Avoidant/Restrictive Food Intake Disorder (ARFID)
ARFID involves persistent restriction in the amount or variety of food that is not driven by fear of weight gain or disturbed body image and leads to nutritional, growth or psychosocial consequences.
Different pathways to restricted eating
Avoidance may relate to texture, smell, taste or appearance; limited interest in food or appetite; or fear of choking, vomiting, pain or an allergic reaction. These pathways can overlap and can affect children, adolescents and adults.
ARFID is more than ordinary selective eating. Diagnosis requires weight loss or inadequate growth, significant nutritional deficiency, reliance on supplements or tube feeding, or marked interference with social life. A person can be medically affected at different body weights.
Assessment
- The restriction is not better explained by lack of available food or a culturally accepted practice.
- It does not occur exclusively during anorexia or bulimia and is not driven by weight or shape concerns.
- Medical assessment considers growth, vital signs, hydration, deficiencies, gastrointestinal or swallowing problems and co-occurring neurodevelopmental or anxiety needs.
Coordinated treatment
Care may involve a doctor, an eating-disorder-informed dietitian and psychological treatment adapted for ARFID. Gradual exposure can address feared or avoided foods without abruptly removing safe foods.
Family-based support can structure meals without blame. Speech and language or occupational assessment may be useful when swallowing, oral-motor or marked sensory needs are present.
When urgent care is needed
Seek help before weight becomes very low when food range is narrowing, growth stalls, dizziness or fatigue develops, or social life is restricted. Fainting, confusion, inability to drink, very little urine, rapid weight loss, chest pain or an unusually slow or irregular pulse needs urgent medical assessment.