This article was co-authored by Amy Chow. Amy Chow is a Registered Dietitian and the Founder of Chow Down Nutrition, a family and child nutrition consulting service in British Columbia (BC), Canada. With over nine years of experience, Amy has a special interest in pediatric nutrition, food allergy management, and eating disorder recovery. Amy holds a Bachelor’s degree in Nutritional Sciences from McGill University. She gained her clinical experiences at residential and outpatient eating disorder treatment programs as well as for BC Children’s Hospital before starting her own business. She has been featured on Find BC Dietitians, Dietitians of Canada, Food Allergy Canada, Recovery Care Collective, Parentology, Save on Foods, National Eating Disorder Information Centre (NEDIC), and Joytv.
There are 8 references cited in this article, which can be found at the bottom of the page.
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Avoidant/Restrictive Food Intake Disorder (ARFID)—sometimes called Food Neophobia or Selective Eating Disorder (SED)—is an eating disorder where the consumption of food is severely limited. With children, this can be a problem for feeding that begins in early childhood or even in infancy.[1] Limitations are based on a food’s smell, texture, appearance, taste, or on a past experience with the food. If you suspect ARFID in yourself or a loved one, begin by noticing primary symptoms, work to understand the motivations behind the behavior, and rule out a normal phase of “picky eating." Of course, any disorder is best diagnosed by a medical professional. Seek professional guidance if you or someone you love is suffering from ARFID.
Steps
Noticing Primary Symptoms
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1Look for prolonged expressions of “picky eating.” On the surface, ARFID will look like regular “picky eating,” meaning that the individual will only eat select foods and refuse all others. If this behavior persists for more than four months, or appears to get worse, you may be dealing with more than just pickiness.[2]
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2Notice if certain food groups are restricted altogether. Individuals with ARFID will often refuse entire food groups, such as vegetables, meat, or dairy. Notice if the individual has completely removed entire food groups from their diet.Advertisement
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3Count the number of foods. An individual with ARFID usually accepts less than 20 foods. Begin keeping track of the number of different foods the individual will accept, and if that number comes to 20 or less, you may be dealing with ARFID.[3]
Understanding Motivations
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1Determine the reasons for food avoidance. Individuals with ARFID with typically avoid foods based on sensory qualities, such as smell, taste, or texture. They may also avoid foods that are touching each other. Additionally, a previous bad experience with a certain food (such as choking or food poisoning) could be to blame. Try to uncover the motivations for the individual’s limited diet.[4]
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2Realize that this avoidance is not based on weight. Unlike other eating disorders, ARFID involves fear or anxiety around certain foods, and is not motivated by the desire to lose weight. If food is being restricted to achieve a certain weight or body type, you may be dealing with anorexia or a related eating disorder.[5]
- Even though weight may not be a problem for adults with ARFID, children with ARFID are often underweight and have diminished bone mineral density.
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3Look for emotional responses. When a person with ARFID is presented with a new food, they will likely experience fear and anxiety.[6] This fear and/or anxiety can be quite severe, and it is noticeably different from the normal response of someone who simply does not like a food.[7] Visible signs of fear or anxiety can include:
- Tensing of the shoulders or other muscles.
- Fidgeting.
- Sweating.
- Crying.
- Shaking in the hands.
- Inability to look at the food.
- A need to immediately leave the table.
Ruling Out Normal “Picky Eating”
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1Look at the age of onset. Occurrences of ARFID can begin anytime from birth to the age 4. If an adult is experiencing ARFID, it is likely to have started occurring during childhood.[8]
- Picky eating phases are common in children between 18 months and 3 years of age, but these phases will usually pass within a few months.
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2Recognize related disorders. ARFID is often occurs alongside other medical or emotional conditions. If the individual has been diagnosed with any of these other conditions, ARFID is a more likely diagnosis than simple “picky eating.” Consider the possibility of:[9]
- Obsessive-Compulsive Disorder (OCD)
- Autism (including Asperger Syndrome and PDD-NOS)
- Food trauma
- Oral-motor delay
- Swallowing disorders
- Sensory Processing Disorder (SPD)
- Gastrointestinal disorders
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3Notice the refusal food despite hunger. Most picky eaters will succumb under the weight of hunger. Individuals with ARFID, on the other hand, will not. The fear/anxiety of consuming a certain food will outweigh feelings of hunger in an ARFID individual.[10]
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4Be aware of more extreme symptoms. If ARFID is left unchecked for long periods of time, it can result in lasting, long-term symptoms. These include weight loss, malnutrition, and/or lethargy.[11] Additionally, ARFID can be very difficult socially, and may impair a person’s interaction with others.[12]
Expert Q&A
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QuestionWhat is the cause of avoidant restrictive food intake disorder?
Amy ChowAmy Chow is a Registered Dietitian and the Founder of Chow Down Nutrition, a family and child nutrition consulting service in British Columbia (BC), Canada. With over nine years of experience, Amy has a special interest in pediatric nutrition, food allergy management, and eating disorder recovery. Amy holds a Bachelor’s degree in Nutritional Sciences from McGill University. She gained her clinical experiences at residential and outpatient eating disorder treatment programs as well as for BC Children’s Hospital before starting her own business. She has been featured on Find BC Dietitians, Dietitians of Canada, Food Allergy Canada, Recovery Care Collective, Parentology, Save on Foods, National Eating Disorder Information Centre (NEDIC), and Joytv.
Registered DietitianAvoidant restrictive food intake disorder is usually caused by anxiety related to food. It differs for each individual, but often children with this disorder will be scared to eat outside their home or very fearful of trying new foods.
References
- ↑ https://www.nationaleatingdisorders.org/blog/what-exactly-arfid
- ↑ https://kidshealth.org/en/parents/arfid.html
- ↑ https://www.eatingdisorderhope.com/blog/effective-treatments-adults-arfid
- ↑ https://www.nationaleatingdisorders.org/blog/what-exactly-arfid
- ↑ https://www.eatingdisorders.org.au/eating-disorders-a-z/arfid/
- ↑ Amy Chow. Registered Dietitian. Expert Interview. 16 September 2020.
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4145233/
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2854063/
- ↑ https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid
- ↑ https://www.eatingdisorders.org.au/eating-disorders-a-z/arfid/
- ↑ https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid
- ↑ https://kidshealth.org/en/parents/arfid.html
- ↑ Amy Chow. Registered Dietitian. Expert Interview. 16 September 2020.
About This Article
If you think you or a loved one might have Avoidant/Restrictive Food Intake Disorder, or ARFID, look out for common symptoms, such as picky eating that lasts longer than 4 months. A person with ARFID might avoid eating entire food groups, such as vegetables or meat. Typically, someone with this condition is willing to eat no more than 20 different foods, so keep track of the number of foods they are actually willing to accept. People with ARFID usually avoid foods based on sensory reasons, like taste, smell, or texture, so try to find out why they aren’t eating certain things. If there’s another reason, like concerns about weight or an upset stomach, then the problem may not be ARFID. For expert advice on how to tell the difference between ARFID and normal picky eating, keep reading!
Medical Disclaimer
The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.
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