What is ARFID?

Avoidant Restrictive Food Intake Disorder (ARFID) is a feeding or eating disturbance as manifested by persistent failure to meet appropriate nutritional and/or energy needs leading to 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 psycho-social functioning

It is not:

• the result of a lack of available food or an associated culturally sanctioned practice

• explained by another medical or mental disorder, so that if you treat that, the eating problem will go away

• typically associated with any abnormalities in the way in which someone perceives their body weight or shape

• just picking eating

• a lesser eating disorder

Unfortunately the incidence and prevalence are relatively unknown since it is the newest eating disorder, only falling into this diagnostic category since May 2013. One fifth of people surveyed report avoiding certain foods because of sensory issues, those with ARFID are more likely to be younger and male, with the mean onset age of 11 years old, and recent studies estimate that it may impact as many as 2%-14% of children. An ARFID diagnosis is seen in approximately 15% of new eating disorders cases, 20% report a fear of vomiting or choking, 75% of children with ARFID have an anxiety disorder and nearly 20% are neurodivergent.

Individuals with ARFID typically present with a lack of interest in eating or food in general and tend to have unreliable cues for hunger and fullness. Someone might find themselves avoiding foods based on textures, smells, or other sensory characteristics, while others may exhibit strong worry about the consequences of eating certain foods, such as vomiting, choking, or fear of an allergic reaction, all of which are often unrelated to their body image or weight.

Although picky eaters have a decreased range of foods, individuals with ARFID have a restricted variety, typically less than twenty total items, which doesn't meet the basic nutrition expectation of incorporating at least ten foods from each food group.  Along these lines, a picky eater typically eats more than one food from most food or texture groups, someone with ARFID refuses entire categories of food textures or nutrition groups (specifically proteins, fruits, and/or vegetables). Whereas picky eaters (and even typical eaters) may burn out on certain foods they eat frequently, those with ARFID tend to never re-acquire them, something called food jagging.