Avoidant/restrictive food intake disorder (ARFID) is part of a cluster of diagnoses called the feeding and eating disorders. Feeding and eating disorders are a group of psychiatric conditions that include:
Feeding and eating disorders are characterized by a persistent disturbance in eating behaviors. These disorders are linked to alterations in the consumption of food or absorption of nutrients, and can result in severe distress, physical health problems, and psychosocial impairment. People with anorexia nervosa are significantly underweight because they eat very little food in an effort to lose weight or prevent weight gain. People with binge eating disorder and bulimia nervosa eat large quantities of food in a short period of time (called a "binge"); people with bulimia nervosa also attempt to prevent weight gain by compensating for these binges in an inappropriate way, usually by vomiting, excessively exercising, fasting, or misusing laxatives or other medications. People with pica regularly eat non-nutritious, non-food substances. People with avoidant/restrictive food intake disorder have little interest in food or avoid many types of foods, which results in nutrition deficits.
Several of these disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder, are characterized by serious disturbances in body image and a preoccupation with weight and shape. Other disorders, including pica and avoidant/restrictive food intake disorder, are characterized by atypical eating behaviors but are not prominently associated with body image disturbances. Some feeding and eating disorders, including anorexia nervosa and avoidant/restrictive food intake disorder, cause the individual to be significantly underweight or malnourished as a result of their eating behaviors. Other disorders, including bulimia nervosa and binge eating disorder, do not produce marked weight loss and are typically associated with normal or higher than expected weight.
ARFID is a psychiatric disorder wherein an eating disturbance (such as lack of interest in food, avoidance of certain foods because of sensory characteristics, or concerns about potentially aversive consequences of eating) leads to one or more of the following:
To receive a diagnosis of ARFID, the eating disturbance must not be explained by a lack of food, a culturally-sanctioned practice, or another eating disorder such as anorexia nervosa. If the individual experiences significantly distorted body weight or shape, another eating disorder (e.g., anorexia nervosa) may be a more appropriate diagnosis. Similarly, the disturbance must not be fully explained by symptoms of another mental or physical illness. For example, if the symptoms are due to loss of appetite secondary to a major depressive episode, ARFID would not be diagnosed.
ARFID was newly included in DSM-5 as a replacement and extension of the DSM-IV diagnosis of feeding disorder of infancy or early childhood. Consistent with this designation, ARFID is more common in children than adults. The prevalence of the disorder in adults is unknown.
ARFID severity can range from mild to severe. In severe cases, ARFID can lead to serious nutritional deficits and considerable impairment in social relationships. Many people with ARFID also have other psychiatric conditions, most commonly anxiety disorders, obsessive-compulsive disorder, autism spectrum disorder, attention deficit/hyperactivity disorder, and intellectual developmental disorders.
Very little is known about the neurobiology of ARFID. However, ARFID has been linked to a history of gastrointestinal conditions and related medical problems. Additionally, ARFID appears to be associated with higher rates of anxiety in the family of origin.
At this time, there is not enough scientific information to inform us about what treatments are effective for ARFID. We recommend that any individual struggling with a mental health or learning disorder speak to their doctor about it, and consider consulting with a therapist or other appropriate specialist.