What is ARFID? aka Avoidant Restrictive Food Intake Disorder

ARFID is an eating disorder characterized by a person’s limited food intake- either in quantity, or type of food, or both, and that this restrictive eating pattern interferes with quality of life and/ or physical health. If body image concerns are present, an individual would not qualify for an ARFID diagnosis.

ARFID can affect folks of all ages, and the restrictive eating patterns could have been present for most of their life, or precipitated by an averse life event. Usually the interference in functioning is related to eating in non-home environments. Individuals with ARFID feel immense social pressure to eat more flexibly when visiting friends or relatives, at celebrations, at restaurants, when traveling. Many children and adults with ARFID may avoid these environments or activities to avoid the associated stress, and in this way their social network is constrained.

A higher incidence of ARFID is seen in neurodivergent folks who have existing diagnoses of Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Sensory Processing Disorder (SPD). However, ARFID diagnoses are present in a majority of folks without these concurrent issues. The restrictive food repertoire may be related to taste or smell sensitivities, or increased or decreased interoceptive awareness- which is akin to internal sensation awareness. Some people feel strong sensations of their internal physiological and emotional systems, whereas others do not. For example, some people may not notice hunger cues like others, or feel very quickly full or uncomfortable when nearing stomach fullness. In addition, those with sensitive sensory systems, may experience tastes, textures and smells much more intensely than the average person, making eating much more intense. 

Depending on the nature of the development & expression of ARFID symptoms, there are different treatment options available. A few evidence-based modalities include Cognitive Behavioural Therapy (CBT) and Exposure and Response Prevention (ERP), Responsive Feeding Therapy, and Ellyn Satter’s Division of Responsibility Model. If fear of choking or difficulty chewing or swallowing is a concern, an assessment from a speech-language pathologist or occupational therapist may be informative. It is important to note that the treatment goal for ARFID is to help the individual feel more functional around food, however this may look, and to ensure physical wellbeing.

It is prudent to seek medical assessment from your GP, and baseline lab-work and heart rate function (ECG) may be warranted. It is important to monitor weight and nutritional deficiencies. A registered dietitian can be a valuable addition to the treatment team. Our RD, Ally Choo, works alongside families and therapists to monitor growth and nutrition, and she has many creative ideas for making meals and snacks more calorie and nutrient dense. Two of our mental health therapists- Susanne Leach and Krista Blatchford, have experience and training treating eating disorders, including ARFID.

It is important to note that as with all eating disorders, ARFID has the potential to be life threatening. If safe foods have diminished, weight has been affected, or there are any physical symptoms present, such as dizziness, syncopal episodes (nearing fainting), chest pain or irregular heart beat, fatigue, etc, it is very important to seek regular appointments with a physician.