea or diarrhea, or food allergies.
One or more of the following symptoms must be present in order to qualify for this diagnosis.
- Significant weight loss (as determined by clinical judgment), or failure to achieve expected weight gain, or faltering expected growth in children.
- Significant nutritional deficiency.
- Dependence on nutritional supplements or being tube fed.
- Significant interference with every day social or psychological functioning.
The disorder isn’t better explained by lack of food (due to socioeconomic or other factors), lack of access to food or proper nutrition, or cultural practices.
If anorexia nervosa or bulimia nervosa is already diagnosed in the person, this disorder is secondary to those diagnoses.
The disorder can’t be explained by a pre-existing medical condition, disease, or other mental disorder. For instance, individuals with autism and developmental disorders may be more sensitive to food as they often experience heightened sensory feedback. Typically ARFID would not be diagnosed in the presence of such disorders.
Risks Associated with Avoidant/Restrictive Food Intake Disorder
If a person experiences ARFID for longer than three (3) months, they may experience increased risks to their overall health. This is especially true in children and teenagers. Unexplained weight loss and malnutrition are typically found in people with undiagnosed ARFID. In children, additional risk factors include developmental delays, and failure to achieve expected growth targets typical of their peers. Some people will experience increasing gastrointestinal complications, and may even have an anxiety disorder due to the feelings surrounding food and eating.
Treatment of ARFID
Treatment of ARFID focuses on understanding the value of good nutrition and learning to combat misconceptions and false beliefs about food and eating. Treatment is best conducted with a mental health professional who specializes in eating disorders.
This entry has been adapted for DSM-5 criteria; diagnostic code 307.59 (F50.8).
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.