An Introduction to ARFID: Avoidant Restrictive Food Intake Disorder
Print Friendly, PDF & Email

ARFID – More than just picky eating!

What is ARFID

Have you, your child, or a loved one been dubbed as an “extreme picky eater”? While certain levels of picky eating can be normal, it’s possible that an individual’s lack of interest in eating, avoidance, or fear of food could indicate a more serious issue.

In this blog post, we will explore some of the basics of ARFID (Avoidant Restrictive Food Intake Disorder), including what it is, approaches to ARFID treatment, and how a Dietitian can help. If you suspect that you or someone you know may have ARFID, seeking a further assessment from a Medical Doctor, Psychiatrist, or Psychologist is recommended.

What is ARFID?

ARFID stands for Avoidant Restrictive Food Intake Disorder. It is a type of eating disorder which became more clearly defined when it was introduced in the 5th edition of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) in 2013 (American Psychiatric Association, 2013). As described in Brigham et al. (2018), ARFID is characterized by either an extreme avoidance of food (due to the sensory characteristics of food such as taste, smell, texture, colour…etc.), a lack of interest in eating, or even a fear of choking. As a result, individuals living with ARFID are usually quite restricted with their intake in terms of both variety and volume of food.

According to the American Psychiatric Association (2021), a diagnosis of ARFID requires that the food restriction must result in other health implications, such as nutritional deficiencies, weight loss, poor growth and/or reliance on nutritional supplements or tube feeds. Beyond the impact on nutrition status, they also note that individuals may also experience impairments in social functioning due to their inability to participate in social activities involving food.

Who is most at risk for developing ARFID? How does it develop?

While ARFID can be diagnosed in any individual at any age, a study by Fisher et al. (2014) has shown that it is more likely to affect males and young children. According to the National Eating Disorders Association (2018), individuals living with neurodiversity such as Autism Spectrum Disorder or ADHD are also more likely to develop ARFID. Currently, the cause for the development of ARFID is unknown, though Brigham et al. (2018) predict that it could be a combination of both genetic and environmental factors. Individuals who have had a bad or traumatic experience with food may also be predisposed to developing ARFID.

How is ARFID different from other Eating Disorders?

Unlike eating disorders such as Anorexia Nervosa or Bulimia Nervosa, the National Eating Disorder Information Centre (2022) highlights that individuals living with ARFID do not engage in restrictive eating patterns due to a fear of weight gain, dieting or body dissatisfaction. They also note that the food restriction should not be the result of limited or lack of access to food or another medical condition.

What is the treatment process for ARFID?

A multidisciplinary team approach is recommended when pursuing treatment for ARFID given that it can have significant implications on an individual’s physical and mental health. A treatment team should involve a Medical Doctor and a mental health provider such as a Therapist or Psychologist, and may also include a Registered Dietitian, a Gastroenterologist, an Occupational Therapist and Speech Language Pathologist (Brigham et al., 2018). While the severity of each case may vary in terms of the interventions needed, in general, the treatment for ARFID may include the following:

1. Achievement and maintenance of a normal body weight

2. Correction of any nutritional deficiencies

3. Reducing anxiety/fear related to food and eating

4. Increasing food variety in the individual’s diet

While a study by Couturier et al. (2020) reviews some of the current Psychological and Pharmacological interventions for treating ARFID, more research is needed to further understand how to best support individuals living with this eating disorder.

How can a Dietitian Help?

Having a Dietitian as part of your treatment team is critical to ensure proper assessment, evaluation, and monitoring of you or your loved one’s diet. In addition to providing guidance on potential nutrient deficiencies, they can offer support in other areas such as:

1. Dietary strategies for meeting nutrient needs

2. Implementing and adjusting tube feed care plans

3. Guidance on the reintroduction of fear/unfamiliar foods

4. Simplifying the meal planning and preparation process

5. Creating a safe and supportive environment for trying new foods

6. Reducing mealtime challenges for families with children

A Registered Dietitian will ensure that you are involved in the treatment process every step of the way, including the decision making on what foods or mealtime situations you would like to challenge first.

