Avoidant/Restrictive Food Intake Disorder (ARFID)

ARFID, or avoidant/restrictive food intake disorder, is an eating disorder characterized by the voluntary limiting of food intake that is not related to distorted body image concerns, but instead to anxieties about food itself.

In 2013, ARFID diagnosis criteria was added to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a clinician’s handbook published by the American Psychological Association that provides standardized classifications of mental health conditions.

While there is at this time limited research on the prevalence of ARFID, a 2022 study in The Journal of Eating Disorders reported that between 0.5% and 5% of children and adults in the United States have this disorder. Though ARFID most often first appears during childhood, it can develop at any age. Childhood ARFID sometimes persists into adulthood.

People with ARFID restrict their food intake because of anxiety surrounding the consumption of certain foods. They may have fears of choking or vomiting, or they may strongly dislike foods that have a certain taste, color, texture, or smell. A traumatic experience, such as force-feeding or a prior instance of choking, may lead to ARFID.

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Some underlying neurological conditions, including autism, have been linked to the disorder. A person may be predisposed to ARFID if there is a history of eating disorders in their family.

Unlike the eating disorder anorexia nervosa, persons with ARFID don’t experience a distorted body-image or a desire to lose weight through severe calorie restriction.

Although ARFID is sometimes called “selective eating disorder,” it is not the same as being a picky eater. Picky eaters are usually young children who resist only a few, selected foods items, and being a picky eater doesn’t affect the child’s appetite or growth. Picky eating during childhood tends to go away on its own as the child grows into adolescence.

But ARFID can persist into adulthood and sometimes may not go away without treatment.

ARFID can have dangerous complications if a person is unable to consume sufficient nutrients to maintain their health. Treatment for ARFID often involves cognitive behavioral therapy. Sometimes gastroenterology treatment to address GI discomfort or medication to reduce anxiety and fears about food intake are used as well.

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Symptoms of ARFID

ARFID symptoms impact the physical, psychological, and behavioral aspects of a person’s life. These include:

Physical symptoms

  • Significant weight loss
  • Lack of growth in children
  • Impaired immune function
  • Muscle weakness
  • Low body temperature
  • Abdominal pain/stomach cramps
  • Constipation
  • Irregular menstrual cycles
  • Cold intolerance
  • Lethargy
  • Dizziness
  • Thinning of body hair

Psychological symptoms

  • Loss of interest in eating
  • Feelings of anxiousness about the consequences of eating, such as choking or vomiting
  • Vague gastrointestinal complaints or upset stomach around mealtimes
  • Difficulty concentrating

Behavioral symptoms

  • Picky, selective eating habits
  • Avoidance of foods that have an unwanted taste, color, texture, or smell
  • Avoidance of social activities that may involve eating.

FAQs

What is ARFID in Adults?

While children usually grow out of picky eating, sometimes ARFID lasts into adulthood. Adults with ARFID are more likely to require medical intervention or hospitalization for the condition. ARFID in adults can cause nutritional deficiencies and gastrointestinal issues as well as psychosocial issues.

In adults, ARFID symptoms are often related to avoidance behaviors affiliated with sensory characteristics such as the taste, color, texture, or smell of foods. Sometimes, even the appearance or temperature of food is off-putting to an adult who has avoidant/restrictive food intake disorder.

Weight loss in adult ARFID patients is not related to body image distortion, as is the case in patients with anorexia or bulimia.

What is ARFID in children?

ARFID in children is more than the typical “picky eating” behaviors that many children exhibit. ARFID puts children at risk of nutritional deficiencies and physical, mental, and behavioral health problems associated with the disorder.

Signs of avoidant restrictive food intake disorder in children may include:

  • Fears or resistance to new or unfamiliar foods
  • Fears or negative reactions to certain smells, textures, tastes, or colors of food
  • Overall lack of interest in food and often being “not hungry”
  • Fears of adverse consequences of eating, such as choking or vomiting
  • Food avoidance behaviors such as complaining of stomach pain, having a temper tantrum, or refusing to eat

Restricted eating in children can result in failure to reach normal weight goals for the child’s age or meet nutritional needs. It can also affect social development and possibly delay puberty.

How Do I Get an ARFID Diagnosis?

According to the National Eating Disorders Association, a diagnosis of avoidant/restrictive food intake disorder is made when restricted food intake leads to excessive weight loss with possible nutritional deficiencies, when food supplements or tube feeding are required, or when restricted food intake interferes with social and interpersonal relationships.

