Table of ContentsView AllTable of ContentsWhat Is ARFID?SymptomsHealth IssuesCausesDiagnosisRisk FactorsTreatmentCoping
Table of ContentsView All
View All
Table of Contents
What Is ARFID?
Symptoms
Health Issues
Causes
Diagnosis
Risk Factors
Treatment
Coping
It usually occurs in childhood but can develop at any age. It is more severe than typical childhood “picky eating” and tends to affect the child’s overall appetite, food intake, growth, and development.
This article discusses the symptoms and risk factors for ARFID, as well as how it is diagnosed and treated.
Theresa Chiechi
What Is Avoidant Restrictive Food Intake Disorder (ARFID)?
Being a relatively new recognized eating disorder, there is still much unknown about ARFID, particularly as it relates to older adolescents and adults. Ongoing research in this area will hopefully shed more light on this important topic to help people experiencing it.
Among eating disorder diagnoses, ARFID is estimated to occur in 5% to 14% of people in inpatient eating disorder programs and as many as 22.5% in pediatric eating disorder day treatment programs.
Compared to those with other eating disorders (such as anorexia nervosa and bulimia nervosa), people with ARFID tend to be younger, more often males, and commonly have other psychiatric and/or medical symptoms.
ARFID vs. Anorexia
ARFID is similar to the eating disorder anorexia in that it involves restricting food intake. However, ARFID differs in that it does not involve anxiety or obsession over body weight, appearance, or the fear of fatness.
Nonetheless, ARFID and anorexia have similar physical symptoms (and thus, medical consequences) due to both disorders involving a failure to meet nutritional needs.
ARFID vs. Food Neophobia
Food neophobia is the fear of trying new foods. It is similar to ARFID in that this condition can significantly affect a child’s food choices and the quality of their diet.
Children with ARFID may have food neophobia, but their food selectiveness is more severe having strong negative reactions to smells, tastes, textures, or colors of foods, not just new foods. Others with ARFID may have a very low appetite and overall lack of interest in eating or be afraid to eat due to a fear of pain, choking, or vomiting.
ARFID Signs and Symptoms
Below are both behavioral and physical signs and symptoms people with ARFID often exhibit.
Behavioral
Individuals with ARFID may exhibit the following behavioral, psychological, or physical symptoms:
Physical
Physical symptoms may include:
Health Issues Related to ARFID
ARFID may lead to problems associated with poor nutrition, such as:
Poor nutrition related to ARFID can cause:
Causes of ARFID
The exact cause of ARFID is not known. Many experts believe there may be a combination of genetic, psychological, and social factors involved, as well as potential triggering events (such as choking).
Factors such as trauma,anxiety,autism, anddevelopmental disordersmay be involved.Some kids with ARFID also have gastroesophageal reflux disease (GERD),eosinophilic esophagitis, allergies, or other medical conditions that can lead to feeding problems.
How ARFID Is Diagnosed
Individuals with avoidant restrictive food intake disorder avoid eating and restrict their food intake to such an extent that they are not meeting their nutritional needs. Because of this, they may have one or more of the following symptoms for diagnosis:
Healthcare providers must exclude other diagnoses, such as physical illness and other mental disorders that decrease appetite and/or intake, such as other eating disorders or depression. External factors, such as sufficient access to food, should also be excluded prior to diagnosis.
If left untreated, nutritional deficiencies can be life-threatening. In addition, social functioning can be noticeably decreased, such as not participating in family meals or spending time with friends when food is involved.
Risk Factors of ARFID
While there are still some unknowns about ARFID, researchers have been able to identify some risk factors. Individuals may be more likely to develop ARFID if they have:
Children whose picky eating doesn’t go away after prolonged periods, or who have extreme picky eating, have a higher risk of developing ARFID. Many children with ARFID are also at high risk for other psychiatric disorders.
Therapy, such as cognitive-behavioral therapy, is commonly used to help patients normalize their eating and help decreaseanxiety around food.Family-based treatment and parent training may also be beneficial. Medicines may be prescribed to increase appetite or treat anxiety.
Most children with ARFID can be treated at home, but some will need to go to a more intensive hospital-based program. For example, someone with severe weight loss, malnutrition, or other serious health issues will need treatment in a hospital. Some children with ARFID will need tube feeding or nutrition formulas to get the calories and vitamins they need.
