ARFID: Understanding the Symptoms, Causes and Treatment

Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder characterised by avoiding or restricting food intake, often resulting in nutritional deficiencies, weight loss, or difficulties meeting nutritional needs. Unlike anorexia nervosa, ARFID is not driven by concerns about weight, body shape, or a desire to lose weight. ARFID can affect both children and adults and can have a significant impact on physical health, emotional wellbeing, and daily life. Although awareness of ARFID is increasing in the UK, it remains a relatively misunderstood condition.

What is Avoidant Restrictive Food Intake Disorder (ARFID)

ARFID involves persistent difficulties with eating that lead to inadequate nutrition or energy intake. Individuals with ARFID may avoid certain foods because of their texture, taste, smell, appearance, or a fear of negative consequences such as choking, vomiting, or becoming unwell. The condition can make social situations involving food challenging and may affect growth, development, and overall health if left untreated.

  • Eating a very limited range of foods.

  • Avoiding foods based on texture, colour, smell, or taste.

  • Fear of choking, vomiting, or swallowing difficulties.

  • Lack of interest in eating or food.

  • Difficulty meeting nutritional needs through diet alone.

  • Anxiety around mealtimes or trying new foods.

Physical symptoms may include:

  • Weight loss or difficulty maintaining a healthy weight.

  • Nutritional deficiencies.

  • Fatigue and low energy levels.

  • Dizziness or fainting.

  • Delayed growth in children and adolescents.

  • Gastrointestinal complaints such as constipation or abdominal discomfort.

Common signs and symptoms of ARFID include:

What causes ARFID?

There is no single cause of ARFID. It is thought to develop through a combination of biological, psychological, and environmental factors.

Sensory sensitivities Many individuals with ARFID experience heightened sensitivity to the taste, texture, smell, or appearance of food. This can make certain foods feel overwhelming or unpleasant.

Fear-based experiences ARFID may develop following a distressing experience involving food, such as choking, vomiting, allergic reactions, or severe gastrointestinal illness. This can lead to anxiety around eating and avoidance of certain foods.

Neurodevelopmental conditions ARFID is more commonly seen in individuals with neurodevelopmental conditions such as Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), although it can occur in anyone.

Psychological factors Anxiety disorders, obsessive-compulsive traits, and other mental health difficulties may contribute to restrictive eating behaviours and food avoidance.

How is ARFID diagnosed?

ARFID is diagnosed following a comprehensive assessment by a specialist psychiatrist.

This may include:

A detailed assessment | The psychiatrist will explore eating habits, food preferences, sensory sensitivities, fears around eating, and the impact these difficulties have on daily life.

Physical health assessment | Weight, growth, nutritional status, and any health concerns related to restricted eating will be assessed.

Blood tests | Blood tests may be recommended to identify nutritional deficiencies or other health complications resulting from limited food intake.

If you are concerned that you or your child may be experiencing symptoms of ARFID, seeking professional advice can help provide clarity and support.

Treatment for ARFID

Treatment focuses on improving nutritional intake, reducing anxiety around food, and expanding the range of foods an individual feels comfortable eating.

Cognitive Behavioural Therapy (CBT) - CBT can help individuals challenge fears around eating, reduce food-related anxiety, and gradually increase tolerance of new foods.

Nutritional Support A registered dietitian can provide guidance on meeting nutritional needs, addressing deficiencies, and developing balanced eating habits.

Exposure-Based Approaches Gradual exposure to new foods in a structured and supportive way can help individuals become more comfortable with previously avoided foods.

Family Therapy  For children and young people, involving parents and carers in treatment can be an important part of supporting progress and creating positive mealtime experiences.

Seeking Help

ARFID is a recognised and treatable eating disorder. If restricted eating is affecting your health, nutrition, or quality of life, professional support is available.

Early intervention can help prevent complications and improve long-term outcomes. With the right treatment and support, individuals with ARFID can develop a healthier and more varied relationship with food.