What is ARFID?

-Increasing ARFID awareness, education opportunities, training options, and treatment access for all-

What is This Five Letter Acronym All About?

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:

It is not:

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.

How Does ARFID Present?

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.

Is ARFID Different Than Picky Eating?

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.

National Eating Disorders Association. (2021, July 14). Statistics & Research on Eating Disorders. Retrieved January 28, 2022 from https://www.nationaleatingdisorders.org/statistics-research-eating-disorders

Norris, M., Spettigue, W., & Katzman, D. (2016). Update on eating disorders: current perspectives on avoidant/restrictive food intake disorder in children and youth. Neuropsychiatric Disease and Treatment, 12, 213-18. https://doi.org/10.2147/NDT.S82538 

Nicely, T.A., Lane-Loney, S., Masciulli, E., Hollenbeak, C., & Ornstein, R.M. (2014). Prevalence and characteristics of avoidant/restrictive food intake disorder in a cohort of young individuals in day treatment for eating disorders. Journal of Eating Disorders, 2, 21. https://doi.org/10.1186/s40337-014-0021-3 

Fisher, M., Rosen, D., Ornstein, R., Mammel, K., Katzman, D., Rome, E., Callahan, S.T., Malizio, J., Kearney, S., & Walsh, B.T. (2014). Characteristics of avoidant/restrictive food intake disorder in children and adolescents: a " new disorder " in DSM-5. Journal of Adolescent Health, 55(1), 49-52. https://doi.org/10.1016/j.jadohealth.2013.11.013