Going far beyond typical picky eating, avoidant restrictive food intake disorder (ARFID) is a type of eating disorder characterized by avoidance of specific foods that result in a persistent failure to meet one’s nutritional needs. Unlike many other types of eating disorders, individuals with ARFID are not driven by dissatisfaction with their body weight or shape. Rather, food disturbances are often due to extreme sensory sensitivities, fear of vomiting or choking, or lack of interest in eating.

Let’s talk more about what ARFID entails, its diagnostic criteria, its most common warning signs and symptoms, as well as what treatment may look like if you or a loved one is struggling.

What is ARFID?

Avoidant restrictive food intake disorder, otherwise known as ARFID, is a feeding and eating disorder characterized by limited food preferences, avoidance of certain foods or textures, and restricted overall food intake. Unlike other eating disorders such as anorexia nervosa or bulimia nervosa, ARFID is not driven by concerns about body weight or shape.

Individuals with ARFID often have a narrow range of accepted foods, which may be due to a variety of individual concerns such as sensory issues, aversions to certain tastes or textures, fear of choking or vomiting, or a lack of interest in food. This disorder can manifest itself in various ways, such as a limited number of preferred foods, avoidance of entire food groups, or a reluctance to try new foods.

It’s important to note that ARFID is different from typical ‘picky eating’ patterns, as it involves persistent and severe limitations on food intake that have harmful consequences for physical and psychological health. It’s also common for people with ARFID to have co-occurring mental health conditions, such as anxiety and depression, with one 2021 study finding that 70% of individuals diagnosed with ARFID have an anxiety disorder.

How ARFID is Diagnosed

According to the DSM-5, to receive a diagnosis of avoidant restrictive food intake disorder (ARFID), individuals must meet the following criteria:

1. An eating or feeding disturbance: Apparent lack of interest in eating or food, avoiding certain sensory characteristics of food, or concern about negative consequences of eating (such as choking or vomiting) that manifests itself in consistent failure to meet nutrition needs and is associated with at least one of the following:
   1. Significant weight loss (or not achieving expected weight gain or hindering proper growth in children)
   2. Significant nutritional deficiencies
   3. Dependence on enteral feeding or oral nutritional supplements
   4. Interference with psychosocial functioning
2. The eating disturbance cannot be attributed to a concurrent medical condition or associated with another mental disorder.
3. The eating disturbance is not due to a lack of available or accessible food or an associated culturally sanctioned practice.
4. The eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of the disturbance being associated with one’s body weight or shape dissatisfaction.

One of the primary ways that ARFID is differentiated from other eating disorders is by its focus on disturbed eating patterns and lack of preoccupation with body weight or shape. Also, although ARFID is most often recognized and diagnosed in children and adolescents, it can affect any individual regardless of age and is not exclusive to any gender.

Not sure if it’s an eating disorder? Take our eating disorder screener to gain a better understanding of whether you or a loved one may be struggling.

Warning Signs and Symptoms of ARFID

In addition to the diagnostic criteria outlined in the DSM-5, there are also several common warning signs and symptoms associated with avoidant restrictive food intake disorder (ARFID). Keeping in mind that individuals with ARFID experience symptoms differently and won’t necessarily display all of the warning signs listed below, here are the most common symptoms to be aware of:

• Limited food preferences: A very narrow range of accepted foods, often with a strong preference for specific textures, tastes, or colors.
• Avoidance of certain foods: Aversion to certain foods, smells, or textures, which goes beyond typical picky eating.
• Limited food variety: Limited variety in the types of foods consumed, resulting in inadequate nutritional intake.
• Reluctance to try new foods: A reluctance or refusal to try new foods or unfamiliar dishes, even if they are similar to accepted foods.
• Dependence on certain brands or preparation methods: Insistence on specific brands or preparation methods for preferred foods, displaying rigidity in food choices.
• Mealtime rituals or routines: The presence of specific rituals or routines during meals, such as only eating with certain utensils, which may be used as coping mechanisms.
• Sensory sensitivities: Heightened sensitivity to sensory aspects of food, such as texture, temperature, or smell.
• Fear of choking or vomiting: A significant fear of choking or vomiting, which may contribute to the avoidance of certain foods or textures.
• Social avoidance: Avoidance of social situations involving food, such as parties or gatherings, due to limited food choices or fear of judgment.
• Negative impact on daily functioning: Impaired daily functioning, including disruptions in social, academic, or occupational aspects of life as a result of disturbed eating patterns.
• Physical symptoms: Physical symptoms like fatigue, dizziness, or nutritional deficiencies due to inadequate food intake.

Overcoming ARFID

Treatment for avoidant restrictive food intake disorder widely varies from person to person depending on their unique circumstances and needs, along with the severity of the disorder. Most often, treatment will consist of a multidisciplinary team of specialized professionals who work to address all physical and psychological concerns related to the disorder. This treatment team may comprise of a therapist, dietitian or nutritionist, primary care physician, psychiatrist, and other specialized healthcare professionals.

In addition to this, having the proper support system is an essential part of the recovery journey, which is why we’ve created our RecoVERY community to provide individuals with community support, beneficial recovery resources, and valuable psychoeducation. Join the community for free today to see how it can help you reimagine your relationship with food and body image.

Alongside our community, VERY’s virtual eating recovery treatment is designed to help individuals with all types of eating disorders achieve and maintain a lasting, successful recovery. Supported by a team of compassionate, specialized professionals, our goal is for all of our members to live a life filled with purpose and meaning, free from the eating disorder.

Have questions? Schedule a free consultation to learn more about how our team can complement your recovery journey.