What it is
ARFID involves persistent avoidance or restriction of food intake leading to weight loss, nutritional deficiency, dependence on supplements/enteral feeding, or significant psychosocial interference—without body image concerns driving the restriction. Common ARFID profiles:
- Sensory sensitivity (taste, texture, smell, appearance)
- Fear of aversive consequences (choking, vomiting, GI pain)
- Low appetite/interest in food
ARFID affects children and adults and often co-occurs with anxiety, autism spectrum condition, ADHD, and GI disorders.
Common signs and symptoms
- Very limited “safe” foods; mealtime distress; slow eating
- Weight faltering or nutritional deficiencies (iron, vitamin D, etc.)
- Avoidance after a choking/vomiting event or ongoing GI discomfort
- Social avoidance around food (parties, school lunches)
Why it happens
- Sensory processing differences heighten disgust/aversive responses
- Learned fear after traumatic eating/GI events
- Interoceptive awareness differences reduce hunger cues
- Reinforced avoidance reduces opportunities for positive food learning
What helps
- Multidisciplinary care
- Therapist (CBT-AR/CBT for ARFID or exposure-based), Registered Dietitian, medical provider; SLP or OT for oral-motor/sensory needs
- Therapies
- CBT-AR: gradual exposure to foods, sensory desensitization, fear reduction
- Family-Based Treatment adaptations for youth: structured support to expand diet
- For fear-of-consequences subtype: interoceptive exposure, GI coordination
- Nutrition strategies
- Stepwise food chaining (build from safe foods), fortify intake (smoothies, supplements)
- Monitor growth/vitals and labs; treat deficiencies
- School/work supports
- Accommodations for safe foods and gradual exposure plans
Hospitalization or enteral support is rarely needed but can be lifesaving in severe cases.
When to seek help now
- Rapid weight loss, dehydration, or fainting
- Severe nutritional deficiency or inability to meet minimal intake
- Significant growth faltering in children/teens
How to talk to a clinician
- “I (or my child) avoid many foods not due to body image. We’d like CBT-AR/exposure therapy, nutrition support, and coordination with GI/OT/SLP as needed.”
Resources for readers in the USA
- Immediate help: 988 Suicide & Crisis Lifeline; 911 for medical emergencies
- Find care: Psychology Today (filter for ARFID/eating disorders/CBT); NEDA Helpline; pediatric feeding clinics (for children)
- Low-cost/community: Community Health Centers (findahealthcenter.hrsa.gov); WIC for eligible families; 211
- Insurance tips: Ask about coverage for eating-disorder programs, RD visits, OT/SLP when indicated; copay/coinsurance, deductible, out-of-pocket max
Disclaimer: Educational information, not a diagnosis. If in crisis, use the resources above.