TLDR: ARFID
ARFID (Avoidant/Restrictive Food Intake Disorder) is an eating disorder where someone avoids or restricts food due to anxiety, sensory sensitivities, or low interest in eating — not concerns about body image.
ARFID can develop due to food-related anxiety (such as fear of choking or vomiting), sensory sensitivities, early feeding difficulties, or neurodevelopmental conditions like autism or OCD.
Symptoms can include extreme food restriction, lack of hunger cues, fear around eating, sensory avoidance, weight loss or poor growth, nutritional deficiencies, and avoiding social situations involving food.
ARFID is much more common in autistic people, likely due to sensory sensitivities, rigid routines, and heightened anxiety around food and eating experiences.
Treatment usually involves medical support to address nutrition, alongside psychological therapies such as CBT for ARFID, which helps reduce fear around food and gradually expand safe eating options.
This article was written by Jenup, a non-profit organisation specialising in the early intervention and prevention of eating disorders and body image issues within young people.
What is ARFID?
ARFID, or Avoidant/Restrictive Food Intake Disorder, is a serious eating disorder where someone avoids or restricts food, but not because of concerns about body image. Instead, this avoidance is often linked to intense anxiety or fear around eating, heightened sensitivity to the sensory qualities of food (like texture, taste, or smell), or a very low appetite that leads to little interest in eating. ARFID is often seen in children and teens but can affect anyone, regardless of age, gender, or background.
It’s important to understand that ARFID is not just “picky eating.” People with ARFID may eat very small amounts or stick to a very limited range of foods, which can lead to nutrient deficiencies. Unlike general fussiness, ARFID tends to be more extreme often causing distress and leading to weight loss, malnutrition, or challenges with growth and development if left untreated.
What Causes ARFID?
Experts don’t fully know what causes ARFID yet, but research shows it’s likely a mix of different factors, including genetics, mental health, and life experiences. Here are some possible causes:
- Anxiety or fear around food
Some people with ARFID may have had a scary or upsetting experience with food like choking or throwing up which can lead them to avoid certain foods or eating altogether. - Sensory sensitivities
People with ARFID might be extra sensitive to how food feels, smells, or tastes. If certain textures or smells feel “too much,” they might start avoiding those foods completely. - Autism or other conditions
ARFID is more common in people with autism or other developmental differences, like OCD. These conditions can make eating routines or food-related anxiety harder to manage. - Early feeding issues
Kids who had medical problems that made eating painful or uncomfortable might develop ARFID later. If eating feels scary or unpleasant, they might start avoiding it.
What are the symptoms?
ARFID (Avoidant/Restrictive Food Intake Disorder) can look different from person to person there’s no one-size-fits-all. It’s not just about being a “picky eater.” Different people may avoid or limit food for different reasons, so the signs can vary a lot. Here are some things to watch out for:
- Doesn’t notice when they’re hungry.
- Extreme pickiness in food
- Fears of choking or vomiting
- Takes ages to eat meals or feels like eating is a chore.
- Skips meals, especially when focused on other things.
- Sensitive to things like texture, smell, or temperature of certain foods.
- Seen as a “picky eater” by others.
- Only eats foods of a similar colour (like only beige foods).
- Tries to avoid social situations where food will be involved.
- Gets super anxious around food chews carefully, takes tiny bites or sips, etc.
- Loses weight or (if still growing) doesn’t gain weight as expected.
- Lacks certain nutrients (like iron), which could lead to things like anaemia.
- Needs to take supplements to get enough nutrition or energy.
The link between ARFID and autism?
Recent research has highlighted a strong connection between ARFID (Avoidant/Restrictive Food Intake Disorder) and autism. Individuals with ARFID are significantly more likely to be diagnosed as autistic, and likewise, autistic individuals have a higher likelihood of experiencing ARFID. Specifically, the prevalence of autism in people with ARFID is around 16 times higher than in the general population. To put that in context, while autism is diagnosed in about 1% of the general population, that rate rises to over 16% among those with ARFID.
This suggests a substantial overlap between the two with many autistic individuals showing ARFID traits, and many with ARFID displaying traits consistent with autism. This opens the door for further research, particularly on how to best support autistic individuals with ARFID in improving their relationship with food, meeting their nutritional needs, and tailoring care approaches accordingly.
Treatment
Doctors are still learning the best ways to treat ARFID, but there are things that can help. Treatment usually depends on what’s causing it and often focuses on:
- Fixing any health problems
- Figuring out which foods someone avoids and why
- Helping them try those foods safely
If you or someone you know shows signs of ARFID, talk to a GP.
Dealing with health problems
Before other treatment, any physical issues need attention. This might include:
- Multivitamins or minerals like iron or zinc
- Medications to boost appetite
- Advice on safe foods to prevent nutritional problems
- Short-term anxiety medication in some cases
Doctors also check if other health issues make eating hard, like digestion problems or loss of appetite.
Psychological support
After health issues are treated, therapy can help. This can teach new ways of thinking about food and make it easier to try different foods.
CBT (Cognitive Behavioral Therapy)
A talking therapy that helps you deal with tough situations and set goals to try new foods. There’s a version made just for ARFID that gradually helps you eat foods you’ve been avoiding.
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