Avoidant/Restrictive Food Intake Disorder (ARFID) | EDV


This page defines avoidant/restrictive food intake disorder (ARFID). If you are concerned that you or someone you care about may be experiencing ARFID, please reach out to the EDV Hub or call 1300 550 236. 

What is ARFID?

Avoidant/restrictive food intake disorder (ARFID) is the sensory based avoidance, fear or restriction of certain foods, due to sensitivities to texture, smell, temperature, or appearance of the food.

A person may restrict the amount or type of a particular food or avoid a particular food based on factors such as the appearance of the food (e.g., colour, size, shape), texture, smell, temperature, or food group (e.g., all vegetables after a bad experience choking on a vegetable). They may also restrict food intake due to early satiety (i.e., prematurely feels full) or due to past experiences, such as trauma associated with a food experience (e.g., choking).   

Defined by a pattern of eating that is limited in variety (e.g., avoidance of specific foods) and/or volume (e.g., restriction of amount), ARFID can cause a person to become seriously ill because their bodies aren’t getting all the nutrients they need. For example, individuals may experience medical or mental health consequences such as poor growth, diabetes, cardiovascular disease, fatigue, poor self-esteem, family mealtime conflict, peer social isolation, and difficulties with school, relationships and work.  

While ARFID is similar to anorexia nervosa in that a person restricts their food intake, the intent or reason for restricting food intake differs between the two eating disorders. People with ARFID do not restrict food to avoid weight gain/control weight or to change their body size/shape. ARFID is not associated with weight or shape concerns – weight loss or change in shape may occur as a result of poor nutritional intake, not because a person is intentionally engaging in weight control behaviours.   

How does ARFID present?

Individuals of all ages and genders can have clinically significant avoidant/restrictive eating that does not always begin in early childhood. Importantly, food avoidance/restriction does not always or only lead to weight loss. Depending on food intake (type and amount) and reliance on tube feeding/oral supplements, ARFID is experienced by individuals across the weight spectrum. 

How is ARFID diagnosed?

Diagnosis is associated with at least one of the following: 

(1) Significant weight loss (or failure to achieve weight gain/physical growth in children);

(2) Significant nutritional deficiency;

(3) Dependence on tube feeding (supplying nutrients directly to the gastrointestinal tract) or oral nutritional supplements;

(4) Marked interference on an individual’s psychosocial functioning (e.g., impacts on daily activities).

Diagnosis is made if symptoms are not better explained by a concurrent medical condition (e.g., allergies, intolerances, other medical conditions), other mental illness (including other eating disorders, such as Anorexia Nervosa), a lack of available food or a cultural practice (e.g., Ramadan). ARFID differs from picky or fussy eating, which is common in childhood and generally resolves over time (e.g., food neophobia). 

The food avoidance and restriction that define ARFID can lead to medical or mental health consequences that further exacerbate food avoidance and restriction and serve to maintain the illness. ARFID is persistent, more severe, can involve the restriction of both familiar and new foods, and has significant physical and mental health consequences. 

Risk factors for ARFID

There is no single cause of ARFID but there are risk factors that increase the likelihood of it developing.

Biological and psychological risk factors

ARFID and disrupted eating patterns around food are more common in young children with developmental disorders including autism spectrum disorders and ADHD. Research shows children with autism are five times more likely to develop issues associated with eating compared to their peers (Koomar et al., 2021).  

Evidence also tells us that eating disorders have a moderate-high genetic heritability. Ongoing research into this field is analysing hundreds of genes that may influence the chance of developing an eating disorder with the hope of improving treatment and even preventing illness. You can learn more about the Eating Disorders Genetic Initiative (EDGI), the world’s largest ever genetic investigation of eating disorders, here.  

You can learn about risk factors for all eating disorders here. 

Signs and symptoms of ARFID

Some of the more common signs and symptoms of ARFID are listed below.

