What is Avoidant/Restrictive Food Intake Disorder?

Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder characterized by a persistent limitation in the amount or variety of food consumed. Unlike anorexia nervosa, ARFID is not driven by concerns about weight, shape, or appearance. Instead, individuals avoid eating due to sensory sensitivities (such as taste, texture, or smell), fear of negative consequences from eating (like choking, vomiting, or stomach pain), or simply a low interest in food and eating.

While some degree of selectivity or “picky eating” is common—especially in childhood—ARFID goes far beyond that. It can lead to significant nutritional deficiencies, weight loss or failure to grow, dependence on supplements, and interference with social or emotional functioning.

ARFID can occur in children, adolescents, or adults, and may be associated with anxiety, neurodiversity (including autism spectrum conditions), or trauma related to eating. It is a serious but treatable condition. With proper understanding and care, individuals can expand their comfort with food and reduce the anxiety that often surrounds eating.

What does ARFID look like?

ARFID can take many forms, and it may not always look like what people think of as an “eating disorder.” Common features include:

Avoidance based on sensory sensitivity:
Certain textures, tastes, temperatures, or smells may feel intolerable. Individuals might eat only foods that are very familiar or prepared in specific ways—often resulting in a limited range of “safe foods.”

Fear-based restriction:
Some individuals develop a strong fear of choking, vomiting, or gastrointestinal distress after a negative or traumatic eating experience. Even if the original event was minor or long past, the fear can persist and severely limit food intake. ARFID can also develop in individuals with gastrointestinal conditions or food allergies, such as celiac disease or inflammatory bowel disorders. In these cases, the fear and avoidance become disproportionate to the actual medical risk, leading to nutritional deficiencies, functional impairment, and a highly restricted way of living.

Lack of interest in eating or food:
Others describe little or no appetite, or a sense that eating feels like a chore. They may forget to eat or stop after only a few bites.

Physical and nutritional consequences:
ARFID can result in weight loss, nutritional deficiencies, fatigue, and slowed growth in children or adolescents. Some people require medical monitoring or nutritional supplementation to restore health.

Social and emotional effects:
Because eating is central to so many social experiences, individuals with ARFID may avoid social gatherings, travel, or relationships where food is involved. Over time, this avoidance can lead to isolation, shame, or heightened anxiety.

Weight and appearance considerations:
Like in anorexia and atypical anorexia, not all individuals with ARFID are underweight. Some maintain or even exceed a medically “normal” weight range, which can make the disorder harder to recognize. The seriousness of ARFID is not determined by body size but by its impact on nutrition, functioning, and emotional well-being.

Co-occurring challenges:
ARFID often occurs alongside other conditions, such as gastrointestinal disorders, anxiety disorders, obsessive-compulsive traits, sensory processing sensitivities, or neurodevelopmental differences. Recognizing these intersections is key to effective treatment.

It’s important to remember that ARFID is not simply “picky eating” or defiance—it is a complex disorder that requires empathy, understanding, and specialized care.

How do you treat ARFID?

Treatment for ARFID focuses on maintaining adequate nutritional intake and gradually expanding the range of foods a person can tolerate while addressing the emotional, sensory, and relational factors that contribute to avoidance.

Psychotherapy:
Therapy provides a supportive space to explore fears, discomforts, or associations around eating and to reduce anxiety through gradual exposure and emotional processing.

• Understanding the underlying causes: Therapy helps clarify whether avoidance stems from sensory sensitivities, anxiety, past trauma, or low interoceptive awareness (difficulty sensing hunger and fullness).

• Reducing anxiety and avoidance: Through gentle, stepwise exposure to feared foods or sensations, individuals can build tolerance and regain confidence in eating.

• Developing emotional and sensory regulation skills: Mindfulness, grounding techniques, and body-based awareness can help individuals manage discomfort without retreating from food entirely.

• Family and relational support: For children and adolescents, family-based interventions are often central—helping caregivers support eating without pressure or conflict.

Nutritional rehabilitation:
A registered dietitian specializing in eating disorders can assist in restoring balanced nutrition, introducing new foods safely, and preventing nutritional deficiencies. Progress may begin with small, achievable changes that build over time.

Medications:
While there is no specific medication for ARFID, psychiatric medications may be used to treat co-occurring anxiety or obsessive-compulsive symptoms that interfere with eating. These are typically most helpful when integrated into a broader treatment plan.

Medical monitoring:
Because ARFID can result in malnutrition or physical complications, periodic medical assessments are essential to monitor weight trends, growth (in children), and overall health.

Support and collaboration:
Recovery from ARFID often benefits from an interdisciplinary team—including therapists, physicians, and dietitians—who can coordinate care and reinforce progress across settings. Involving family or supportive others can also reduce isolation and provide structure during the recovery process.

The path toward recovery

Recovery from ARFID is about more than expanding one’s diet—it’s about restoring a sense of safety, curiosity, and pleasure in eating. As the fear and rigidity around food begin to soften, individuals can rediscover nourishment as something sustaining and shared, rather than stressful or dangerous.

With understanding, patience, and skilled support, people with ARFID can develop the confidence to explore new foods, reconnect with hunger and fullness cues, and participate more freely in the social and emotional aspects of eating and life.