AvoidantRestrictive

AvoidantRestrictive, often abbreviated ARFID, refers to a pattern of avoidant or restrictive eating that can lead to significant health and psychosocial impairment. It is differentiated from dieting or body-image concerns because weight loss or nutritional impact is not driven by a desire to control weight or dissatisfaction with body shape. ARFID is recognized in clinical classifications as a distinct eating disturbance.

Typical presentations fall into several patterns. Some individuals have sensory-based aversions to certain textures, colors, smells, or temperatures of food. Others fear aversive consequences such as choking, coughing, or vomiting. A third pattern is a general lack of interest in eating or food. Together or separately, these patterns may cause substantial weight loss or stunting in children, nutritional deficiencies, dependence on oral supplements or tube feeding, and marked impairment in social, educational, or family functioning.

Causes and risk factors are multifactorial. They can include temperament, neurodevelopmental conditions (notably autism spectrum disorder), anxiety disorders, and gastrointestinal issues. Sensory processing differences, family environment, and genetic factors may also contribute. ARFID can occur across age groups and often coexists with other medical or psychiatric conditions.

Diagnosis involves clinical evaluation to confirm persistent avoidance or restriction of food intake with resulting health consequences, while ruling out lack of available food and excluding other medical or mental disorders. Growth, nutrition status, and psychosocial impact are considered.

Treatment is typically multidisciplinary, combining medical monitoring, nutritional rehabilitation, and psychological intervention. Evidence supports cognitive-behavioral therapy adapted for ARFID, exposure-based strategies, and family-based approaches. Some cases require supplemental nutrition or enteral support. Early intervention tends to improve long-term outcomes, though trajectories vary and some individuals experience chronic symptoms.