Avoidant-Restrictive Food Intake
Disorder (ARFID)
Written by Jessie Menzel, PhD, UCSD Eating Disorders Program
Symptoms
Persistent pattern of disordered eating or feeding characterized by:
o Lack of interest in food or poor appetite.
o Fears about negative consequences of eating (e.g., vomiting, choking, allergic reaction).
o Selective or picky eating.
The pattern of disordered eating is also accompanied by at least one of the following:
o Significant weight loss or failure to gain weight/grow as expected.
o Nutritional deficiency (e.g., anemia).
o Dependence on nutritional supplements or tube feeding.
o Impairment in psychosocial functioning.
Disordered eating is not due to cultural practice or lack of available resources
No significant body image distortion or fear of weight gain
Warning Signs
Restricted or reduced intake accompanied by frequent somatic (i.e., pertaining to bodily
symptoms and discomfort) complaints with no organic cause
Lack of appetite or interest in food
Expressed fears of choking or vomiting associated with reduced intake or refusal to eat meals
or snacks
Inability or reluctance to eat in front of others (e.g., at school, at a friend’s house, in a
restaurant)
Picky eating that is unresolved by late childhood
Limited range of preferred foods that becomes narrower over time (i.e., picky eating that
progressively worsens)
© 2016 National Eating Disorders Association. Permission is granted to copy and reprint materials for
educational purposes only. National Eating Disorders Association must be cited and web address listed.
www.NationalEatingDisorders.org Information and Referral Helpline: 800.931.2237
Health Consequences
Increased risk for Failure to Thrive (not meeting expected
standards of growth) due to inadequate nutritional intake.
Many individuals with ARFID have stunted growth or have
fallen off their growth curves for weight and height.
Nutritional deficiencies (e.g., anemia or iron deficiency) and malnutrition which may be
characterized by fatigue, weakness, brittle nails, dry hair/hair loss, difficulty concentrating, and
reduction in bone density.
Weight loss or severe underweight.
About ARFID
ARFID is the second most common eating disorder in children 12 years and younger.
Prevalence rates for ARFID range from 8% to 14% in an eating disorder treatment setting.
ARFID can be diagnosed in children, adolescents, and adults.
Individuals with ARFID are at high risk for other psychiatric disorders, in particular anxiety
disorders and depression. In fact, individuals with ARFID have a higher rate of anxiety disorders
than individuals with anorexia nervosa.
Roughly 20% of individuals with ARFID are males.
References
Nicely, T., Lane-Loney, S., Masciulli, E., Hollenbbeak, C., & Ornstein, R. (2014). Prevalence and
characteristics of avoidant/restrictive food intake disorder in a cohort of young patients in day
treatment for eating disorders. Journal of Eating Disorders, 2. Doi: 10.1186/s40337-014-0021-3.
Nicholls, D., Lynn, R., & Viner, R. (2011). Childhood eating disorders: British national surveillance study.
The British Journal of Psychiatry, 198, 295-301.
Norris, M., Robinson, A., Obeid, N., ,Harrison, M., Spettigue, W., & Henderson, K. (2014). Exploring
avoidant/restrictive food intake disorder in eating disorder patients: A descriptive study. International
Journal of Eating Disorders, 47, 495-499.
Ornstein, R., Rosen, D., Mammel, K., Callahan, T., Forman, S., Jay, M., et al. (2013). Distribution of eating
disorders in children and adolescents using the proposed DSM-5 criteria for feeding and eating
disorders. Journal of Adolescent Health, 53, 303-305.
Zucker, N., Copeland, W., Franz, L., Carpenter, K., Keeling, L., Angold, A., et al. (2015). Psychological and
psychosocial impairment in preschoolers with selective eating. Pediatrics, 136, 1-9.
© 2016 National Eating Disorders Association. Permission is granted to copy and reprint materials for
educational purposes only. National Eating Disorders Association must be cited and web address listed.
www.NationalEatingDisorders.org Information and Referral Helpline: 800.931.2237