Contact us to learn more about ways to tackle an eating disorder. 

If you or a loved one are struggling with anorexia, bulimia, ARFID, or binge eating disorder contact us for nutrition support.
We have several Eating Disorder Dietitians on our team with a unique specialization in  nutrition support for eating disorder recovery. We collaborate with your family doctor and psychologist to move forward at a pace you can manage for recovery. 

Check out these related blogs on our website:  


1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

2. American Psychiatric Association. (2021, March). What are eating disorders? Psychiatry.org – What are Eating Disorders? Retrieved October 24, 2022, from https://psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders

3. Brigham, K. S., Manzo, L. D., Eddy, K. T., & Thomas, J. J. (2018). Evaluation and Treatment of Avoidant/Restrictive Food Intake Disorder (ARFID) in Adolescents. Current pediatrics reports, 6(2), 107–113. https://doi.org/10.1007/s40124-018-0162-y

4. Couturier, J., Isserlin, L., Norris, M., Spettigue, W., Brouwers, M., Kimber, M., McVey, G., Webb, C., Findlay, S., Bhatnagar, N., Snelgrove, N., Ritsma, A., Preskow, W., Miller, C., Coelho, J., Boachie, A., Steinegger, C., Loewen, R., Loewen, T., Waite, E., … Pilon, D. (2020). Canadian practice guidelines for the treatment of children and adolescents with eating disorders. Journal of eating disorders, 8, 4. https://doi.org/10.1186/s40337-020-0277-8

5.Fisher, M. M., Rosen, D. S., Ornstein, R. M., Mammel, K. A., Katzman, D. K., Rome, E. S., Callahan, S. T., Malizio, J., Kearney, S., & Walsh, B. T. (2014). Characteristics of avoidant/restrictive food intake disorder in children and adolescents: a “new disorder” in DSM-5. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 55(1), 49–52. https://doi.org/10.1016/j.jadohealth.2013.11.013

6. National Eating Disorders Association. (2018, February 22). Avoidant restrictive food intake disorder (ARFID). National Eating Disorders Association. Retrieved October 24, 2022, from https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid

7. National Eating Disorder Information Centre. (2022). Avoidant and restrictive food intake disorder. NEDIC. Retrieved October 24, 2022, from https://nedic.ca/eating-disorders-treatment/avoidant-and-restrictive-food-intake-disorder/

Print Friendly, PDF & Email

As seen in


Success stories

"I am a psychologist in private practice and it is very important to me that my clients have the best care with other health care professionals. For that reason Health Stand Nutrition is my only source for exceptional Dietitians. Andrea and her team provide highly knowledgeable, compassionate, and real world support to my clients who require assistance with food lifestyle. I trust my clients to them and you would be in excellent hands making them part of your health care team."
Adele Fox, Psychologist
“This is the first time I feel satisfied; my cravings have diminished dramatically and I have a whole new relationship with food. I am eating guilt-free for the first time in my life. My energy has also dramatically increased and I feel great!
Rhonda Jenkins, Nutrition Counseling Client
“The Dieticians at Health Stand Nutrition help you to take action on the science behind eating well by making it practical, understandable, and fun. Their office is cozy and not at all clinical or intimidating. I felt like I was sitting down with a really smart, caring friend who wanted to help me make the best choices for my lifestyle and food preferences. They really are the best in the business.”
Marty Avery, Nutrition Counseling Client
“I have come to think of the program as a one stop shopping excursion for everything one needs to know about creating a joyous relationship with food and our bodies. In a single word, the course has gifted me with freedom from the punishing rigidity of disordered eating, old stories that never were true, and body dysmorphia that did nothing but make me lose sight of a body that has done everything I've asked, despite my careless dismissal of her needs. Now when I look in the mirror I find myself shifting from harsh criticism to gentle gratitude.”
Lynn Haley, Pursuit of Healthiness Online Course Participant
“I spent 3 hours when first diagnosed with type 2 diabetes. I learned more from my Dietitian about food in those 3 hours than I had learned in all the years of my life. I also love the newsletter, there is always something to learn.”
Peter Whitehead, Nutrition Counseling Client
“I didn’t realize how strong my “diet mentality” was, and all the rules I had in my head about food. I was in a cycle of reward/punish/binge/cringe. I booked with your business very reluctantly, on the repeated advice of my doctor, to get my slowly rising cholesterol levels in check. I thought I knew everything about food, and my behaviour with food, but I was definitely re-schooled. My weight is creeping down, I feel good about my diet, exercise, body image, and lifestyle.”
Amy Floyd, Nutrition Counseling Client
“Thanks Andrea for an amazing presentation, I have heard all positive remarks from attendees and the evaluations show the same sentiment. It is really gratifying when a speaker does their “homework” and weaves in our profession’s day to day challenges within their content, you did an awesome job of this! You truly took the “die” out of Dietician! Your information on healthy eating and simplifying how we can work towards this as we are all so busy really hit the mark. Andrea connects very well with her audience; she is energetic, funny, and very approachable.”
Carole Ann LaGrange, Transfusion Medicine Safety Officer

