Avoidant Restrictive Food Intake Disorder

Avoidant restrictive food intake disorder (ARFID) is an extreme form of picky eating characterized by weight loss, serious health conditions and high levels of stress around eating. Foods are avoided because of repulsive characteristics like taste, texture and smell. Aversion to food can also be heavily influenced by past negative experiences with eating including choking or vomiting. ARFID is not driven by concerns about weight loss or body image even though weight loss is common. ARFID can be a co-occurring diagnosis alongside Autism Spectrum Disorder due to the sensory issues that overlap both disorders. 

Additional Symptoms:

  • sudden and significant weight loss

  • reliance on supplements to maintain weight like Ensure or a feeding tube

  • in children, failure to achieve expected weight gains

  • difficulty being around foods in social settings leading to avoidance and social impairment

  • anxiety in anticipation of what foods may be available at gatherings or when eating away from home is necessary

  • anxiety around food can be related to a fear of choking or vomiting, having experienced one of these yourself or seeing it happen to someone else

  • lack of interest in food and often report no appetite 

Picky Eating

As you can see from the information above, ARFID is more extreme than picky eating and significantly affects the mental and physical functioning. Children with picky eating have strong preferences and aversions to certain foods, tastes, textures or smells associated with food. They have a limited amount and variety of foods they are willing to eat. Rigid thinking and inflexibility are common. These children will report being hungry and ready to eat a food they enjoy. Developmentally appropriate picky eaters are generally able to maintain weight even with a limited amount and variety of foods they will eat. Families will often report extensive attempts to reward and/or punish children in an effort to grow the circle of foods they will eat. Mealtime power struggles are common and lead to frustration and hopelessness on the part of parents.