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Avoidant Restrictive Food Intake Disorder (ARFID)

Patient information A-Z

This is a relatively new diagnostic term devised by the American Psychiatric Association in 2013. It is used to describe children who have challenges with feeding because of the very restricted number of foods they will accept.

The main characteristics are:

  • A diet made up of very few foods, often as small as five to ten food items which are usually dry, beige carbohydrates. An accepted food may have to be of one specific brand, flavour or type. Bread, for example, may have to be soft and white, with no crusts and of a particular brand.
  • An extreme fear of new food (the neophobic response), which means that these children will show an enhanced disgust response to foods that are not normally accepted.
  • Foods are refused because of their sensory properties. This may include the look, taste and feel in the mouth as well as the smell of food. If a child is made to eat a disliked food, they will show a strong ‘disgust’ response, gagging or vomiting even at the sight of the food.
  • A seeming lack of interest in eating or lack of appetite. Children will go without rather than eat foods that are unacceptable to them.
  • The children’s restricted diet may mean that they do not take in enough calories to grow properly or that they don’t get enough vitamins, minerals or fibre for optimum health and wellbeing.
  • In some cases, children may require tube feeds or special food supplements in order for them to get adequate nutrition.
  • The restricted diet may lead to problems with the child’s ability to cope with school mealtimes and take part in social functions. The child is likely to feel very anxious about situations involving food. They often have general anxiety and are fearful of change.
  • They are very difficult to move on in terms of what foods they accept, particularly in the early years, because of their fear of food.

Contacts and further information

References and sources of evidence

Information courtesy of the Birmingham Food Refusal Service

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Cambridge University Hospitals
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