Mental health symptoms
  • Fear of consequences associated with eating/feeding 
  • Appearing to be a ‘picky eater’, is fearful of, or has a phobia of certain foods 
  • No evidence of being preoccupied with body shape or weight but rather experiences anxiety about the food itself  
  • Anxiety and fear around food and/or eating 
  • Sensory sensitivity 
  • Overly sensitive to certain aspects of foods, focusing on taste, texture, smell, temperature or food group 
  • May feel prematurely full while eating 
  • Lack of interest in eating or food 
Behavioural symptoms
  • Not eating enough or skipping meals entirely 
  • Is not engaging in behaviours to attempt to control weight (e.g., lose weight, prevent weight gain, change body size/shape)
  • Disinterested in food or forgetting to eat 
Social symptoms
  • Avoiding events where food will be served or becomes distressed when preferred foods aren’t available 
  • Impaired school or work performance 

Need to have a chat? 

If you are concerned about yourself or someone you love, our team at the EDV Hub are here to help.

Contact the EDV Hub today

Physical signs and effects of ARFID

ARFID can affect the functioning of the entire body. The below graphic outlines some of the key systems and organs that can be impacted when someone is experiencing ARFID.

Treatment and recovery from ARFID

There are several evidence-based treatments available for ARFID. Full recovery from ARFID is possible.

At EDV, we understand that recovery from an eating disorder is an individual and unique process. How someone defines and experiences recovery is often inclusive of their life stage, intersectional life experiences, priorities, responsibilities, support systems, and access to services. You can read more about recovering from an eating disorder here.   

The first step towards recovery is to talk about what you are experiencing. This may start with a health professional, a helpline, a trusted family member or friend, a teacher, a coach, or a spiritual leader. If you find that the person you speak to doesn’t validate your feelings, or have much knowledge about eating disorders, it’s important not to ignore your symptoms. We encourage you to reach out to Eating Disorders Victoria (EDV) for a conversation, which can include next steps for receiving treatment.   

Types of treatment for ARFID

In Australia, commonly prescribed treatment approaches for ARFID include:  

  • Cognitive behaviour therapy (CBT) has been identified as an effective treatment for people with ARFID. This may encompass gradual exposure to feared foods, relaxation techniques, and support for behaviour change around eating.  
  • Responsive feeding therapy (RFT) is considered an effective treatment for ARFID in children. RFT requires parents or carers to create distraction free and pleasant routines around mealtimes, modelling positive mealtime behaviour and allowing the child to express hunger cues.  
Accessing treatment for ARFID

Accessing treatment requires navigating different parts of the health care system. Treatment options are available in both the public and private health system. We understand this can be confusing and encourage you to reach out if you have any questions. 

For most people, treatment will start with a visit to a GP. A GP is normally a central point of contact during treatment and recovery, and can provide diagnosis, medical monitoring and referral to specialist services. 

We encourage you to learn more about accessing treatment by visiting the following pages:  

Recovery support at EDV

Find out how EDV can help guide and support your recovery: 

  • EDV Hub – helpline service providing information, navigation and general support. Open Mon – Fri, 9.30am – 4.30pm.  
  • Telehealth Counselling – up to five, free 30–45-minute sessions with a trained counsellor to help you take the next step in your recovery.   
  • Telehealth Nurse – free and expert guidance with registered nurses who specialise in eating disorders.   
  • Online Support Groups – peer-led groups that provide an open space to discuss what you are struggling with, reflect on current challenges and discuss coping tools. Different groups are available depending on your needs. You are welcome to attend multiple groups.   
  • Peer Mentoring Program – 1:1 recovery support with an EDV mentor who has experienced and recovered from an eating disorder. The program allows for 13 mentoring sessions over a six-month period.  
  • Severe and Enduring Eating Disorder Program (SE-ED) – group-based program focusing on quality of life for those with long-term eating disorders 
  • Carer and Family Support – carer specific services including 1:1 coaching and online courses 
  • LearnED eLearning platform – for self-paced education and online courses  
  • EDV Podcast – for lived experience perspectives and professional insights  
  • EDV Newsletters – for recovery support delivered directly to your inbox 

Eating Disorders Victoria (EDV) is here to help.

No matter what stage you are at in your journey, our understanding and supportive team can help you take the next steps. Learn about our range of free-to-access support services by following the link below. 

How EDV can help

Koomar, T., Thomas, T. R., Pottschmidt, N. R., & Michaelson, J. J. (2021). Estimating the Prevalence and Genetic Risk Mechanisms of ARFID in a Large Autism Cohort. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.668297 

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