• Mental Health
    • Anxiety
    • Depression
    • Bipolar Disorder
    • ADHD
    • Addiction
      • What is Addiction?
      • What Are Behavioral Addictions?
      • Addiction vs Dependence
      • Addiction Myths vs Facts
      • Addiction Statistics
      • How to Help a Friend
      • Find an Addiction Specialist
    • Eating Disorders
    • Personality Disorders
      • Obsessive Compulsive Personality Disorder
        • OCD vs. OCPD
    • Trauma
      • Post-Traumatic Stress Disorder
        • PTSD & COVID-19
      • Childhood Trauma
    • Sexual Disorders
      • Anorgasmia
      • Female Sexual Arousal Disorder (FSAD)
      • Hypoactive Sexual Desire Disorder (HSDD)
      • Premature Ejaculation (PE)
      • Delayed Ejaculation
    • Schizophrenia
  • Therapy Techniques
    • Online Therapy
      • Best Online Therapy
      • Online Therapy for Teens
      • Best LGBTQ Online Therapy
      • Best Online Therapy for Insurance
    • Psychotherapy
    • Cognitive Behavioral Therapy (CBT)
      • CBT for Anxiety
      • CBT for Social Anxiety
      • CBT for Panic Disorder
      • CBT for Insomnia
      • CBT Online
    • Dialectical Behavior Therapy (DBT)
      • DBT for Teens
    • Acceptance and Commitment Therapy (ACT)
    • Eye Movement Desensitization and Reprocessing (EMDR)
      • EMDR for PTSD
      • EMDR for Anxiety
      • EMDR Online
    • Art Therapy
    • Applied Behavior Analysis (ABA)
    • Exposure and Response Prevention
    • Group Therapy
    • Hypnotherapy
    • Motivational Interviewing
    • Person Centered Therapy
    • Rational Emotive Behavioral Therapy
    • Sex Therapy
  • Types of Therapists
    • Faith-Based & Christian Counselors
    • Life Coaching
    • Family Therapist
      • Child & Teen Counseling
    • Marriage & Couples Counselors
      • Premarital Counseling
    • Psychiatrist
      • Psychology vs. Psychiatry
    • Psychotherapist
    • Grief Counselors
    • Online Therapists
  • Starting Therapy FAQ
    • Does Therapy Work?
      • How to Find a Therapist
      • Helping a Friend or Loved One
    • How to Choose a Therapist
      • Finding a Black Therapist
      • Finding a Latinx Therapist
      • Finding an LGBTQ-Friendly Therapist
      • Finding a Therapist as a Young Adult
      • Finding an Online Therapist
    • Preparing for Your First Session
    • Types of Mental Health Professionals
    • Mental Health Insurance
      • HSAs for Therapy
      • Sliding Scale Therapy Fees
    • Mental Health in the Workplace
      • Asking for a Mental Health Day
      • Taking Time Off for Mental Health
    • Top Mental Health Organizations
      • Mental Health Resources Outside the U.S.
  • About Us
    • About Us
    • Editorial Policy
    • Advertising Policy
    • Privacy Policy
    • Contact Us
    • Write for Us
    • Join the Directory
    • Careers
  • Therapist Directory
    • Find a Therapist
    • Join the Directory
    • Directory Login
  • Mental Health
    • Anxiety
    • Depression
    • Bipolar Disorder
    • ADHD
    • Addiction
      • What is Addiction?
      • What Are Behavioral Addictions?
      • Addiction vs Dependence
      • Addiction Myths vs Facts
      • Addiction Statistics
      • How to Help a Friend
      • Find an Addiction Specialist
    • Eating Disorders
    • Personality Disorders
      • Obsessive Compulsive Personality Disorder
        • OCD vs. OCPD
    • Trauma
      • Post-Traumatic Stress Disorder
        • PTSD & COVID-19
      • Childhood Trauma
    • Sexual Disorders
      • Anorgasmia
      • Female Sexual Arousal Disorder (FSAD)
      • Hypoactive Sexual Desire Disorder (HSDD)
      • Premature Ejaculation (PE)
      • Delayed Ejaculation
    • Schizophrenia
  • Therapy Techniques
    • Online Therapy
      • Best Online Therapy
      • Online Therapy for Teens
      • Best LGBTQ Online Therapy
      • Best Online Therapy for Insurance
    • Psychotherapy
    • Cognitive Behavioral Therapy (CBT)
      • CBT for Anxiety
      • CBT for Social Anxiety
      • CBT for Panic Disorder
      • CBT for Insomnia
      • CBT Online
    • Dialectical Behavior Therapy (DBT)
      • DBT for Teens
    • Acceptance and Commitment Therapy (ACT)
    • Eye Movement Desensitization and Reprocessing (EMDR)
      • EMDR for PTSD
      • EMDR for Anxiety
      • EMDR Online
    • Art Therapy
    • Applied Behavior Analysis (ABA)
    • Exposure and Response Prevention
    • Group Therapy
    • Hypnotherapy
    • Motivational Interviewing
    • Person Centered Therapy
    • Rational Emotive Behavioral Therapy
    • Sex Therapy
  • Types of Therapists
    • Faith-Based & Christian Counselors
    • Life Coaching
    • Family Therapist
      • Child & Teen Counseling
    • Marriage & Couples Counselors
      • Premarital Counseling
    • Psychiatrist
      • Psychology vs. Psychiatry
    • Psychotherapist
    • Grief Counselors
    • Online Therapists
  • Starting Therapy FAQ
    • Does Therapy Work?
      • How to Find a Therapist
      • Helping a Friend or Loved One
    • How to Choose a Therapist
      • Finding a Black Therapist
      • Finding a Latinx Therapist
      • Finding an LGBTQ-Friendly Therapist
      • Finding a Therapist as a Young Adult
      • Finding an Online Therapist
    • Preparing for Your First Session
    • Types of Mental Health Professionals
    • Mental Health Insurance
      • HSAs for Therapy
      • Sliding Scale Therapy Fees
    • Mental Health in the Workplace
      • Asking for a Mental Health Day
      • Taking Time Off for Mental Health
    • Top Mental Health Organizations
      • Mental Health Resources Outside the U.S.
  • About Us
    • About Us
    • Editorial Policy
    • Advertising Policy
    • Privacy Policy
    • Contact Us
    • Write for Us
    • Join the Directory
    • Careers
  • Therapist Directory
    • Find a Therapist
    • Join the Directory
    • Directory Login
Skip to content

