Equip: What is ARFID?

ARFID is an eating disorder where a person struggles to eat enough food, enough different kinds of food, or both—but not because they want to lose weight or are trying to change the way their body looks. Instead, people with ARFID struggle to eat because of extreme sensory sensitivities, fear of a bad outcome from eating, or lack of interest in eating. Just like other eating disorders, ARFID can result in serious consequences for mental and physical health and can occur at any age, from young children to adults.

While ARFID is often misunderstood as “picky eating,” it’s a diagnosable eating disorder that can be incredibly disruptive to life and poses serious risks to a person’s mental and physical health. There’s no single cause of ARFID: it emerges out of a combination of environmental and genetic factors.

ARFID signs and symptoms

Physical symptoms of ARFID

Noticeable weight loss

Lack of weight gain or falling off the growth curve in growing kids

Constipation, abdominal pain, and other gastrointestinal issues

Impaired immune function

Eating very small amounts of food

Lack of expected weight gain or falling off the growth chart for growing kids and teens

Food sensory sensitivity

Inflexible eating habits, such as insisting on specific preparation of meals

Fear of contamination, choking, or nausea from food

Lack of appetite

Little to no interest in food

Difficulty trying new or unfamiliar foods

Reliance on nutritional supplements

Behavioral symptoms of ARFID

Sleep problems

Difficulty concentrating

Lethargy

Common questions about ARFID

What does ARFID treatment look like?

ARFID treatment generally requires a slightly different approach than treatment for other eating disorders. As with treatment for other eating disorders, if a patient needs to gain weight, the initial focus of treatment is weight restoration. This is because when the body is malnourished, the brain is too, and a malnourished brain doesn’t think clearly or take in new information well. For ARFID patients that don’t need to gain weight, treatments are focused on normalizing eating habits, reducing anxiety, learning how to cope with uncomfortable physical sensations, and gradually increasing food variety to meet nutritional needs.

During treatment, patients and their supports also meet regularly with their treatment team to learn tools and skills that help them cope with the challenges of recovering from ARFID. To accomplish this, our clinicians may use different treatment modalities, including family-based treatment for ARFID (FBT-ARFID), cognitive behavioral therapy for ARFID (CBT-AR), and exposure and response prevention (ERP).

You can learn more about Equip’s approach to ARFID treatment on our blog.

Does ARFID occur in adults?

While ARFID is identified more frequently in children, it does affect adults. Though research is limited, one study suggests that ARFID may account for 9.2% of adult eating disorders. Many adults have ARFID symptoms that began in childhood and never received treatment for, while others may develop ARFID later in life, often after an adverse food-related event, like a foodborne illness, an allergic reaction, or choking.

What are the causes of ARFID?

Research on ARFID is still relatively new compared to other eating disorders—we're still learning a lot about it! As with all eating disorders, there is likely no single identifiable cause of ARFID. While some ARFID cases can be triggered by a specific event that causes a fear of solid food—like choking, vomiting, or sickness—we still don’t know why some people who experience these events develop ARFID and others don’t.

Very early research suggests, though, that neurobiological and psychological factors are likely involved in the development of ARFID. You can learn more about the causes of eating disorders on our blog.

Is there a connection between ARFID and autism?

Studies suggest that there is a connection between ARFID and autism. One meta-analysis found that children with autism spectrum disorder (ASD) were five times as likely to have feeding problems than children without ASD. Current research shows that autism occurs at higher rates in those with ARFID than in the general population: while the overall autism rate is 1.5%, estimates of co-occurring ARFID and ASD range from 12.5%-33.3%. Learn more about autism and neurodivergence in eating disorders.