ARFID Explained: Signs, Causes, and How It’s Treated

What Is ARFID (Avoidant Restrictive Food Intake Disorder)?

While many children, teens, and even adults go through phases of “picky eating,” Avoidant Restrictive Food Intake Disorder (ARFID) is a much more serious concern. ARFID is an eating disorder that affects a person’s ability to eat enough food for proper nutrition and energy, often leading to physical health and emotional challenges. 

Although awareness has grown over the past decade, many people remain unaware of ARFID, highlighting the importance of continued education and advocacy in understanding this complex disorder (National ARFID Foundation, 2025).

 ARFID can manifest in different ways, and it is often categorized into four main subtypes:

Sensory-Based Avoidance of Foods

Avoidance of certain foods due to how they taste, feel, smell, or look (e.g., soft textures, strong smells, or mixed foods).

Low Appetite or Lack of Interest in Eating

Low appetite, disinterest in food, forgetting to eat, or being easily distracted during meals. These individuals may not feel hunger or may find eating to be a chore.

Fear of Eating or Adverse Consequences

Anxiety or fear around eating due to concerns like choking, vomiting, or stomach pain. This often develops after a negative eating experience.

ARFID Plus: When Body Image Concerns Overlap

ARFID symptoms combined with increased concerns about weight or body image. While traditional ARFID does not involve body image concerns, some individuals may show overlapping traits with other eating disorders.

Signs and Symptoms of ARFID

ARFID is often associated with persistent failure to meet appropriate nutritional and/or energy needs. This may result in:

• Significant weight loss or poor growth (especially in children)
• Nutritional deficiencies (such as low levels of vitamins, minerals, or protein)
• Requiring nutritional supplements or feeding tubes to maintain adequate health
• Difficulty participating in traditional eating experiences (like social meals or social events that involve food) (Eddy, 2025)

 Signs that someone you care about may be struggling with ARFID can include:

•   Weight loss or suppressed growth (which can be shown on a growth chart)
•   Common symptoms of malnutrition, including constipation, cold intolerance, and/or lethargy
•   Excess energy intake due to preference for energy-dense foods
•   Reports of consistent, vague gastrointestinal issues (“upset stomach”, feeling full, etc.) around mealtimes that have no known cause
•   Limited range of preferred foods that becomes narrower over time (i.e., picky eating that progressively worsens)
•   Dramatic restriction in types or amount of food eaten (not having soft foods, limited food groups)
•   Will only eat certain textures of food (crunchy, soft, liquids)
•   Fears of choking or vomiting
•   Lack of appetite or interest in food
•   Eating patterns are not driven by body image disturbance or fear of weight gain (Eddy, 2025)

What causes ARFID?

 The exact cause of avoidant/restrictive food intake disorder (ARFID) is unknown. Research suggests a correlation with:

• Anxiety
• Fear
• Genetics
• Social, cultural, and environmental influences
• Trauma (Cleveland Clinic, 2023).

How Is ARFID Treated?

The main goals in treating ARFID are to:

• Improve nutritional intake and ensure the individual is getting enough food to grow and stay healthy
• Slowly expand the range of foods an individual feels safe and comfortable eating.
•  Reduce fear and anxiety around food through therapy and support.
• Help individuals enjoy eating again and engage more fully in social situations involving food (Eddy, 2025). 

The Dietitian’s Role in ARFID Recovery

A dietitian can work on increasing the intake of a client’s preferred foods to promote nutritional rehabilitation and weight gain, if needed.

A dietitian may work with the individual on slowly trying new foods with a similar texture or flavor to a preferred food. For example, if a preferred food is a chocolate chip cookie, the first step in trying a new food with a similar flavor could be a chocolate chip granola bar. Trying new foods can happen in a session with a member of the treatment team. 

Before tasting a new food, a dietitian may simply explore with the individual by touching the new food, smelling it, picking it up with their hands, or touching it with a fork. At Healthier Tomorrows, our dietitians are happy to work on exploring challenging foods at a pace that feels comfortable!

 If you think you, your child, or someone you care about might be struggling with ARFID, it’s important to seek help from a treatment team, including a registered dietitian who specializes in eating disorders.