When most people think of eating disorders, they often picture someone overly concerned with their body image—restricting calories, skipping meals, and obsessing over weight. But what if we told you that not all eating disorders revolve around body image? In fact, there’s an entire diagnosis that has little to do with appearance at all: Avoidant/Restrictive Food Intake Disorder, or ARFID.
Though lesser known than anorexia or bulimia, ARFID is just as real and can have serious effects on both physical and mental health. Understanding what it is, where it comes from, and how it shows up in daily life can help more people spot it earlier—and get the help they need.
What is ARFID?
Avoidant/Restrictive Food Intake Disorder is a relatively new diagnosis, officially recognized in the DSM-5 in 2013. Unlike other eating disorders, ARFID is not driven by body image concerns. Individuals with ARFID aren’t avoiding food to lose weight or change how they look—they’re often avoiding food because of fear, discomfort, or lack of interest in eating.
This can include:
- Extreme sensitivity to textures, smells, or the appearance of food
- Fear of choking, vomiting, or gastrointestinal discomfort
- Persistent lack of interest in food or eating in general
Though ARFID may start without weight concerns, it can evolve into disorders like anorexia over time, especially if weight loss becomes a new focus due to external pressure or control. That’s why early recognition is so important.
What Causes ARFID?
ARFID doesn’t have a one-size-fits-all cause. Instead, it often arises from a combination of sensory sensitivity, past negative experiences, and underlying anxiety. Some common contributing factors include:
Sensory processing differences
Some people are highly sensitive to how foods feel, taste, or smell. A mushy banana or slimy mushroom might feel unbearable, not just unappealing.
Negative food experiences
A traumatic experience, such as choking, vomiting, or severe reflux, can leave a lasting imprint, leading to food avoidance out of fear.
Neurodivergence
ARFID is more common in people with conditions like autism spectrum disorder or ADHD, where sensory sensitivities and routine-based behaviors are more prevalent.
Anxiety
Generalized anxiety, obsessive-compulsive tendencies, or specific food-related fears can fuel avoidance behaviors over time.
In ARFID, restriction stems from fear, disgust, or sensory overload, not body image concerns. And while that may seem like a small difference, it’s a key one.
Recognizing ARFID: Symptoms and Everyday Clues
So, how can you tell if someone is struggling with ARFID, rather than just being a “picky eater”? It usually goes deeper than preference and often causes distress or disruption in daily life.
Common ARFID symptoms include:
- Eating a very limited range of foods
- Avoiding entire food groups or textures
- Lack of appetite or disinterest in food
- Weight loss, poor growth, or nutritional deficiencies
- Dependence on supplements or meal replacements
Food Rituals and Safe Foods
People with ARFID often have very specific food rituals that help them feel more in control or safe. These might include:
- Only eating foods that are a certain brand or shape
- Needing foods to be the same temperature or color
Avoiding foods that have touched other items on the plate
They also tend to have a list of “safe foods”—items that are familiar, predictable, and not distressing. While this list varies by individual, common safe foods might include:
- Plain pasta or noodles
- Crackers or chips
- Chicken nuggets
- Toast or plain bread
- Applesauce or bananas
- Cereal without milk
While these foods may not seem unusual, the lack of variety and inability to tolerate deviation can impact nutrition, social experiences, and overall well-being.
When ARFID Becomes a Concern
It’s normal for kids—and even some adults—to have food preferences or go through picky phases. But ARFID goes beyond that. The key differences are severity, duration, and impact.
Ask yourself:
- Is this affecting their growth or health?
- Are they avoiding social situations involving food (like school lunches or family dinners)?
- Is there emotional distress related to food or eating?
- Have they stopped gaining weight or lost weight unexpectedly?
If the answer is yes to any of these, it may be time to seek support. ARFID can lead to malnutrition, vitamin and mineral deficiencies, and even hospitalization if left untreated.
Seeking Help: What ARFID Treatment Looks Like
The good news? ARFID is treatable. While recovery may look different from other eating disorder treatments, many people make meaningful progress with the right support.
Some of the most effective treatment approaches for ARFID include:
Cognitive Behavioral Therapy (CBT-AR)
Some practitioners use a specialized form of CBT designed specifically for ARFID. It helps individuals identify and challenge unhelpful thoughts and fears related to food. Through gradual, supported exposure, CBT-AR promotes increased flexibility around eating, reduces anxiety, and helps expand dietary variety. Sessions often include goal-setting, food experiments, and skills for managing distress. It’s evidence-based and particularly effective when tailored to individual needs and sensory profiles.
Exposure Therapy
Exposure therapy involves the gradual, systematic introduction of feared or avoided foods in a supportive setting. The goal is to reduce anxiety through repeated, controlled exposure. This process helps desensitize the nervous system, build tolerance, and foster a sense of mastery over time. Therapists may use visual, olfactory, and tactile exposures before tasting, depending on the individual’s readiness.
Nutritional Counseling
A registered dietitian helps address nutrient deficiencies, support balanced eating, and expand food variety at a pace that feels safe. This process often involves creating personalized nutrition plans, supplement strategies if needed, and collaboration with therapists to reinforce progress. Dietitians also educate on the importance of macronutrients and micronutrients, helping reduce food-related anxiety while respecting sensory preferences and individual goals.
It’s important to seek out professionals with experience in ARFID, as it requires a different approach than other eating disorders. Compassionate care and patience are key.
Final Thoughts: Awareness Leads to Compassion
ARFID may not get the same level of attention as anorexia or bulimia, but its impact is very real. By expanding our understanding of eating disorders, we open the door to more inclusive, compassionate conversations.
The next time someone says they “just don’t eat that,” consider what might be going on beneath the surface. It’s not always about pickiness—and it’s certainly not always about weight.Whether you’re personally struggling or worried about a loved one, know this: ARFID is valid, it’s treatable, and you’re not alone. Contact us to get started today.
