ARFID: Causes, Symptoms & Treatment in Children and Adults

ARFID is gaining attention in India due to rising cases among children and growing recognition of psychological causes of malnutrition beyond traditional eating disorders.

• It was formally recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association in 2013.

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About Avoidant/Restrictive Food Intake Disorder (ARFID)

• Avoidant/Restrictive Food Intake Disorder (ARFID) is a mental health-related eating disorder characterized by restrictive food intake.
• Not Driven by Body Image: It is not driven by body image concerns or fear of weight gain.

• Health Consequences: It leads to significant weight loss, nutritional deficiency, growth restriction (in children), and impaired social/academic functioning.
• Distinction from Picky Eating: It is distinct from ordinary “picky eating” due to severity and health consequences.
• Affected Population: It can affect both children and adults.

Causes

• While the exact cause of this disorder is unknown, research suggests it may be:
  • Sensory Aversion: Dislike of specific food textures, smell, or appearance.
  • Fear-Based Avoidance:  Fear of harmful consequences such as choking or vomiting.
  • Genetic Factors: Family history of eating disorders.
  • Psychosocial Influences: Social, cultural, and environmental factors.
  • Traumatic Experiences: Past incidents like food insecurity, choking, force feeding, or severe illness.

Treatment of ARFID

• Psychological Therapies: Psychological therapies, particularly cognitive behavioural approaches, help individuals slowly and safely try new foods, manage anxiety, and build positive eating experiences.
• Role of Family: Families can play an important role in helping the individual with ARFID. 
  • The family should remain calm and supportive. 
• Gradual Introduction of New Foods: Add new foods slowly without creating pressure or anxiety.
• Positive Mealtime Environment: Maintain regular, calm, and low-stress meal routines to support recovery.
• Professional Support Required:  Gradual Food Expansion: Slow increase in variety of foods to improve nutritional intake.
• Multidisciplinary Approach: A team of mental health professionals, doctors and nutritionists/dietitians have to work together to help the individual become better and then sustain the improvement.
• Sustained Monitoring: Continued support to maintain long-term recovery and prevent relapse.

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Distinction from Other Eating Disorders

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