Working with a multidisciplinary team of healthcare professionals, which includes physical, nutritional, psychological, and psychiatric interventions, can offer a holistic approach to recovery.
Coping With ARFID
The way in which one person copes may be different from another person. One of the main goals in coping with an eating disorder is to turn to healthy coping strategies, rather than dysfunctional or destructive ones. The following strategies may be helpful for the person with ARFID or other eating disorders:
As a parent, you can be supportive and encourage positive attitudes about exercise and nutrition at home. The following tips may help children with ARFID:
Parents and carers of people with ARFID play an important role in recovery. Those who care for individuals with ARFID must have healthy coping skills as well.Parents and carers need to be physically, emotionally, and spiritually healthy, as a loved one’s recovery can be just as difficult to cope with.
Engaging in self-care, joining a support group (in person or online), or participating in therapy are just a few ways to manage the responsibility of caring for someone with an eating disorder.
If you are concerned your child may have an eating disorder, call your healthcare provider for advice. They can recommend nutrition and mental health professionals who have experience with the condition.
Need Help?If you or a loved one are coping with an eating disorder, contact theNational Alliance for Eating DisordersHelpline at 1-866-662-1235 for support.
Need Help?
If you or a loved one are coping with an eating disorder, contact theNational Alliance for Eating DisordersHelpline at 1-866-662-1235 for support.
Summary
Treatment involves working with a multidisciplinary team of health professionals. ARFID is a serious condition that can become life-threatening if untreated. Talk with a healthcare provider if you are concerned your child or someone you care about has ARFID or another eating disorder.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Substance Abuse and Mental Health Services Administration.Table 22, DSM-IV to DSM-5 avoidant/restrictive food intake disorder comparison.Katzman DK, Norris ML, Zucker N.Avoidant restrictive food intake disorder.Psychiatr Clin North Am. 2019;42(1):45-57. doi:10.1016/j.psc.2018.10.003Norris ML, Spettigue WJ, Katzman DK.Update on eating disorders: current perspectives on avoidant/restrictive food intake disorder in children and youth. Neuropsychiatr Dis Treat. 2016 Jan 19;12:213-8. doi: 10.2147/NDT.S82538Białek-Dratwa A, Szczepańska E, Szymańska D, et al.Neophobia-A Natural Developmental Stage or Feeding Difficulties for Children?Nutrients. 2022 Apr 6;14(7):1521. doi: 10.3390/nu14071521Nemours KidsHealth.Avoidant restrictive food intake disorder (ARFID).National Eating Disorders Association.Avoidant restrictive food intake disorder (ARFID).Micali N, Tombeur E. ARFID - Trouble de restriction/évitement de l’ingestion d’aliments : caractéristiques cliniques [ARFID - avoidant and restrictive food intake disorder : clinical characteristics].Rev Med Suisse. 2019;15(638):394-397.Merck Manual.Avoidant/Restrictive food intake disorder.Brigham KS, Manzo LD, Eddy KT, Thomas JJ.Evaluation and treatment of avoidant/restrictive food intake disorder (ARFID) in adolescents.Curr Pediatr Rep. 2018;6(2):107-113. doi:10.1007/s40124-018-0162-yAmerican Psychiatric Association. (2022).Diagnostic and statistical manual of mental disorders: DSM-5-TR. American Psychiatric Association Publishing.Thomas JJ, Wons OB, Eddy KT.Cognitive-behavioral treatment of avoidant/restrictive food intake disorder.Curr Opin Psychiatry. 2018;31(6):425-430. doi:10.1097/YCO.0000000000000454Monteleone AM, Fernandez-Aranda F, Voderholzer U.Evidence and perspectives in eating disorders: a paradigm for a multidisciplinary approach.World Psychiatry. 2019;18(3):369-370. doi:10.1002/wps.20687Hernando A, Pallás R, Cebolla A, García-Campayo J, Hoogendoorn CJ, Roy JF.Mindfulness, rumination, and coping skills in young women with eating disorders: a comparative study with healthy controls.PLoS One. 2019;14(3):e0213985. doi:10.1371/journal.pone.0213985Treasure J, Nazar BP.Interventions for the carers of patients with eating disorders.Curr Psychiatry Rep. 2016;18(2):16. doi:10.1007/s11920-015-0652-3
