Avoidant/Restrictive Food Intake Disorder

Avoidant/Restrictive Food Intake Disorder (ARFID) is a diagnosis that has been acknowledged relatively recently (in 2013). It may be informally known as Selective Eating Disorder (SED). ARFID may occur during childhood, but it can also develop in adults. Currently, little is known about effective treatments and interventions and the course of illness for individuals who develop ARFID. Other unknown factors include the age at which ARFID develops and whether or not it presents as a risk factor for later-onset eating disorders.

In ARFID, a person may experience food disturbances to the point that they do not meet their appropriate nutritional and/or energy needs. This may be underlined by factors such as avoidance due to the sensory characteristics of food, a lack of interest in eating or food, or worries about the consequences of eating.

Individuals affected by ARFID may present with:

  • Clinically significant restrictive eating leading to weight loss, or a lack of weight gain
  • Nutritional deficiencies
  • Reliance on tube feeding and oral nutritional supplements
  • Disturbances in psychosocial functioning

Research has also identified behaviours and difficulties such as:

  • Food avoidance
  • Restrictive eating
  • Selective eating since childhood
  • Decreased appetite
  • Abdominal pain
  • A heightened fear of vomiting and/or choking
  • Possible food texture issues
  • Generalised anxiety
  • Gastrointestinal symptoms

There may be some body image concerns, though different to those seen in cases of anorexia and bulimia. Those with ARFID may be less likely to report typical eating disorder behaviours such as purging and excessive exercise.

Research has identified some possible contributory factors. In children, there may be a fear of physical illness related to shape/weight for example, high cholesterol and/or obesity leading to heart disease. Other children who were underweight due to feeding and eating disturbances have reported teasing from peers.