Food limitation associated with the following do not meet the criteria for ARFID diagnosis:

  • Limited food intake due to food insecurity, religious fasting, or the presence of an additional medical condition
  • Limited food intake due to a distorted body image or a desire to minimize body size and shape
  • Limited food intake that results from a medical condition that does not exceed expected amounts of weight loss or cause a major complication to the overall health of the patient

A diagnosis of ARFID often involves a physical exam and blood or urine tests to determine a patient’s general health, possible nutritional deficiencies, and possible organ dysfunction.

Is There a Link Between ARFID and Autism?

ARFID includes some similarities to autism spectrum disorder. A 2023 study 
reported in Current Opinion in Psychiatry found “a considerable overlap between ARFID and autism,” with 8% to 55% of children diagnosed with ARFID also having characteristics of autistic spectrum disorder.

Impact and Complications of ARFID

The consequences of ARFID can be severe. Consistently eating a highly selective, restrictive diet that avoids multiple foods or categories of food, such as fruits, vegetables, or meats, may result in deficiencies of key nutrients and lead to negative physical outcomes.

ARFID can also affect a person’s socialization opportunities. People with ARFID may avoid family dinners or avoid participating in other activities that involve food. Relationships, as well as work or school responsibilities, may suffer.

Serious complications arising from ARFID may include:

  • Malnutrition
  • Dehydration
  • Electrolyte imbalances
  • Anemia
  • Low blood pressure
  • Lowered bone density
  • Irregular heartbeat
  • Delayed puberty
  • Reduced physical growth

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      Icarus Nevada

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      About Us – Icarus Nevada At Icarus Nevada in Las Vegas, we provide compassionate, evidence-based care for individuals facing substance use and mental health challenges. Our mission is to support every client’s path to long-term wellness with dignity, respect, and personalized treatment. We offer a full continuum of care designed to meet clients
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      5166 State Hwy 48 Dickson, TN 37055
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      Ingrained Recovery

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      At Ingrained Recovery, we believe in healing the whole person—mind, body, and spirit. Located in the heart of Eastman, Georgia, our treatment center offers a safe and supportive environment where individuals can begin their journey toward lasting recovery. Our team is dedicated to helping each client uncover the root causes of their struggles wit
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      Silver Hill Hospital CT 6840
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      Icarus Wellness and Recovery

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      Icarus Wellness and Recovery in Boise, Idaho is dedicated to supporting individuals and families on their journey to holistic healing and long‑term well‑being. Our mission is to empower each person who walks through our doors with compassion, evidence‑based therapies, and personalized care plans designed to foster meaningful growth and emotio
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      385 Tremont Ave East Orange, NJ 07018
      4.8
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      East Orange VA Medical Center is a veterans addiction treatment center that’s located in East Orange, New Jersey. They set out every day to help veterans and their families who are struggling with drug and alcohol misuse by providing several types of services both night and day. They offer a comprehensive outpatient program that will give you all
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      Robby Green
      3 months ago
      Always good people there. I hope they all get to stay
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      5 months ago
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      VA New Jersey Health Care System East Orange VA Medical Center NJ 7018
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      40 Skokie Valley Road Suite 200 Northbrook, IL 60062
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      I’ve always enjoyed working with the outreach, intake, and clinical teams at SunCloud Health. Their expertise in treating eating disorders, mental health conditions, and substance use disorders is evident in their compassionate approach to care. Suncloud is such a wonderful resource for specialized treatment!
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      633 Umatilla Boulevard Umatilla FL, 32784
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      The Recovery Village Drug and Alcohol Rehab FL 32784
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      Catalina Behavioral Health

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      Catalina Behavioral Health welcomes individuals and families in Tucson, AZ, to a caring and compassionate environment where healing begins. We specialize in customized mental health and substance use treatment across various levels of care, ensuring clients receive the support and structure best suited to their unique needs. Levels of Care Offered
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      Brianna Racamato
      3 years ago
      I can’t even begin to express my gratitude towards Monte Nido and especially the staff. Coming to residential at Monte Nido truly saved my life and I don’t believe that I would be here today if I didn’t go here.
      Toni Puma
      3 years ago
      Monte Nido - Laurel Hill MA 2155
      3
      The facilities at Monte Nido - Laurel Hill in Medford, MA 1 The facilities at Monte Nido - Laurel Hill in Medford, MA 2

