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Avoidant/Restrictive Food Intake Disorder (ARFID)

What Is ARFID?

Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder characterized by avoiding food or eating very limited quantities, resulting in failure to meet nutritional needs. Unlike anorexia nervosa, ARFID does not involve concerns about body weight or shape. People with ARFID may avoid foods based on sensory characteristics (texture, appearance, smell, taste), fear of negative consequences from eating (such as choking or vomiting), or lack of interest in eating or food. ARFID can occur at any age but is particularly common in children and adolescents.

What Are the Signs of ARFID?

Common signs include significant weight loss or failure to achieve expected growth in children, significant nutritional deficiency, dependence on nutritional supplements or tube feeding, marked interference with psychosocial functioning, eating a very limited variety of foods (selective eating), avoidance of entire food groups, fear of eating after a traumatic incident (such as choking), lack of appetite or interest in food, concerns about consequences of eating without concern about weight or body shape, and social difficulties related to eating restrictions.

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What Causes ARFID?

ARFID can develop from various factors including sensory sensitivities (particularly common in individuals with autism spectrum disorder), traumatic experiences related to eating (choking, severe vomiting, painful gastrointestinal symptoms), anxiety or phobic responses to food or eating, low appetite or lack of interest in eating, learned associations between certain foods and negative outcomes, temperamental factors such as high anxiety or behavioral inhibition, and underlying medical conditions affecting eating.

How Is ARFID Different from Other Eating Disorders?

ARFID is distinct from other eating disorders in that it does not involve distorted body image, fear of weight gain, or desire to be thin. The avoidance or restriction of food is not motivated by weight or shape concerns. However, like other eating disorders, ARFID can have serious physical and psychological consequences and requires professional treatment.

How Can Treatment Help?

Cognitive-behavioral therapy for ARFID focuses on gradually expanding food variety through exposure-based interventions, addressing anxiety or fear related to eating, increasing appetite awareness and responsiveness, improving tolerance of food-related sensory experiences, nutritional rehabilitation to correct deficiencies, and addressing any underlying anxiety, perfectionism, or rigidity.

Treatment is individualized based on the specific factors maintaining the restricted eating. This may include systematic desensitization to new foods, cognitive work to address fearful thinking