ARFID: Signs, Symptoms, & Treatments

Published: January 10, 2023 Updated: January 25, 2023
Published: 01/10/2023 Updated: 01/25/2023
Headshot of Nicole Arzt, LMFT
Written by:

Nicole Arzt

LMFT
Headshot of Naveed Saleh, MD, MS
Reviewed by:

Naveed Saleh

MD, MS
  • What Is ARFID?Definition
  • Signs of ARFID In Children & AdultsSigns
  • ARFID SymptomsSymptoms
  • Causes & Risk Factors of ARFIDCauses
  • Diagnosing Avoidant Restrictive Food Intake DisorderDiagnosing
  • ARFID TreatmentTreatment
  • How to Get Help For ARFIDGet Help
  • Final Thoughts on ARFIDConclusion
  • Additional ResourcesResources
  • ARFID InfographicsInfographics
Headshot of Nicole Arzt, LMFT
Written by:

Nicole Arzt

LMFT
Headshot of Naveed Saleh, MD, MS
Reviewed by:

Naveed Saleh

MD, MS

ARFID, short for avoidant restrictive food intake disorder, refers to limiting food, causing significant nutritional deficiencies, weight loss (or failure to gain expected weight), and problems with behavioral functioning. Any of these symptoms may warrant the need for help. While similar to anorexia, people with ARFID do not experience distress over body weight, size, and shape.1

If you’re struggling with an eating disorder, speaking with a therapist can help. BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you.

Choosing Therapy partners with leading mental health companies and is compensated for marketing by BetterHelp

Visit BetterHelp

What Is ARFID?

ARFID is a type of eating disorder where people do not consume enough food to meet their daily nutritional needs. Some people with ARFID experience anxiety or phobias over certain foods or types of eating. Others lack interest in eating or report having low appetites.2

ARFID tends to be more common in childhood or adolescence, but the onset can occur at any age. Many people with ARFID eat only certain types of food and in minimal amounts. This pattern may result in health problems and may require treatments ranging from needing nutritional supplements to feeding via tubes.

Staci Belcher, Research Professional of Nutritional Sciences at the University of Georgia“ARFID impacts people all across the age spectrum, from young children to adults. In children, doctors may notice a stalling in their growth or weight loss,” says Staci Belcher, Research Professional in Nutritional Sciences at the University of Georgia. “Parents and caregivers may observe a lack of interest in foods, food restriction or fear, preference for specific flavors or textures (such as crunchy, sweet), or fear of vomiting/choking. In adults, ARFID clients may experience the above as well as having a relatively small list of foods they regularly eat. Because of that, they may have inflexible eating behaviors, food restriction, weight loss, or complaints of frequent fullness or upset stomach.”

