Avoidant Restrictive Food Intake Disorder (ARFID) was previously referred to as “Selective Eating Disorder.” ARFID is similar to anorexia in that both disorders involve limitations in the amount and/or types of food consumed, but unlike anorexia, ARFID does not involve body image issues.
A person with ARFID is not merely a “picky eater,” but rather, does not consume enough calories to grow and develop properly. In children, this results in malnutrition, low weight gain, and restricted growth.
The risk factors for ARFID may vary from person to person. Researchers do know that:
- ARFID is more common in children and young adolescents and less common in late adolescence and adulthood.
- Children who don’t outgrow normal picky eating, or in whom picky eating is severe, appear to be more likely to develop ARFID.
- Individuals on the autism spectrum, with ADHD, or that have intellectual disabilities are much more likely to develop ARFID.
- Many children with ARFID also have an anxiety disorder.
According to the National Eating Disorder Association (NEDA), the warning signs and symptoms of ARFID include the following:
Behavioral and psychological
- Dramatic weight loss
- Dresses in layers to hide weight loss or stay warm
- Reports constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy
- Reports consistent, vague gastrointestinal issues (“upset stomach”, feels full, etc.) around mealtimes that have no known cause
- Dramatic restriction in types or amount of food eaten
- Will only eat certain textures of food
- Fears of choking or vomiting
- Lack of appetite or interest in food
- Limited range of preferred foods that becomes narrower over time (i.e., picky eating that progressively worsens).
- No body image disturbance or fear of weight gain
Physical
Because both anorexia and ARFID involve an inability to meet nutritional needs, both disorders have similar physical signs and medical consequences.
- Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)
- Menstrual irregularities—missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period)
- Difficulties concentrating
- Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate)
- Postpuberty female loses menstrual period
- Dizziness
- Fainting/syncope
- Feeling cold all the time
- Sleep problems
- Dry skin
- Dry and brittle nails
- Fine hair on body (lanugo)
- Thinning of hair on head, dry and brittle hair
- Muscle weakness
- Cold, mottled hands and feet or swelling of feet
- Poor wound healing
- Impaired immune functioning
Learn more about this eating disorder and others on the NEDA website.
Source: National Eating Disorder Association | Avoidant Restrictive Food Intake Disorder (ARFID), https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid | Copyright NEDA © 2018. Last reviewed November 2022.
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