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Avoidant/Restrictive Food Intake Disorder (ARFID)

Avoidant/Restrictive Food Intake Disorder (ARFID) is not a new eating disorder, but the diagnosis was just added to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. People with this disorder develop disordered eating patterns, but unlike anorexia or bulimia, they don’t have poor body image or a fear of gaining weight. Symptoms of the ARFID, which often appear in infancy or early childhood and can continue into adulthood, include:

  • Lack of interest in food or poor appetite
  • Fears about consequences of eating (choking, vomiting, allergic reactions)
  • Selective or picky eating (only eating certain foods)


In order to make the diagnosis of ARFID, one of the following must be present in addition to the pattern of disordered eating:

  • Significant weight loss or failure to gain weight and grow
  • Nutritional deficiencies
  • Dependence on nutritional supplements or tube feeding
  • Impaired psychosocial functioning

Source: According to the National Eating Disorders Association


While it’s normal for children to develop odd eating patterns at some point during childhood, like only eating chicken or refusing to eat certain colored foods, the behavior often resolves after a short time. ARFID is more than picky eating and has many health risks associated with it, such as malnutrition, anemia, severely low body weight, weight loss and failure to grow (height and weight). Anxiety and depression often co-occur with ARFID as well. If the disorder is not treated and the individual reaches a dangerously low weight, more serious complications, which are similar to the complications found in anorexia, can develop including:

  • Cardiac problems
  • Kidney and liver failure
  • Osteoporosis
  • Low blood sugar
  • Constipation
  • Gastrointestinal problems
  • Electrolyte imbalances

Warning Signs

If your child is in a stage of picky eating, don’t automatically assume that they have ARFID. A diagnosis can only be made by a professional. However, if the disordered eating patterns continue into late childhood or the teen years and you notice some of the following warning signs, it’s best to get a consultation with an eating disorder specialist.

  • Restricting foods or reducing the amount of food consumed
  • Frequent physical complaints with no identified cause
  • Poor appetite and lack of interest in food and it’s not caused by a physical health condition or medication
  • Fears of choking or vomiting as reasons for not eating
  • Difficulty eating in front of others
  • Picky eating that worsens over time


Even though ARFID is a relatively new eating disorder, it can be effectively treated by eating disorder specialists. In addition to treating physical complications of the disorder, psychotherapy, exposure therapy and behavioral interventions are helpful. Co-occurring disorders, such as anxiety and depression, also need to be addressed in order to have a full and successful recovery.

Silver Hill Hospital has a dedicated eating disorders program for adults and adolescents. Treatment for ARFID is offered in both inpatient and residential treatment settings to ensure patients receive the comprehensive care they need. Whether it is rooted from mental issues or physical issues, the experienced and dedicated staff can help patients overcome the disorder and go on to live a healthy and prosperous lives. Learn more about the eating disorder treatment program.

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