ARFID vs. Anorexia

ARFID and anorexia nervosa both include the symptom of food restriction; however, the underlying motives are different. Someone with anorexia limits food because they want to lose weight or achieve a certain body type. They fear weight gain and often punish themselves with extreme dieting techniques to consume as few calories as possible.

Someone with ARFID is not motivated by weight loss. Instead, they often restrict calories unintentionally, and it’s because they fear or lack interest in eating.

ARFID vs. Picky Eating

Research shows that 8%-50% of children between 2 and 11 years old are picky eaters.3 However, being particular about food is a relatively normal part of childhood development. Although picky eaters may be frustrating for family members, the individual isn’t necessarily disturbed by their habits.

Picky eaters usually have specific food preferences and can maintain appropriate weight goals. People with ARFID may demonstrate substantial weight loss, and they may show no interest in eating whatsoever. They may also be disturbed by certain food textures or fear certain food-related consequences like vomiting, choking, or getting sick.

Picky eaters may turn down most foods and only choose to eat their favorites, but someone with ARFID may report they don’t feel hungry, never think about food, and often forget to eat because food just isn’t a priority.

Signs of ARFID In Children & Adults

Many parents mistake ARFID for picky eating. After all, the two conditions can look similar. A child with ARFID, however, may seemingly avoid every type of food. Unlike a picky eater, a child with ARFID can fail to achieve specific weight and growth milestones without treatment for the condition.

Adults with ARFID may show similar characteristics as children with ARFID. For example, they may avoid social settings where food is involved (due to fear of eating or fear of feeling embarrassed for how they eat). In long-term cases, adults with ARFID may struggle with serious health consequences due to inadequate nutrition.

ARFID Symptoms

The main symptom of ARFID is failing to eat enough food to meet nutritional needs. Understanding why someone does not eat enough food will help determine if ARFID is the appropriate diagnosis, or if it’s another condition. ARFID consists of both psychological and physical symptoms that cause significant distress to an individual’s well-being.

Common psychological symptoms of ARFID include:1

  • Sudden refusal to eat certain foods
  • Reported fears of choking or vomiting
  • Having no appetite (or a very low appetite)
  • Eating very slowly and barely consuming whatever is served
  • Problems with eating in social situations
  • Limiting food intake to avoid feared or disliked textures
  • Difficult chewing and digesting

Common physical symptoms of ARFID include:1

  • Rapid weight loss (or failing to gain expected weight in childhood)
  • Gastrointestinal distress
  • Difficulty concentrating
  • Fatigue
  • Dizziness or fainting
  • Insomnia or other sleep-related problems
  • Loss of menstruation (or menstrual irregularities)
  • Feeling cold all the time

Popular Choices For Online Therapy 

BetterHelp  – Best For Those “On A Budget”


Online-Therapy.com – Best For Multiple Sessions Per Week

According to 14 Best Therapy Services (updated on 1/16/2023), Choosing Therapy partners with leading mental health companies and is compensated for marketing by BetterHelp and Online-Therapy.

Causes & Risk Factors of ARFID

Like any eating disorder, there isn’t a specific cause that causes ARFID. Instead, ARFID likely results from a combination of genetic, psychological, environmental factors, and triggering events (i.e., choking). Certain risk factors may exacerbate one’s predisposition to develop this condition.

In addition, people with ARFID may also meet the criteria for other mental health issues like obsessive compulsive disorder (OCD), attention deficit/hyperactivity disorder (ADHD), or anxiety disorders.

Causes and risk factors for ARFID include:

  • Autism (people with autism are much more likely to have ARFID)
  • Having a history of severe picky eating in childhood
  • Traumatic experiences (e.g., choking)
  • Co-morbid mental health issues (e.g., depression, OCD, ADHD, anxiety)
  • Family history of ARFID
  • Gastroesophageal reflux disease (GERD)

Diagnosing Avoidant Restrictive Food Intake Disorder

To diagnose ARFID, a medical professional will usually engage in a complete assessment of the individual’s medical and mental health history. If diagnosing a child, the medical professional will often speak to both the parents and the child to understand the presenting issue.

To diagnose ARFID properly, a qualified healthcare professional will assess the individual’s eating habits and other lifestyle factors, such as if they have an underlying medical condition (like diabetes), mental health conditions, or specific cultural practices surrounding food intake.4 It’s essential to fully separate ARFID from picky eating or other eating disorders.

ARFID Treatment

Treating ARFID often requires a comprehensive, multidisciplinary approach. The specific treatment will vary based on the severity of the individual’s condition and past history of professional intervention. If the individual has co-occurring mental health issues, treatment should provide adequate interventions for all symptoms.

