Avoidant Restrictive Food Intake Disorder (ARFID)

What is ARFID
Symptoms of ARFID
A note about picky eating and AFRID
Emotional and behavioral signs of ARFID
Physical signs of ARFID
Health consequences of ARFID
Facts about ARFID

What is ARFID?

Avoidant Restrictive Food Intake Disorder (ARFID, pronounced are-fid) is similar to anorexia in that both disorders involve limitations in the amount and/or types of food consumed, but unlike anorexia, people with ARFID do not restrict their eating because of self-esteem, body issues, or a desire to be thin.

Symptoms of ARFID

  • An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:
    • Significant weight loss (or failure to achieve expected weight gain or faltering growth in children).
    • Significant nutritional deficiency.
    • Dependence on enteral feeding or oral nutritional supplements.
    • Marked interference with psychosocial functioning.
  • No evidence of a disturbance in the way in which one’s body weight or shape is experienced.
  • The eating disturbance is not attributable to a concurrent medical condition or not better explained by another mental disorder.

A note picky eating and ARFID

Although many children go through phases of picky or selective eating, a person with ARFID is more severe. Children with AFRID often do not consume enough calories and nutrients to grow and develop properly, which can stall appropriate growth and weight gain. In adults, nutritional deficiencies can interrupt basic body functions and result in weight loss.

Emotional and behavioral signs of ARFID can include:

  • Dramatic restriction in types or amount of food eaten
  • Will only eat certain textures of food
  • Fears of choking or vomiting
  • Lack of appetite or interest in food
  • Limited range of preferred foods that becomes narrower over time (i.e., picky eating that progressively worsens)
  • Taking an extended period of time to eat
  • Sensory sensitivities

Physical signs of ARFID can include:

  • Stomach cramps, other gastrointestinal complaints (constipation, acid reflux, etc.)
  • Difficulties concentrating
  • Abnormal labs (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate)
  • Dizziness and/or fainting
  • Feeling cold all the time
  • Sleep problems
  • Menstrual irregularities—amenorrhea, irregular periods or only having a period while on contraceptives (this is not considered a “true” period)
  • Cuts and calluses across the top of finger joints (a result of inducing vomiting)
  • Dental problems, such as enamel erosion, cavities, and tooth sensitivity
  • Dry skin
  • Dry and brittle nails
  • Swelling around area of salivary glands
  • Fine hair on body (lanugo)
  • Hair loss, dry and brittle hair 
  • Muscle weakness
  • Cold, mottled hands and feet or swelling of feet
  • Poor wound healing
  • Impaired immune functioning
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Health consequences of ARFID

Like with anorexia, the body can be denied the essential nutrients it needs to function normally, so it is forced to slow down all of its processes to conserve energy. This “slowing down” can have serious medical consequences:

  • Abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing. The risk for heart failure rises as heart rate and blood pressure levels sink lower and lower.
  • Reduction of bone density (osteoporosis), which results in dry, brittle bones.
  • Muscle loss and weakness.
  • Severe dehydration, which can result in kidney failure.
  • Fainting, fatigue, and overall weakness.

Facts about ARFID

  • People with autism spectrum conditions are much more likely to develop ARFID, as are those with ADHD and intellectual disabilities.
  • Children who don’t outgrow normal picky eating, or in whom picky eating is severe, appear to be more likely to develop ARFID.
  • Many children with ARFID also have a co-occurring anxiety disorder, and they are also at high risk for other psychiatric disorders.
  • ARFID can result in problems at school or work due to difficulties eating with others and extended times needed to eat.
  • Studies show that many people with ARFID have suffered a traumatic childhood experience.

Please reach out for help and support.

If you think you are or someone you care about is struggling with ARFID, contact us here or click below to schedule an appointment online.

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