Condition Basics

What is avoidant/restrictive food intake disorder (ARFID)?

Avoidant/restrictive food intake disorder (ARFID) is an eating disorder in which a person eats a limited variety or amount of food. Their limited diet can affect their health if they don't get the nutrition they need. It can also make it hard for them to function in social settings, such as school or work.

Unlike other eating disorders, ARFID is not due to concerns about body shape or weight. It's due to negative feelings about foods, such as fear or disgust, or by low appetite.

ARFID often starts in childhood and may get worse over time. Treatment can help change unhealthy eating patterns before they become set. If it's not treated, this disorder can last for many years.

What are the symptoms?

People who have ARFID eat a very limited diet. This isn't because they're concerned about their weight or don't have access to food. Instead:

• Some of them may have a strong dislike of the texture, taste, or smell of many foods.
• Some may be fearful because of a scary experience when eating, such as choking or vomiting.
• Some may not feel hungry and may eat very little.

Because of their limited food choices, they may not get the nutrition they need. Children who have ARFID may weigh less and be smaller than other children their age.

Their limited diet may also lead to family conflicts. They may avoid activities like parties, travel, and eating out where their preferred foods aren't available. This can make them socially isolated.

How is it diagnosed?

ARFID can be hard to diagnose. Your doctor will need to rule out other conditions, including other eating disorders. The doctor will do a physical exam and ask about eating habits and the social impact of these habits. Tests may be done to check for problems like food allergies and lack of proper nutrition.

What causes it?

The cause is unclear. It sometimes starts after an event like a choking episode. ARFID may be due to factors such as genetics. It often occurs along with other mental health conditions, such as an anxiety disorder, autism spectrum disorder (ASD), or attention deficit hyperactivity disorder (ADHD).

How is ARFID treated?

Be sure to look for a doctor or program that treats people who have ARFID. What works for other eating disorders may not work as well for ARFID.

In general, treatment focuses on improving nutrition and reducing negative feelings about foods. You may work with:

• A doctor. They will treat any medical conditions that have been caused by ARFID, such as heart problems or bone loss (osteoporosis). They may also prescribe vitamins or other supplements to help with nutrition.
• A counselor or other mental health professional. They can help you overcome the things that keep you from eating a varied diet. One type of cognitive behavioral therapy (CBT) that can help with ARFID is called CBT-AR. Another type of therapy that can help is family-based treatment for ARFID, or FBT-ARFID.
• A registered dietitian. They can help you learn about nutrition and healthy ways to eat.

If ARFID has caused health problems, you may need to be treated in a hospital.

How can you care for yourself at home?

Here are some things you can do to take care of yourself during recovery from an eating disorder.

• Try to stick to your treatment plan. Go to any counseling sessions you have. If you can't go, or if you don't think the sessions are helping, talk to your counselor about it. And take any medicines you've been prescribed exactly as directed.
• Work on healthy eating habits. Listen to what your counselor and dietitian say about healthy eating. You can work with them to make a plan to eat a variety of healthy foods.
• Learn healthy ways to deal with stress. Managing stress is important in recovery. Find what works for you. You could try things like journaling, volunteering, reading, or meditating.
• Wear clothes that fit your body now, just as it is. When you look in the mirror, try to find things you like about yourself instead of focusing on what you don't like.
• Get support from others. This might be from caring family members or friends or an eating disorders support group.
• Take it easy on yourself. Focus on your good qualities. Don't blame yourself for your disorder. And remember that recovery takes time and that you can make progress one goal at a time.