Avoidant Restrictive Food Intake Disorder (ARFID)

Avoidant Restrictive Food Intake Disorder (ARFID), previously known as Selective Eating Disorder (SED), is a type of eating disorder, as well as feeding disorder, where the individual limits her consumption of certain foods based on the food’s appearance, smell, taste, texture, brand, presentation, or a past negative experience with the food. Women with ARFID have no significant body image distortion or fear of weight gain as with Anorexia and Bulimia. ARFID can be diagnosed in children, adolescents, and adults, and it is the second most common eating disorder in children 12 years and younger. Individuals with ARFID are at high risk for other psychiatric disorders, in particular anxiety disorders and depression.

Eating behaviors can include a lack of interest in food or poor appetite, fears about negative consequences of eating (e.g., vomiting, choking, allergic reaction), and selective or picky eating. The pattern of disordered eating is also accompanied by significant weight loss or failure to gain weight/grow as expected, nutritional deficiency (e.g., anemia), dependence on nutritional supplements or tube feeding, and impairment in psychosocial functioning.

Behavioral and psychological signs of ARFID

• Dramatic weight loss
• Dresses in layers to hide weight loss or stay warm
• Complains of constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy
• Consistent, vague gastrointestinal complaints (upset stomach, feels full, etc.) around mealtimes that have no known cause
• Post-puberty loss of menstrual period
• Dramatic restriction in types or amount of food eaten
• Will only eat certain textures of food
• Fears of choking or vomiting
• Lack of appetite or interest in food
• Limited range of preferred foods that becomes narrower over time (i.e., picky eating that progressively worsens)
  No body image disturbance or fear of weight gain
• Physical signs of ARFID

Because both Anorexia and ARFID involve an inability to meet nutritional needs, both disorders have similar physical signs and medical consequences.

• Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)
• Menstrual irregularities—missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period)
• Difficulties concentrating
• Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate)
  Dizziness
• Fainting/syncope
• Feeling cold all the time
• Sleep problems
• Dry skin
• Dry and brittle nails
• Fine hair on body
• Thinning of hair on head, dry and brittle hair (lanugo)
• Muscle weakness
• Cold, mottled hands and feet or swelling of feet
• Poor wound healing
• Impaired immune functioning