Understanding ARFID: More Than Just Picky Eating

By: Olivia Kline, EDC Administrative Assistant

ARFID, short for Avoidant/Restrictive Food Intake Disorder, is a relatively common but often misunderstood eating disorder. While it can resemble "picky eating," ARFID goes far beyond mere food preferences. Officially recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), ARFID is now acknowledged as a serious mental health condition requiring professional treatment.


What Is ARFID?

ARFID is characterized by a pattern of restrictive eating that leads to an inability to meet appropriate nutritional or energy needs. Unlike anorexia or bulimia, ARFID is not driven by concerns about body image or weight. Instead, food avoidance is often related to:

• Low interest in eating
  
• Sensory sensitivities (e.g., texture, smell, appearance)
  
• Fear of negative consequences like choking, vomiting, or nausea
  

Warning Signs of ARFID

If you’re concerned about yourself or a loved one, here are some common signs to look out for:

• Very limited variety of food choices
  
• Consistent avoidance of new foods or certain textures
  
• Noticeable weight loss or lack of growth in children
  
• Physical symptoms from poor nutrition
  
• High levels of anxiety or distress around eating

Can Adults Have ARFID?

Yes, adults of any age can be diagnosed with ARFID. The DSM-5 officially recognizes that this eating disturbance can occur at all ages.


How Is ARFID Different From Other Eating Disorders?

What makes ARFID unique from other eating disorders is that the disturbance in eating is not driven by body image concerns. Instead, individuals with ARFID may:

• Eat only a very limited number of familiar or “safe” foods
  
• Show strong preferences for certain textures or temperatures
  
• Have little to no interest in food or eating
  
• Display food-avoidance behaviors related to a fear of adverse reactions to eating, such as nausea, stomach aches, or vomiting. In some cases, the fear-based avoidance may be related to past traumatic experiences, such as choking incidents. 

How is ARFID Diagnosed? 

ARFID can be diagnosed by a qualified mental health professional with training in identifying eating disorders. According to the DSM-5, ARFID can be diagnosed when all of the following criteria (A - D) are met:

A. Eating disturbance with one or more of the following:

• Significant weight loss (or failure to gain weight/grow appropriately in children)
  
• Nutritional deficiencies
  
• Dependence on nutritional supplements or tube feeding
  
• Marked interference with daily life or social functioning

B. The issue is not due to food unavailability or cultural/religious practices.

C. The eating disturbance is not better explained by anorexia nervosa or bulimia nervosa, and there are no body image concerns.

D. If another medical or mental health condition is present, the eating disturbance is more extreme than typically seen with that condition.


Are There Different Types of ARFID?

While the DSM does not officially recognize subtypes of ARFID, there are some common presentations of ARFID that many clinicians have observed:

• Avoidant - avoiding different foods due to sensory sensitivities, such as texture, smell, or taste
• Aversive - fear of aversive consequences of eating that have nothing to do with body image or medically recognized food allergies, such as a fear of gastrointestinal symptoms
• Restrictive - an overall lack of interest in food with little motivation to eat
• “ARFID Plus” - ARFID may co-occur with other mental health issues 

How is ARFID Treated?

With support, recovery from ARFID is possible! Treatment usually involves a team-based approach, often including:

• Eating Disorder Therapist: A licensed mental health professional addresses the psychological aspects, guiding clients through gradual food exposures and helping treat any co-occurring anxiety, depression, or trauma.
• Registered Dietitian: A dietitian ensures nutritional needs are met, reintroduces food groups, and helps develop a sustainable meal plan.
• Physician: Medical monitoring ensures the body is functioning properly and that nutritional deficiencies are being addressed.

Together, this multidisciplinary team works to support both mental and physical recovery.


How We Help at The Eating Disorder Center

At The Eating Disorder Center, we specialize in supporting individuals struggling with ARFID. Our therapists are highly skilled, action-oriented, and many are personally recovered from eating disorders themselves. We believe in setting recovery goals and conducting in-session exposures, such as eating meals or snacks together.

We collaborate closely with local physicians, dietitians, and psychiatrists to create a personalized, team-based treatment plan for every client.


Interested in ARFID Therapy in Florida?

Our experienced clinicians--Jennifer Rollin, MSW, LCSW-C, Lauren Levine, MSW, LCSW-C, and Rachel Steinhardt, LMHC—provide virtual eating disorder therapy throughout the state of Florida, including in Boca Raton.

We offer free 15-minute consultations and are happy to answer your questions.

• Call us at 301-246-6856
• Or fill out our contact form to get started.

You are not alone—and help is available.
We are honored to support individuals on their journey to recovery from ARFID.

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Schedule a free 15 min consult for eating disorder therapy in FL, or recovery coaching worldwide.
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Click here.

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Eating Disorder Therapy Boca Raton  is a premier outpatient eating disorder therapy center founded by Jennifer Rollin. We specialize in helping teens and adults struggling with anorexia, binge eating disorder, bulimia, OSFED, and body image issues. We provide virtual eating disorder therapy in Boca Raton, Ft. Lauderdale, Palm Beach, Pinecrest, Parkland, Naples, Miami Shores, Palmetto Bay. Virtual eating disorder therapy throughout Florida.

References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

*Disclaimer: The information is provided for educational and informational purposes only. It is not intended to be a substitute for your independent medical decision-making nor a recommendation or endorsement for any particular treatment plan, organization, provider, professional service, or product.