Avoidant Restrictive Food Intake Disorder (ARFID)
What is ARFID?
ARFID stands for avoidant restrictive food intake disorder. People with ARFID restrict the amount and/or types of food they eat. ARFID is more than being a picky eater. You may restrict your food intake to an extent that it has a negative impact on your physical and/or mental health. It may:
- cause you to become underweight
- cause nutritional deficiencies
- cause you to rely on nutritional supplements or tube feeding
- have a significant impact on your day-to-day life
- impact your mental health
It is not driven by worries around body shape or weight.
Symptoms of ARFID
There are lots of factors that contribute to the avoidance or restriction of food intake. There’s a wide range of possible signs and symptoms of ARFID. If you have ARFID, you may not have all of these signs.
Possible signs and symptoms of ARFID include:
- sensitivity to some types of food depending on the texture, smell, taste, appearance or temperature
- only eating a very limited range of food
- always having the same meals
- always eating something different to everyone else
- trying to avoid social situations where food is present
- finding it difficult to recognise when you’re hungry
- feeling full quickly
- taking a long time to eat meals
- finding eating a chore
- being anxious at mealtimes
- Feeling that having certain foods will cause you harm, for example, fear of choking, an allergic reaction or being sick
- chewing food carefully, taking small bites and sips
- nutritional deficiencies like low iron, B12 or folate levels caused by not having enough of these in your diet.
You might also need to take supplements to make sure your nutritional and energy needs are met.
ARFID can have a negative impact on your physical and mental health at any age. For example, a young person might not gain weight as expected and it could affect their growth or you might find anxiety about eating has an impact on their day to day life.
What causes ARFID?
Someone with ARFID might have one or more reasons for their avoidance or restriction of food at any time. Sometimes there’s no clear reason.
These are some of the most common reasons.
Sensory based avoidance or restriction of intake
If you have sensory based avoidance, you’re likely to be sensitive to the taste, texture, smell or appearance of certain food types. You may also only be able to eat foods at a certain temperature or colour.
Concerns about the consequences of eating
Someone who’s had a distressing experience with food might be worried about the consequences of eating. For example, concerns about vomiting or choking could cause fear and anxiety around food.
Low interest in eating
Someone with a low interest in eating might be unable to recognise feelings of hunger. They might have a generally poor appetite. They might also have a low interest in eating or see eating as a chore and not something that’s enjoyed.
Related conditions
Someone might have ARFID as a condition on its own.
Sometimes there are other conditions that occur alongside ARFID. The most common are:
- anxiety disorders
- autism
- ADHD
- physical health problems like gastro intestinal conditions
How can we help?
Since 2022 we have been providing assessment for ARFID for all ages and we may also provide treatment where physical and/or mental health risks are high. For lower risk presentations we may provide support and consultation to other services such as primary care, schools, adult mental health services, LD services and CAMHS.
Assessment for ARFID
We provide a multidisciplinary assessment with at least two members of our team which may include a Dietitian, an occupational therapist, nurse practioners,CBT therapist, psychologist. You may also be seen by one of our psychiatrists or psychologists.
ARFID Resources
If you feel that you or your child are suffering from avoidant restrictive food intake disorder, we would recommend that you have a look at the following resources:
Please speak to your GP, mental health team or your child's school nurse or paediatrician to request a referral to our service.