Belcher encourages, “ARFID, like all eating disorders, is best treated through a team approach. Eating disorder specialists, including registered dietitians, licensed therapists, and medical providers including psychiatrists, should work together to identify strategies to renourish clients and begin to expand foods the client eats. Many clients’ symptoms improve with a specific type of Cognitive Behavioral Therapy for ARFID: CBT-AR. A dietitian and therapist work closely to plan for, execute, and process food exposures. Consistent and continued exposure to new foods and processing the emotional experience is the path to an improved quality of life, and health.”

Therapy

Therapy can be highly effective for treating ARFID, providing a safe and supportive environment for recovery. Your therapist will work with you to develop reasonable goals and identify realistic steps towards achieving those goals.

Types of therapy for ARFID include:

  • CBT: Cognitive behavioral therapy (CBT) helps people identify negative or unhelpful thoughts and transition them into more realistic ones.
  • ERP: Exposure and response prevention (ERP), a part of CBT, encourages people to identify and gradually expose themselves to specific fears.5
  • Family therapy: Family therapy may be recommended for children with ARFID. Family sessions may focus on education about the condition and practical coping skills for managing symptoms.

Medication

There are currently no FDA-approved psychiatric medications for ARFID; however, research shows that mirtazapine and lorazepam can reduce food-related anxiety. Furthermore, olanzapine may help reduce rigid thoughts about food.6

Similarly, physicians may recommend specific supplements or vitamins to ensure nutritional balance. If the individual has co-occurring mental health issues, it is important to evaluate the need for medication.

How to Get Help For ARFID

If you suspect you have ARFID, it is important to visit your primary care physician first. They will conduct a full physical and determine the severity of your condition via bloodwork, urine testing, or X-rays. They may also refer you to specialists such as registered dietitians and ARFID specialists.

You should follow similar guidelines for children. Talk to your child’s pediatrician about your concerns. It may be helpful to write down the symptoms you observe and note when they started and how frequently they present. Your pediatrician may also provide referrals for child ARFID specialists.

In severe cases, hospitalization is necessary. Hospitalization allows for continuous monitoring and evaluation of the physical effects associated with ARFID. Discharge occurs after achieving medical stabilization.

How to Find a Therapist

If you’re interested in finding a therapist to help you deal with symptoms of ARFID, start your search in a free online therapist directory. You can narrow down your search by things like cost, expertise, and location.

Supporting Someone With ARFID

It can be difficult to know how to help someone with an eating disorder. Remember ARFID isn’t just someone being picky about their eating habits. Let the person know you understand that this eating disorder isn’t their fault. Ask them how you can best support them through their struggle.

Belcher notes, “Clients often have to navigate comments about their eating, especially those related to ‘picky eating.’ Understanding that ARFID is not ‘picky eating,’ and that it is a complex eating disorder, shifts the focus from judgment to support. Avoid all comments about what they choose to eat or not eat. Restaurants or events with unknown food sources can cause stress, thus, serve or request foods your loved one enjoys and offer emotional support throughout the event. For younger children, ensure foods they enjoy are available and seek the guidance from their care team to increase accepted foods.”

Final Thoughts on ARFID

ARFID can be a confusing and even frightening condition for individuals and their loved ones. Fortunately, intervention and treatment can help people live meaningful, healthy lives. Early recognition can be paramount in improving how you feel. If you suspect you or a loved one is struggling with ARFID, reach out for support as soon as possible.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

Talk Therapy 

Online-Therapy.com – Get support and guidance from a licensed therapist. Online-Therapy.com provides 45 minute weekly video sessions and unlimited text messaging with your therapist for only $64/week. Get started  Get Started

Virtual Psychiatry

Talkiatry Get help from a real doctor that takes your insurance. Talkiatry offers medication management and online visits with top-rated psychiatrists. Take the online assessment and have your first appointment within a week. Free Assessment

Starting Therapy Newsletter

A free newsletter for those interested in learning about therapy and how to get the most benefits out of therapy. Get helpful tips and the latest information. Sign Up

DBT Skills Course

Jones Mindful Living Dialectical Behavior Therapy (DBT) is a popular treatment for BPD. Learn DBT skills with live weekly classes and online video courses for only $19 per month. Free One Week Trial

Choosing Therapy Directory 

You can search for therapists by specialty,  experience, insurance, or price, and location. Find a therapist today.

Choosing Therapy partners with leading mental health companies and is compensated for marketing by Jones Mindful Living, Online-Therapy.com, and Talkiatry.