Event Planner for Laboratory Diagnostic Imaging Annual Event

I am a family physician who sees patients with a myriad of eating concerns – from wanting to know how to plan healthy meals for active families, to weight loss, to eating disorders, and so on. I cannot recommend the Health Stand team highly enough. I have worked with (and been to!) other Dieticians in the past and too often find that they just ask for food logs and make suggestions that are easily obtained online or in books. The Dieticians at Health Stand offer much more than just telling clients what they “should be eating.” In contrast, the team really does more of a counselling practice, and they work hard to help their clients learn more about why their eating habits may be off track and not optimal for them, as well as helping people to effect change at a deep level that, most importantly, is sustainable for lifetime health.”
Dr. Deb Putnam, Family Physician

Nutrition Counseling Client & Referring Physician

“I am a busy mom, with kids in high level sports, working full-time downtown, and running our home acreage outside the City. I now have the knowledge and tools I need to plan for and manage the chaos of meal planning.”
Gillian Gray, Pursuit of Healthiness Online Course Participant
“As a construction company, we select speakers who can relate to our industry and its employees. Andrea’s message was delivered with humor and empathy. She makes people feel as though they can make changes without leaving behind every favorite food. Andrea focused her presentation on healthy eating as a way to keep energy high throughout the day. This message and the way it was delivered resonated with our predominantly male, blue collar culture. I would highly recommend Andrea as a speaker for groups such as ours. She will get your message across without alienating anyone in your audience – which is a huge hurdle when trying to introduce a wellness program in the workplace!”
Stephanie Wood, HR and Safety Manager

Fisher Construction Group, Burlington, WA

I found my Dietitian warm, funny, and skilled at teaching nutrition concepts without the overwhelm. The general approach of each session was to mix science with emotion, which was exceedingly effective in helping me shift my perspective on food from one of anxiety to one of joy and curiosity.”
Erin Kronstedt, Nutrition Counseling Client
“Excellent presentation! What a refreshing change to have a speaker inspire rather than “lecture” about nutrition. Your captivating stories, tips and overall approach to healthy eating uplifts and puts people at ease. It was great to hear we don’t need to strive to be perfect eaters, and that small changes really can make a difference in how we feel and in our health. Thanks to Andrea, we have solutions to our everyday nutrition challenges that can actually work in real life!”
Tina Tamagi, Human Resources

ARC Resources Ltd.

“Had I not joined this course I would have struggled with no focus, low energy, and mindless eating. Excellent teaching and motivation. This is not just a course, it is a nutrition club with mentorship, support, and connections with other people with similar situations.”
Lorri Lawrence, Pursuit of Healthiness online course participant

Pin It on Pinterest

Share This