What Is ARFID?

Avoidant restrictive food intake disorder (ARFID) is an eating disorder similar to anorexia. Both conditions involve intense restrictions on the amount of food and types of foods you eat.

But unlike anorexia, people with ARFID aren’t worried about their body image, shape, or size.

Many children will have phases of picky eating. But ARFID (which doctors used to call selective eating disorder) is different. Someone with ARFID doesn’t eat enough calories for their bodies to work properly. In kids, this can lead to delayed weight gain and growth. In adults, ARFID can not only cause dangerous weight loss, but it could also keep them from being able to maintain basic body functions.

Causes

Doctors don’t know what causes ARFID. Some experts believe that people who get it might have extreme sensitivity to taste or texture. They might have had a bad experience with food -- like choking or vomiting -- that makes them fearful or anxious about food.

People most likely to get ARFID include:

  • Children who never outgrow picky eating
  • People on the autism spectrum
  • Those with ADHD

Kids with ARFID often have anxiety disorders. They also have a greater chance of other psychiatric issues.

Symptoms

Some of the physical signs of ARFID are like those of anorexia. They include:

People with ARFID might have behavioral or psychological symptoms, as well. For example:

  • The need to dress in layers to hide weight loss or stay warm
  • Drastic restriction in the types or amount of food they'll eat
  • Difficulty eating with others
  • Fear of vomiting or choking

Diagnosis

To figure out if you have ARFID, your doctor will ask questions about your eating habits. They'll want to know if you:

  • Have a lack of interest in eating
  • Avoid food based on things like texture or how it looks or smells
  • Are very concerned about things that can happen to you while you eat, like choking
  • Take a lot of nutritional supplements
  • Use a feeding tube
  • Only have eating trouble during bouts of anorexia or bulimia

They'll also check to see if you have:

  • Very low weight or major weight loss
  • Malnutrition
  • Trouble with daily tasks
  • Another medical condition or mental disorder that better explains the problem

Continued

Treatment

Your team will focus on enhancing your nutrition and dealing with your feelings about food. Treatments might include:

  • A personalized meal plan by a dietitian
  • Prescription nutritional supplements
  • Speech therapy to help your motor skills for eating
  • Prescription drugs to help your appetite or anxiety
  • Meetings with a psychiatrist or psychologist to treat other mental health conditions that could affect your ARFID
  • Cognitive behavioral therapy to help you with your feelings about food and eating

In some cases, you may need to stay at the hospital for a period of time to help with weight gain or more serious medical needs related to your ARFID.

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on February 25, 2021

Sources

SOURCES:

National Eating Disorders Association: “Avoidant Restrictive Food Intake Disorder (ARFID).”

Massachusetts General Hospital: “Avoidant/Restrictive Food Intake Disorder in Children: What You Need to Know.”

ARFID Awareness UK: "Diagnosing ARFID," "What is ARFID?"

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