For Further Reading

  • Patient and Family CBT-AR Workbook
  • Information About ARFID In Children
  • When to Wonder: Picky Eating Resources
  • ARFID Child Screening Questionnaire
  • 10 Best Eating Disorder Movies for 2022
  • Mental Health America
  • National Alliance on Mental Health
  • MentalHealth.gov

ARFID Infographics

 ARFID Treatment

6 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Avoidant Restrictive Food Intake Disorder (2021). National Eating Disorder Association. Retrieved from: https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid.

  • Avoidant/Restrictive Food Intake Disorder (ARFID). National Eating Disorders Collaboration. Retrieved from: https://nedc.com.au/eating-disorders/eating-disorders-explained/types/arfid/.

  • Picky eating during childhood: A longitudinal study to age 11-years (2011). US National Library of Medicine. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943861/.

  • Avoidant/restrictive food intake disorder: Signs and symptoms (2021). KidsHealth. Retrieved from: https://kidshealth.org/en/parents/arfid.html

  • Exposure and Response Prevention (ERP). International OCD Foundation. Retrieved from: https://iocdf.org/about-ocd/ocd-treatment/erp/.

  • Evaluation and treatment of Avoidant/Restrictive Food Intake Disorder (ARFID) in Adolescents (2018, April). Current Pediatric Report. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534269/.

update history

We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

  • Originally Published: September 24, 2021
    Original Author: Nicole Arzt, LMFT
    Original Reviewer: Naveed Saleh, MD, MS

  • Updated: January 10, 2023
    Author: No Change
    Reviewer: No Change
    Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources.

Recent Articles

FT Depression and Weight Gain
Depression & Weight Gain: Connection & Management
Depression can trigger weight gain or weight loss. There are several contributing factors to depression and weight gain, such...
';
Body Image: What It Is & How It Affects Mental Health
Body Image: What It Is & How It Affects Mental Health
A person's body image can affect the person's mental and emotional well-being, and could possibly lead to more serious...
';
Orthorexia: Signs, Symptoms, & Treatments
Orthorexia: Signs, Symptoms, & Treatments
Do you or a loved one have obsessive thoughts on healthy eating? Orthorexia is a rather new eating disorder...
';
Bulimia Nervosa: Symptoms, Signs, & Treatments
Bulimia Nervosa: Symptoms, Signs, & Treatments
People with bulimia alternate between eating large quantities of food (binge eating) and engaging in activities or behaviors to...
';
Binge Eating Disorder: Signs, Symptoms, & Treatments
Binge Eating Disorder: Signs, Symptoms, & Treatments
Binge eating disorder is characterized by excessive food intake compared to what another person would normally eat along with...
';
Social Media & Eating Disorders: Links & Risks
Social Media & Eating Disorders: Links & Risks
Social media exposes individuals to unrealistic beauty ideals which increases the likelihood of developing eating disorders and related body...
';
Headshot of Nicole Arzt, LMFT
Written by:

Nicole Arzt

LMFT
Headshot of Naveed Saleh, MD, MS
Reviewed by:

Naveed Saleh

MD, MS
  • What Is ARFID?Definition
  • Signs of ARFID In Children & AdultsSigns
  • ARFID SymptomsSymptoms
  • Causes & Risk Factors of ARFIDCauses
  • Diagnosing Avoidant Restrictive Food Intake DisorderDiagnosing
  • ARFID TreatmentTreatment
  • How to Get Help For ARFIDGet Help
  • Final Thoughts on ARFIDConclusion
  • Additional ResourcesResources
  • ARFID InfographicsInfographics
If you are in need of immediate medical help:
Medical
Emergency
911
Suicide Hotline
800-273-8255
See more Crisis Hotlines
  • About Us
  • Contact Us
  • Write for Us
  • Careers
  • Editorial Policy
  • Advertising Policy
  • Privacy Policy
  • Terms of Service
  • No Surprises Act
For immediate help call:
Medical Emergency:
911
Suicide Hotline:
988
Click For More Crisis Hotlines
For immediate help call:
Medical Emergency:
911
Suicide Hotline:
811
See more Crisis Hotlines
here
logo
This site complies with the HONcode standard for trustworthy health information:
verify here.
This website is certified by Health On the Net Foundation. Click to verify.
Choosing Therapy Logo
We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. By clicking “Accept”, you consent to the use of ALL the cookies. However, you may visit Cookie Settings to provide controlled consent. Cookie settings ACCEPT
Privacy & Cookies Policy

Privacy Overview

We use cookies to facilitate website functionality. Also, we use third-party cookies to track your website behavior and target advertising. These cookies are stored in your browser only with your consent, and you have the choice of opting out.
Necessary
Always Enabled

Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.

Non Necessary

Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. It is mandatory to procure user consent prior to running these cookies on your website.

Save & Accept