ARFID: Causes, Symptoms & Treatment in Children and Adults

27 Feb 2026

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.

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.

About Picky eating

Picky eating refers to a common, usually temporary behaviour especially in children where individuals show selective preference for certain foods and avoid others, without causing significant nutritional deficiency or functional impairment.

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

Basis of Comparison	ARFID (Avoidant/Restrictive Food Intake Disorder)	Anorexia Nervosa	Bulimia Nervosa
Primary Motive	Avoidance due to sensory issues, fear of choking/vomiting, or lack of interest in food	Intense fear of gaining weight	Fear of weight gain with recurrent binge eating
Body Image Distortion	❌ Absent	✔ Present	✔ Present
Concern About Weight/Shape	❌ No concern	✔ Excessive concern	✔ Excessive concern
Eating Pattern	Restrictive intake without bingeing	Severe calorie restriction	Binge eating followed by purging
Purging Behaviour	❌ Absent	May be present (in some types)	✔ Common (vomiting, laxatives, etc.)
Weight Status	May be underweight or normal	Significantly underweight (in most cases)	Often normal weight
Health Impact	Nutritional deficiencies, growth failure	Severe malnutrition, hormonal imbalance	Electrolyte imbalance, dental erosion

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