ARFID – Avoidant/Restrictive Food Intake Disorder

Picky Eating an Eating Disorder?

Avoidant / Restrictive Food Intake Disorder (ARFID) is one of the new categories of eating disorders that has been introduced in the updated version of DSM-5. (DSM-5 is a manual that mental health professionals use to classify mental disorders). A person with ARFID has some sort of issue with certain food or foods, which results in them not receiving adequate nutrition. AFRID (in prior diagnostic manuals) was previously known as Selective Eating Disorder (SED). People with ARFID are sometimes called picky eaters.

A person with ARFID has an eating disorder that does not fit into the more traditional eating disorder categories. ARFID affects mostly people in childhood or infancy, but it can also affect adults.

Some of the more common examples of ARFID are:

  • The person has trouble digesting specific types of food.
  • The person only likes to eat very small portions.
  • The person might be a very slow eater.
  • The person strictly avoids particular types of texture or colors of food.
  • The person has no appetite.
  • The person is afraid to eat; this may happen as a result of choking or vomiting on food that scared them a lot.

Whatever the reason is, the person with ARFID will not be getting an adequate level of nutrition or enough calories. In most cases this will mean that the sufferer loses weight. If the sufferer is a child, they might not lose weight; instead, they do not gain the weight that they should. For a child or infant, weight gain is a very important part of growing up as they should be increasing in height and developing a greater body mass as they get older.

The criteria for ARFID according to DSM-5

  1. The individual needs to present with a disturbed eating or feeding experience which is associated with one or more of the following:
    • Nutritional deficiency as a result of inadequate intake of food
    • Weight loss in adults or failure to gain weight in children
    • Decline in psychological function
    • Dependency on supplements in order to maintain nutritional health
  2. The disturbed eating is not due to an explainable external factor such as food being unavailable or in short supply.
  3. The person does not have the symptom of a distorted body image.
  4. The feeding disturbance or food restriction is not a result of some other physical or mental illness. For example, a person may lose weight due to the flu or food poisoning, but this would not be an example of an eating or feeding disorder, therefore a diagnosis of ARFID would not be relevant.

It is important that a person with ARFID gains weight, and nutritional supplements may need to be given if certain foods are still being avoided. This return to nutrition is important for mental and physical health. Many people with ARFID have issues at school or work due to low levels of nutrition making it hard for them to concentrate and work properly. One of the first symptoms of inadequate nutrition is lack of ability to concentrate, and this is something that parents and teachers can be on the lookout for if they are concerned that a child is not eating as much as they should be.

Other issues might come apparent at school or work as lunchtimes can be difficult. If the person is a very slow eater, they might not get enough time in the lunchtime break to eat enough. This is more of a problem for schoolchildren as in some school districts the lunch break is very short. In adulthood, a person with ARFID might avoid work lunches due to embarrassment over only liking certain foods or feeling uncomfortable eating in public.

Due to the weight loss that ARFID causes, some patients may go on to develop another form of eating disorder such as anorexia nervosa or bulimia nervosa. For this reason, it is very important that a person with ARFID seeks treatment as soon as possible. If you are concerned that your child might have ARFID, or that you suffer from it yourself, it is important that you act now to find a professional that will help you or your child overcome it. Visit our treatment page for more information.

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More information on eating disorders in children.

Written by Tabitha Farrar – 2014


The Center For Eating Disorders
Eating Disorders Review
Psychology Today