      Purposes Recovery

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      7239 Kentwood Ave Los Angeles, CA 90045
      Nestled in the heart of Los Angeles with sweeping views and easy access to LAX, our luxury substance abuse treatment center offers an exceptional healing experience in a serene, upscale setting. We specialize in comprehensive, evidence-based care with a full continuum of services, including medical detox, residential treatment, and aftercare planni
      View Website (352) 706-8237
      Purposes Recovery has no reviews yet. Leave a review.
      15
      15
      310 N 10th St Bismarck, ND 58501
      4.0
      (8 reviews)
      2
      Top 10 Rehab In North Dakota
      CHI Saint Alexius Health’s Archway Mental Health provides mental and behavioral health care services for youths and adults in Bismarck, North Dakota. Their programs include age-specific inpatient treatment, outpatient treatment, and aftercare support. Specialized services are available for seniors and clients with co-occurring addictions and men
      Good most of the time
      TJ M (Michael)
      7 months ago
      So far it has been such a great experience. Dr stout is amazing and listens to your every need without any judgement or ridicule. I highly recommend him.
      alexa “Lex” Raye
      1 year ago
      They helped our son, so much. He’s doing so much better. Please don’t hesitate to come here. It’s a good place to find some assistance.
      Kitty Kattington
      1 year ago
      CHI Saint Alexius Health - Archway Mental Health ND 58501
      2
      The facilities at CHI Saint Alexius Health - Archway Mental Health in Bismarck, ND 1
      4344 W Indian School Rd #22 Phoenix, AZ 85031
      4.6
      (30 reviews)
      At Cornerstone Healing Center we believe in helping people broken by addiction and/or Mental Health Issues heal their minds, body, and spirit. We create an environment where rapid and miraculous recovery can and does happen. Our vision is to provide a safe space for long-term recovery, combining passion, structure, soul-searching, and fun to change
      Great place for recovery. The staff is educated and supportive!
      Taylor Smith
      3 months ago
      The facilities are updated and maintained very well. The staff from management to navigators were top notch. The therapists are authentically kind and extremely helpful as well as knowledgeable. I would recommend Cornerstone to anyone looking to improve their mental health and combat substance abuse issues. Thank you to all of the staff!!!
      Jake Torkelson
      4 months ago
      Cornerstone provides a life-changing experience. The place is very clean, and the staff are very kind and educated.
      Trap Taylor
      4 months ago
      12 Lily Lake Road Waverly, PA 18471
      4.1
      (60 reviews)
      Geisinger Marworth, an entity of Geisinger Health System, is an alcohol and substance use treatment facility located in the rolling hills of Waverly in Northeastern, Pennsylvania. They provide inpatient and outpatient (OP) programs for adult men and women. Geisinger Marworth, an entity of Geisinger Health System, is an alcohol and substance use tr
      Best time of my life..I would go back if I could for a meeting..Best staff and community bar none. I will never forget this place ever.
      Jeannine Borrell
      2 months ago
      I went to Marworth for the first time after relapsing after about 5 years sober. When I went there I was a wildly unpleasant person to be around. I hated the world and myself. I was truly terrible to most of the staff. My behavior was argumentative, smug and mean at best. They still welcomed me back 3 more times. I was eventually given Amy as my primary counselor and, she not only took the time to try and understand why I was like that but, she also challenged me to be better. Over my time there I had the chance to get to know the staff very well. They’re good people. Who genuinely want to help people get to the life they’re meant to have. The specialists, rec team, cafeteria workers,house keeping,security(the list goes on and on)are wonderful. That’s what makes Marworth great. It’s not the amenities. It’s not the rock climbing wall, gym, cafeteria, or anything else you can think of. It’s the people that make this place what it is. Is it perfect? Absolutely not, but nothing is. When I went in there looking for all the things that bothered me, I got nothing out of it. When I allowed them to help me, I got everything out of it.
      Adam Kamienski
      3 months ago
      Loved it great experience helped a lot thanks to great staff great attitudes thank you 6 months clean of opiate addiction and Cocaine
      Geoffrey Kaplan
      10 months ago
      Geisinger Marworth PA 18471
      4
      The facilities at Geisinger Marworth in Waverly, PA 1 The facilities at Geisinger Marworth in Waverly, PA 2 The facilities at Geisinger Marworth in Waverly, PA 3

