What is Avoidant Restrictive Feeding Intake Disorder?

ARFID is an eating or feeding disturbance characterized by one or more of the following concerns:

  • Fear of aversive consequences (e.g., choking, throwing up, allergic reactions).
  • Sensory sensitivity (e.g., tastes, textures, smells).
  • Lack of interest in eating or food (e.g., not feeling hungry, thinking eating is a chore, getting full quickly).

ARFID is also characterized by one or more of the following:

  • Significant weight loss, failure to achieve expected weight gain, or faltering growth in children.
  • Significant nutritional deficiency.
  • Dependence on enteral feeding or oral nutritional supplements.
  • Psychosocial impairment (for example, difficulty eating in restaurants or at friends' homes, avoiding lunch at school or home, declining invitations to parties, playdates, dates, or sleepovers).

Children and adolescents with ARFID present with extremely limited eating habits, often preferring the same foods each day and having difficulty eating a range and variety of foods. Many are “glut” eaters, who prefer to eat just one thing (e.g., pancakes for breakfast) until they tire of it. Often once they are tired of a food they no longer want to eat it again and reject it. Other children may seem to have a low appetite or fear that something bad or scary will happen when they eat certain foods. The eating disturbance is not better explained by a lack of available food or an associated culturally sanctioned practice. It does not occur exclusively during the course of anorexia nervosa or bulimia nervosa. There is no evidence of a disturbance in how 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. When the eating disturbance occurs in the context of another condition or disorder, the severity of the eating disturbance exceeds that routinely associated with the condition or disorder and calls for additional clinical attention.

Patients with ARFID can experience medical complications similar to AN.