Avoidant/restrictive food intake disorder (ARFID) is an eating disorder that affects a person’s ability to eat for different reasons. In this series of articles, learn about ARFID and its causes.

What is ARFID?

Avoidant/restrictive food intake disorder (ARFID) is an eating disorder in which a person restricts or avoids eating food, usually for one or more of the following reasons:

  • Extreme sensitivity or dislike of certain food smells, tastes, appearances or textures
  • Fear of vomiting or choking while eating
  • Lack of interest in eating

ARFID can lead to malnutrition (poor health because of a lack of nutrients or calories).

A person with ARFID does not restrict or avoid food because of:

  • Issues with body weight or body image
  • Lack of available food variety
  • Cultural or religious reasons
  • Another medical or physical condition

Who is Most Likely to Develop ARFID?

Children who are male, younger or diagnosed with another medical condition are more likely to develop ARFID, compared to children who are female, older or have no other medical conditions. ARFID is also more common in children with autism spectrum disorder (ASD) or similar conditions.

What are Common Symptoms of ARFID?

The symptoms of ARFID can be like those of other eating disorders. But unlike other eating disorders, children with ARFID are not concerned with losing weight or changing their appearance.

Symptoms of ARFID can include:

  • Extreme picky eating
  • Extreme fear or anxiety when presented with food outside of their usual diet
  • Strong dislike of or aversion to certain food smells, tastes, appearances and textures
  • Fear that certain foods will cause choking, vomiting or other physical symptoms
  • Lack of interest in eating

If your child has ARFID, they have a higher risk of developing malnutrition. Symptoms of malnutrition can include:

  • Weight loss
  • Fatigue and/or dizziness
  • Abdominal (belly area) pain
  • Constipation or diarrhea
  • Loss of bone density (when bones become less dense and more likely to break)
  • Delayed growth
  • Levels of vitamins that are too low (including vitamin C, vitamin D, iron and others)
  • Dependence on vitamins or supplements to meet nutritional needs
  • In females, amenorrhea (a delay or loss of a menstrual period)

How Do Doctors Diagnose ARFID?

Doctors can diagnose ARFID with one or more of the following tests:

  • Review of your child’s medical history and eating habits
  • Physical exam to check for signs of malnutrition
  • Blood test to check vitamin levels and overall health
  • DXA scan (imaging of the bones in the wrist to check bone density)
  • Evaluation of your child’s body mass index (BMI, or weight in relation to their gender and height)

Your child might also meet with a psychologist (doctor who treats mental health).

How Do Doctors Treat ARFID?

Treatment for ARFID focuses on boosting nutrition and managing feelings around food. ARFID affects both physical and mental health. The care team will help create a treatment plan for your child’s unique medical, nutritional and mental health needs.

Common ARFID treatments can include:

  • Prescription nutritional supplements
  • Creating a personalized meal plan with a dietitian
  • Cognitive-behavioral therapy to help manage feelings around food and eating
  • Speech therapy to improve oral-motor skills necessary for eating
  • Prescription medications to increase your child’s appetite or ease anxiety
  • In some cases, a hospital stay to help with weight gain or more serious medical needs
  • Meeting with a psychiatrist or psychologist to treat other mental health conditions that might relate to your child’s ARFID diagnosis

Rev. 2/2020. MassGeneral Hospital for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.