      Purpose Healing Center Drug and Alcohol Detox – Phoenix

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      Check iconClaimed
      Purpose Healing Center, nestled in the vibrant heart of Phoenix, AZ, is a compassionate haven dedicated to guiding individuals on their journey to holistic healing and sustainable recovery. Our mission is to ignite hope, empower transformation, and cultivate resilience through a comprehensive continuum of care tailored to each person’s unique pat
      View Website (480) 405-5633
      Purpose Healing Center Drug and Alcohol Detox – Phoenix has no reviews yet. Leave a review.
      3017 Pickett Road Durham, NC 27705
      4.8
      (99 reviews)
      10
      Top 10 Rehab In North Carolina
      Structure House is a residential treatment for individuals with binge eating disorder. The program includes recreational activities, fitness therapy, nutritional counseling and more. Structure House is located in Durham, North Carolina. Structure House is compromised to provide support and compassionate care for individuals with a mental health dia
      One of the best investments I’ve made in a long time was to spend 4 weeks in a total health and wellness immersion at Structure House. I tapped into my greatest and most authentic self while there with my wife. Total body, mind and spirit work. Life changing and transformative. I highly recommend that anyone and everyone give this gift to themselves. You will reset, recharge, rejuvenate, reawaken, rediscover, and retransform. They offer a lecture series entitled, “Digging Deeper” by Life Coach Dr. Lacy Frazier. Wow is all I can say! A must visit experience.
      Julius Graham
      2 months ago
      This place gave me a kind of peace I didn’t think I’d find. The staff really got what trauma does to you, and I felt safe for once. Being around other women made it easier to open up. I’m stronger now. I just wish there’d been more family stuff.
      Sheila T.
      3 months ago
      Thank you to all at Structure House from Reservations with Joelle, to welcome with Lisa and Pam, and Mercado and Tiffany. Thank you to Chef Tom, Sondra, Martha, Jeff ….and the whole crew who spoiled me with all delicious meals. I bought the cookbook and have made several of the recipes. Thank you to Ben and Brandy for all the nutrition tips! I keep telling myself protein, starch, vegetables, and fruit not starvation, that keeps my body running properly! My metabolism is back and I have lost more weight! Thank you to Craig, Cameron, and Joe, Randy Allyson Nancy Melissa and Tasha(?). All your workouts were awesome! I joined a gym and have made a circuit with ropes,TRX , weights, rowing machine, medicine ball, crunches and other core exercises! I am going 3 times a week and riding my bike, thank you for your help to get me back to feeling fit! Thank you to Dr P. and Irina I brought my LDL way down and hope to stay on this healthy and fit journey! Thank you to Lacy and Sue for helping me to focus my Why. I want to be and feel healthy and fit! Now when things try to distract me I focus in on my Why and it keeps me on the journey to experience life’s ups and downs with the strongest and most present me possible. My apartment was amazing the grounds are kept beautifully! I can’t express in words how grateful I am! I felt so spoiled! I met some really amazing people there, who shared their experiences, difficulties and shared their strategies. I am so thankful to my husband for finding Structure House and being willing to invest in my health, fitness, and wellbeing! Blessings to all that make Stucture House an amazing Home of wellness, fitness, and health!
      kathy
      3 months ago
      Structure House NC 27705
      6
      6
      The facilities at Structure House in Durham, NC 1 The facilities at Structure House in Durham, NC 2 The facilities at Structure House in Durham, NC 3 The facilities at Structure House in Durham, NC 4
      741 US-1 North Palm Beach, FL 33408
      4.9
      (21 reviews)
      Elan Recovery + Wellness in North Palm Beach, Florida, is an addiction treatment center and mental health care facility. They offer comprehensive outpatient counseling and mentorship to adults seeking recovery in a convenient and comfortable setting. Elan Recovery + Wellness in North Palm Beach, Florida, is an addiction treatment center and menta
      I was the first free 2 weeks of recovery after relapse, it was needed. Thank you for being there when I struggled with my addiction. Curtis
      J-DOG DREW-BOY
      6 years ago
      Goodmorning I would like too say thank you too my family who took the time too find elan for me i was not in a good place my time there brought my life back my kids my family and my smile 😇 I learned alot THANK YOU Too ALL and EVERYONE at elan my life is so much better now i have ME back .I also met wonderful people there that will always have a place in my heart💝💝💝 If ur struggling this os ur place Thank you again lots of love always 😘😘😘 And today is 6 months Great day love u all
      Maria Domingo
      6 years ago
      When I came into Elan I was broken, I had no trust in rehab centers and they changed my way of thinking. They earned my trust and helped me save my life. The staff is truly the best hand picked employees a rehab center could have. All the therapists are phenomenal in what they do, they have all helped me and have gave me the criteria to live a honest clean sober life. The Techs are wonderful they’re so welcoming and do anything to make you comfortable, the lead techs Keri & Scott are so insightful. The family program that the therapist Lystra conducted was the most HEALING EXPERIENCE and has helped with a lifetime worth of damage. We keep in contact weekly and it’s the most beautiful relationship I’ve bonded with a therapist, thank you Lystra for all you do. The Director Barbara I will be forever grateful for she always made time to be there for me. The Clinical Medical staff knows what they are talking about and very understanding. Pastor Craig is the best motivational staff member he’s made a world of a difference in my life. Diane’s groups are AMAZING! I’ve learned so much about why I did what I’ve done and she has always been there for me. If you wanna get deep in the Big Book Larry can direct you with any question and answers you have. Thanks to all these staff members my higher power and my sponsor my sobriety date is 08-21-18 I have recently celebrated Six months, am sponsoring young woman myself, & I couldn’t have done it with out the help of Elan Recovery & Wellness.
      Ninaa
      6 years ago
      Elan Recovery + Wellness FL 33408

