ARFID
Avoidant/restrictive food intake disorder (ARFID) is a serious eating disorder where someone avoids or limits food for reasons that have nothing to do with body image, such as sensory sensitivities, fear of choking or being sick, or little interest in eating. It’s much more than ‘picky eating’.
Signs of ARFID
Someone may show some of these signs, not all of them. ARFID can affect people of any age, gender or background. It often starts in childhood, and it’s more common in autistic people, people with ADHD and people who live with anxiety.
Physical
- Tiredness, dizziness or fainting
- Stomach pain or other gut problems
- Signs of missing nutrients, such as changes to hair, skin or nails
- Feeling cold, or muscle weakness
- In children, not growing or developing as expected
- Loss of or changes to periods
Psychological
- Anxiety or distress around food and meal times
- Fear of choking, vomiting or an allergic reaction
- Strong reactions to the taste, texture, smell or look of food
- Little interest in food, or forgetting to eat
- Trouble concentrating
- No worries about body shape or weight (this is what sets ARFID apart)
Behavioural
- Eating only a small range of ‘safe’ foods, often the same brand or way of cooking
- Dropping foods they used to eat
- Distress when trying new foods
- Eating very slowly, or only small amounts
- Finding it hard to eat with others, at school, work or social events
- Bringing their own food, or skipping meals away from home
Three ways ARFID can show up
Many people have more than one of these. Only a health professional can diagnose ARFID.
- SensoryAvoiding foods because of their taste, texture, smell, temperature or look. Some foods can feel truly overwhelming, not just unpleasant.
- Fear of what might happenAvoiding food because of a fear of choking, vomiting, pain or an allergic reaction, often after a frightening experience.
- Low interest in foodNot feeling hungry, forgetting to eat, or finding eating a chore, so not enough food is eaten.
ARFID or picky eating? Lots of children go through picky stages that ease with time and don’t affect their health. ARFID usually doesn’t improve without support, and it affects health, growth, energy and everyday life. It can start, or carry on, in adulthood.
If you or someone you know is showing these signs, please reach out for help
ARFID is serious, but recovery is possible, even if you’ve lived with it for many years. A good first step is your GP, or the Butterfly Helpline on 1800 33 4673.
ARFID statistics
- 21%of autistic people experience ARFID in their lifetime
- Up to26%of people diagnosed with ARFID also have ADHD
- Any ageARFID often starts in childhood, but adults have it too
Sources
Figures as summarised by Butterfly Foundation, Avoidant/Restrictive Food Intake Disorder (ARFID), from Koomar et al. (2021), autism study, and ADHD study. Research on ARFID is still new, so estimates vary.
Treatment for ARFID
Treatment is tailored to the person and what sits behind their ARFID. It should respect sensory needs and safe foods, and be neurodiversity affirming. It may include:
- Cognitive behavioural therapy for ARFID (CBT-AR), which includes slowly and gently trying foods, at your own pace
- Family-based treatment adapted for ARFID, for children and teenagers
- Responsive feeding therapy, which builds trust and takes the pressure off eating
- A dietitian, to make sure your body gets what it needs, starting with your safe foods
- A speech pathologist if choking or swallowing is a worry, and an occupational therapist for sensory needs
Where to start
See your GP. They can check your physical health and refer you to the right people.
ARFID isn’t currently covered by the Medicare Eating Disorder Treatment and Management Plan. Your GP can still refer you with a Mental Health Treatment Plan (psychology sessions) and a chronic condition plan (sessions with a dietitian, speech pathologist or occupational therapist).
To find someone with ARFID experience, try InsideOut Institute’s treatment services database, or ask the Butterfly Helpline.
Parents and carers: Eating Disorders Families Australia runs a free online ARFID support group.
You can recover. You are not alone ❤️
Read how others found their way through recovery.