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Substance Abuse and Mental Health Services Administration.Table 22, DSM-IV to DSM-5 avoidant/restrictive food intake disorder comparison.Katzman DK, Norris ML, Zucker N.Avoidant restrictive food intake disorder.Psychiatr Clin North Am. 2019;42(1):45-57. doi:10.1016/j.psc.2018.10.003Norris ML, Spettigue WJ, Katzman DK.Update on eating disorders: current perspectives on avoidant/restrictive food intake disorder in children and youth. Neuropsychiatr Dis Treat. 2016 Jan 19;12:213-8. doi: 10.2147/NDT.S82538Białek-Dratwa A, Szczepańska E, Szymańska D, et al.Neophobia-A Natural Developmental Stage or Feeding Difficulties for Children?Nutrients. 2022 Apr 6;14(7):1521. doi: 10.3390/nu14071521Nemours KidsHealth.Avoidant restrictive food intake disorder (ARFID).National Eating Disorders Association.Avoidant restrictive food intake disorder (ARFID).Micali N, Tombeur E. ARFID - Trouble de restriction/évitement de l’ingestion d’aliments : caractéristiques cliniques [ARFID - avoidant and restrictive food intake disorder : clinical characteristics].Rev Med Suisse. 2019;15(638):394-397.Merck Manual.Avoidant/Restrictive food intake disorder.Brigham KS, Manzo LD, Eddy KT, Thomas JJ.Evaluation and treatment of avoidant/restrictive food intake disorder (ARFID) in adolescents.Curr Pediatr Rep. 2018;6(2):107-113. doi:10.1007/s40124-018-0162-yAmerican Psychiatric Association. (2022).Diagnostic and statistical manual of mental disorders: DSM-5-TR. American Psychiatric Association Publishing.Thomas JJ, Wons OB, Eddy KT.Cognitive-behavioral treatment of avoidant/restrictive food intake disorder.Curr Opin Psychiatry. 2018;31(6):425-430. doi:10.1097/YCO.0000000000000454Monteleone AM, Fernandez-Aranda F, Voderholzer U.Evidence and perspectives in eating disorders: a paradigm for a multidisciplinary approach.World Psychiatry. 2019;18(3):369-370. doi:10.1002/wps.20687Hernando A, Pallás R, Cebolla A, García-Campayo J, Hoogendoorn CJ, Roy JF.Mindfulness, rumination, and coping skills in young women with eating disorders: a comparative study with healthy controls.PLoS One. 2019;14(3):e0213985. doi:10.1371/journal.pone.0213985Treasure J, Nazar BP.Interventions for the carers of patients with eating disorders.Curr Psychiatry Rep. 2016;18(2):16. doi:10.1007/s11920-015-0652-3
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Substance Abuse and Mental Health Services Administration.Table 22, DSM-IV to DSM-5 avoidant/restrictive food intake disorder comparison.Katzman DK, Norris ML, Zucker N.Avoidant restrictive food intake disorder.Psychiatr Clin North Am. 2019;42(1):45-57. doi:10.1016/j.psc.2018.10.003Norris ML, Spettigue WJ, Katzman DK.Update on eating disorders: current perspectives on avoidant/restrictive food intake disorder in children and youth. Neuropsychiatr Dis Treat. 2016 Jan 19;12:213-8. doi: 10.2147/NDT.S82538Białek-Dratwa A, Szczepańska E, Szymańska D, et al.Neophobia-A Natural Developmental Stage or Feeding Difficulties for Children?Nutrients. 