Avoidant and restrictive food intake disorder (ARFID) was recognized as a diagnosable feeding disorder in 2013.  

Like the eating disorder anorexia, ARFID involves significant restriction or avoidance of food and significant weight loss or failure to gain weight in when weight gain would otherwise be expected.   Unlike anorexia, however, ARFID does not involve any distress about body shape or size, or fears of fatness.

Many children go through phases of picky or selective eating, however most of these children will eventually eat when they get hungry enough and will consume enough calories to grow and develop properly.  This is not the case for those with ARFID.  For some, a limited variety of food can result in significant weight gain.  ARFID can also result in problems at school or work, due to difficulties eating with others and extended times needed to eat.  Three subtypes of ARFID have been identified although individuals may present with different variation. 


  • Avoidance of foods due to taste, texture, look, smell, temperature, etc.

  • Reluctance to try new foods.

  • Non-preferred foods described as “disgusting” or “gross” and result in gagging or shuddering.

  • Likely to be supertasters (high concentration of fungiform papillae, which contain our taste buds).

  • Experience bitter tastes as particularly strong and aversive. 

  • Typically prefer a white diet with dry and crunchy textures over those that are soft, mushy, or lumpy.

  • May be at a higher body weight due to increased reliance on starchy, energy-dense, processed foods

Lack of Interest

  • Born with a predisposition for low homeostatic appetite (physiological hunger) and/or find food less hedonically rewarding  (pleasurable).

  • Report that they have never had much interest in food, felt pleasure from eating or from the anticipation of eating.

  • History of low weight or failure to thrive due to chronic undereating.

  • Individual and/or family may believe that there isn’t a problem with appetite/weight because “it has always been like that.”

  • Pattern of decreased appetite/intake can become heightened during times of increased stress or illness.

  • Individual becomes known socially as a “light” or small eater and social pressure to eat often fades over time.


  • Associated with a fear of an aversive consequence such as choking, vomiting or an allergic reaction.

  • Preexisting anxious temperament.

  • Preexisting sensitivity to bodily sensations/somatic symptoms.

  • Avoidance leads to missed opportunities to test negative predictions.

  • Safety behaviors further maintain anxiety and interfere with opportunities to disprove catastrophic predictions:


             CHOKING: soft or liquid foods

             that are easier to chew/swallow

             ALLERGIC: foods known not to

             be associated with allergies

             VOMITING: bread or cracker like

             food that they think will be   

             easier on their stomachs