Picky eating?
ARFID
Are you
Aware?
or ARFID?
What is ARFID?
ARFID?
ARFID stands for Avoidant-Restrictive Food Intake Disorder. It’s an eating disorder added to the DSM-5 in 2013. It can affect children, teenagers and adults, with different experiences and support needs at every age. Food avoidance may relate to sensory sensitivities, fear of unpleasant consequences, or little interest in eating. The resulting difficulties can affect nutrition, everyday routines and social situations involving food. Understanding these experiences is an important first step towards recognising when additional support may be helpful. Everyone deserves to have their difficulties taken seriously and approached with patience, understanding and compassion.
What are the symptoms?
ARFID displays itself as an extremely limited diet (restricted to a very low number of “safe foods”), a lack of willingness to eat, or both. Experiences vary: some people struggle with particular textures, tastes or smells, while others fear choking or vomiting, or have little appetite. “Willingness” here should not be understood as a simple choice; eating may feel genuinely difficult or distressing. Signs can also include nutritional difficulties or interference with everyday life. A limited diet alone does not establish a diagnosis, and professional assessment can help clarify the underlying difficulties.
That sounds like picky eating. Is it?
Absolutely not. Picky eating is often grown out of and is an actively made choice, while ARFID can be seen in children and adults alike and continues unless treated. However, picky eating is not always a conscious choice, and individual experiences vary. The important distinction is the impact: ARFID involves eating difficulties associated with significant nutritional, physical or social consequences. It deserves understanding rather than blame or pressure. A qualified professional can help distinguish ordinary food preferences from difficulties that need assessment and support.
How do I know if it’s ARFID or not?
A common litmus test is whether food will be eaten given no other choice. People with ARFID will often still refuse to eat food that isn’t “safe”, or will display physical reactions when ingesting it. However, this is not a reliable diagnostic test, and withholding familiar foods should not be used to test someone. Assessment considers eating patterns, nutritional needs, daily functioning and other possible explanations. A qualified healthcare professional can explore these concerns sensitively and help identify appropriate support without forcing food or dismissing distress.
What can I do about ARFID?
Long story short, personalised Cognitive Behavioural Therapy (CBT) is the most consistent option. Professional therapy is, of course, expensive and not always accessible, That’s not to say all hope is lost, though. Many at-home exposure therapy methods are available. Keep reading to find out more about support and treatment approaches. CBT is one option; the most suitable approach depends on individual needs and may include nutritional, medical and family support. Home exposure work should follow professional guidance, particularly where there are nutritional concerns, swallowing difficulties or significant distress.
RESOURCES
Below is a short list of resources with more detailed explanations as to what ARFID is exactly; a proverbial foot in the door for the other resources listed on the main section.
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Cleveland Clinic has an excellent rundown on the nature of ARFID at https://my.clevelandclinic.org/health/diseases/24869-arfid-avoidant-restrictive-food-intake-disorder
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Felix Economakis does wonderful work in the ARFID space, he’s worth checking out.