2022 Apr 6;14(7):1521. doi: 10.3390/nu14071521Nemours KidsHealth.Avoidant restrictive food intake disorder (ARFID).National Eating Disorders Association.Avoidant restrictive food intake disorder (ARFID).Micali N, Tombeur E. ARFID - Trouble de restriction/évitement de l’ingestion d’aliments : caractéristiques cliniques [ARFID - avoidant and restrictive food intake disorder : clinical characteristics].Rev Med Suisse. 2019;15(638):394-397.Merck Manual.Avoidant/Restrictive food intake disorder.Brigham KS, Manzo LD, Eddy KT, Thomas JJ.Evaluation and treatment of avoidant/restrictive food intake disorder (ARFID) in adolescents.Curr Pediatr Rep. 2018;6(2):107-113. doi:10.1007/s40124-018-0162-yAmerican Psychiatric Association. (2022).Diagnostic and statistical manual of mental disorders: DSM-5-TR. American Psychiatric Association Publishing.Thomas JJ, Wons OB, Eddy KT.Cognitive-behavioral treatment of avoidant/restrictive food intake disorder.Curr Opin Psychiatry. 2018;31(6):425-430. doi:10.1097/YCO.0000000000000454Monteleone AM, Fernandez-Aranda F, Voderholzer U.Evidence and perspectives in eating disorders: a paradigm for a multidisciplinary approach.World Psychiatry. 2019;18(3):369-370. doi:10.1002/wps.20687Hernando A, Pallás R, Cebolla A, García-Campayo J, Hoogendoorn CJ, Roy JF.Mindfulness, rumination, and coping skills in young women with eating disorders: a comparative study with healthy controls.PLoS One. 2019;14(3):e0213985. doi:10.1371/journal.pone.0213985Treasure J, Nazar BP.Interventions for the carers of patients with eating disorders.Curr Psychiatry Rep. 2016;18(2):16. doi:10.1007/s11920-015-0652-3
Substance Abuse and Mental Health Services Administration.Table 22, DSM-IV to DSM-5 avoidant/restrictive food intake disorder comparison.
Katzman DK, Norris ML, Zucker N.Avoidant restrictive food intake disorder.Psychiatr Clin North Am. 2019;42(1):45-57. doi:10.1016/j.psc.2018.10.003
Norris ML, Spettigue WJ, Katzman DK.Update on eating disorders: current perspectives on avoidant/restrictive food intake disorder in children and youth. Neuropsychiatr Dis Treat. 2016 Jan 19;12:213-8. doi: 10.2147/NDT.S82538
Białek-Dratwa A, Szczepańska E, Szymańska D, et al.Neophobia-A Natural Developmental Stage or Feeding Difficulties for Children?Nutrients. 2022 Apr 6;14(7):1521. doi: 10.3390/nu14071521
Nemours KidsHealth.Avoidant restrictive food intake disorder (ARFID).
National Eating Disorders Association.Avoidant restrictive food intake disorder (ARFID).
Micali N, Tombeur E. ARFID - Trouble de restriction/évitement de l’ingestion d’aliments : caractéristiques cliniques [ARFID - avoidant and restrictive food intake disorder : clinical characteristics].Rev Med Suisse. 2019;15(638):394-397.
Merck Manual.Avoidant/Restrictive food intake disorder.
Brigham KS, Manzo LD, Eddy KT, Thomas JJ.Evaluation and treatment of avoidant/restrictive food intake disorder (ARFID) in adolescents.Curr Pediatr Rep. 2018;6(2):107-113. doi:10.1007/s40124-018-0162-y
American Psychiatric Association. (2022).Diagnostic and statistical manual of mental disorders: DSM-5-TR. American Psychiatric Association Publishing.
Thomas JJ, Wons OB, Eddy KT.Cognitive-behavioral treatment of avoidant/restrictive food intake disorder.Curr Opin Psychiatry. 2018;31(6):425-430. doi:10.1097/YCO.0000000000000454
Monteleone AM, Fernandez-Aranda F, Voderholzer U.Evidence and perspectives in eating disorders: a paradigm for a multidisciplinary approach.World Psychiatry. 2019;18(3):369-370. doi:10.1002/wps.20687
Hernando A, Pallás R, Cebolla A, García-Campayo J, Hoogendoorn CJ, Roy JF.Mindfulness, rumination, and coping skills in young women with eating disorders: a comparative study with healthy controls.PLoS One. 2019;14(3):e0213985. doi:10.1371/journal.pone.0213985
Treasure J, Nazar BP.Interventions for the carers of patients with eating disorders.Curr Psychiatry Rep. 2016;18(2):16. doi:10.1007/s11920-015-0652-3
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