      Artemis Adolescent Healing Center

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      Artemis Adolescent Healing Center, located in the serene landscapes of Tucson, Arizona, is a trusted sanctuary dedicated to guiding teens and adolescents toward emotional wellness and recovery. Our mission is to empower young individuals and their families through compassionate care, evidence-based practices, and a vibrant, healing community atmosp
      View Website (520) 614-8647
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      Icarus Recovery Center

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      Check iconClaimed
      Icarus Recovery Center, nestled in the heart of Albuquerque, New Mexico, offers a compassionate, inclusive environment where healing and transformation can truly take flight. Founded on the belief that every individual possesses the strength to rise above challenges, our center is dedicated to providing personalized support on the journey to lastin
      View Website (505) 305-0902
      Icarus Recovery Center has no reviews yet. Leave a review.
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    Finding ARFID Treatment Today

    Treatments for ARFID may include psychoeducation about nutrition and food safety, exposure therapy (gradually introducing new foods), anxiety management, and reward-based contingency interventions (giving praise or small rewards for bites of food eaten).

    Currently there are no medications approved by the FDA for the condition, but medications that address anxiety symptoms are often used in ARFID treatment. Medications to increase appetite are also sometimes used.

    Psychological treatment may include:

    Cognitive Behavioral Therapy

    Cognitive behavioral therapy focuses on the beliefs, values, and thinking processes that maintain ARFID behaviors.

    Family Therapy

    Family therapy supports patients and helps them overcome lack of interest in food and eating, and fears of negative consequences. For instance, family members can emphasize the social interaction and bonding aspects of mealtime and reassure patients that others will be able to intervene if the patient experiences choking.

    Sources for Professional Treatment

    If you need professional treatment, you have a wide range of options, including:

    Inpatient behavioral health treatment may be required if serious medical complications such as cardiac or gastrointestinal issues are present. Inpatient treatment offers 24/7 supervision with both medical and psychological clinicians providing care in a supportive, safe environment.

    Outpatient behavioral health treatment provides treatment in daytime hours without overnight stays. Programs include partial hospitalization, or day programs, typically providing 4-8 hours of treatment per day over 5 days a week.

    Treatment involves individual and group therapy, skills training, and medication management if needed. Intensive outpatient programs typically provide 9-20 hours per week of similar treatment. Regular outpatient programs may meet once or twice a week and offer individual, group, or family counseling and educational workshops.

    Telehealth behavioral health treatment is available using online video conferencing or telephone sessions for people who cannot or prefer not to attend a program in person. You can find behavioral treatment programs near you by asking for a referral from your primary doctor, a nutritionist, or your insurance provider.

    No matter which program you choose, access help as soon as possible to avoid serious consequences. Early intervention is important for achieving the best outcomes for ARFID treatment.

    Get Help Today Phone icon 800-823-7153
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