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Avoidant/Restrictive Food Intake Disorder (ARFID) is an increasingly recognised mental health condition under the category of eating disorders. Unlike commonly known eating disorders such as anorexia nervosa or bulimia, ARFID is not driven by concerns about body image or a desire to lose weight. It represents a serious but treatable disorder that affects nutritional intake, growth, and overall well-being, particularly among children.

What is ARFID?

ARFID is a condition characterised by persistent limitation in the amount or type of food consumed. The restriction is not due to cultural practices, food scarcity, or distorted body image. Instead, it arises from psychological and sensory factors.

Key features include:

• Loss of interest in eating or low appetite
• Anxiety related to eating (e.g., fear of choking or vomiting)
• Avoidance of foods based on colour, taste, smell, or texture
• Extreme selectivity toward specific food groups

While it may initially resemble “picky eating,” ARFID is far more severe and can lead to significant health consequences.

Causes and Risk Factors

The eating difficulties in ARFID arise due to:

• Strong sensory aversions (texture, smell, taste sensitivity)
• Fear-based avoidance (vomiting, choking)
• Lack of appetite or low interest in food
• Preference for specific colours or food presentations

It most commonly develops in infancy or early childhood, though it can persist into adulthood. In children, it is more frequently observed in males.

Research suggests strong associations with:

• Anxiety disorders
• Autism Spectrum Disorder (ASD)
• Attention-Deficit/Hyperactivity Disorder (ADHD)
• Developmental and intellectual disabilities

A genetic predisposition is also likely, as ARFID often runs in families.

Health Implications

Unlike ordinary fussy eating, ARFID can severely affect nutritional status and development.

Consequences may include:

• Inadequate caloric intake
• Stalled weight gain or weight loss
• Impaired vertical growth (reduced height gain in children)
• Nutritional deficiencies
• Delayed physical and cognitive development

If left untreated, ARFID may lead to life-threatening complications due to chronic malnutrition.

Diagnosis and Treatment

ARFID is a genuine health disorder and not a behavioural problem, stubbornness, or attention-seeking. Early identification is critical to prevent long-term damage.

Treatment involves a multidisciplinary approach, including:

• Mental health professionals
• Medical doctors
• Nutritionists/dietitians

The primary therapeutic intervention is Cognitive Behavioral Therapy (CBT), which helps address anxiety, sensory sensitivities, and maladaptive eating patterns. Nutritional rehabilitation and parental counselling are also important in paediatric cases.

With appropriate professional support, individuals can recover and develop a healthy relationship with food.