I only eat roasties, mash, fries and jacket potatoes – at Christmas I try to stomach a sausage to join in festivities

Avoidant restrictive food intake disorder, more commonly known as ARFID, is a condition characterised by the person avoiding certain foods or types of food, having restricted intake in terms of overall amount eaten, or both.

People can have ARFID at any age – from childhood to adulthood.

They might be very sensitive to the taste, texture, smell, or appearance of certain types of food, or only able to eat foods at a certain temperature. This can lead to sensory-based avoidance or restriction of intake.

Others may have had a distressing experience with food, such as choking or vomiting, or experiencing significant abdominal pain. This can cause the person to develop feelings of fear and anxiety around food or eating, and lead to them to avoiding certain foods or textures.

Some people may experience more general worries about the consequences of eating that they find hard to put into words, and restrict their intake to what they regard as ‘safe’ foods.

In some cases, the person may not recognise that they are hungry in the way that others would, or they may generally have a poor appetite. For them, eating might seem a chore and not something that is enjoyed, resulting in them struggling to eat enough.

Sometimes it’s not clear why someone has ARFID, or there may be many overlapping reasons for it.

ARFID can be present on its own, or it can co-occur with other conditions like anxiety disorders, autism, ADHD and a range of medical conditions.

Children and young people with ARFID may fail to gain weight as expected and their growth may be affected.

When a person does not have an adequate diet because they are only able to eat a narrow range of foods, they may not get essential nutrients needed for their health, development and ability to function on a day-to-day basis.

In some people, serious weight loss or nutritional deficiencies may develop, which need treatment.

Possible signs of ARFID include:

• Eating a reasonable range of foods but overall having much less food than is needed to stay healthy.
• Finding it difficult to recognise when hungry.
• Feeling full after only a few mouthfuls and struggling to eat more.
• Taking a long time over mealtimes/finding eating a ‘chore’.
• Missing meals completely, especially when busy with something else.
• Sensitivity to aspects of some foods, such as the texture, smell, or temperature.
• Appearing to be a “picky eater”.
• Always having the same meals.
• Always eating something different to everyone else.
• Only eating food of a similar colour (e.g. beige).
• Attempting to avoid social events where food would be present.
• Being very anxious at mealtimes, chewing food very carefully, taking small sips and bites, etc.
• Weight loss (or in children, not gaining weight as expected).
• Developing nutritional deficiencies, such as anaemia through not having enough iron in the diet.

Get help for ARFID

If you think you might have ARFID, you should make an appointment to discuss this with your GP.

If you are concerned that a family member or friend has ARFID, it is important to talk with them to support and encourage them to seek the right help and support.

You can learn more about ARFID through information pages on the Beat website.

You can also visit ARFID Awareness UK.

If you need support now, Beat’s helplines are open from 3pm to 8pm Monday to Friday.

You can also use their one-to-one web chat or send Beat an email at [email protected]

Source: Beat

ARFID is more than just ‘picky eating‘.

It’s normal for children to go through a phase of selective, called neophobic stage – the fear of trying new foods or refusing foods because they look different or wrong.

From about the age of two, you might notice a child avoiding foods they had previously accepted, or rejecting foods based on perceived flaws, like spots on a banana skin or a broken biscuit.

Most children grow out of this by age five though, some children can remain extreme fussy eaters into adulthood.

ARFID is a complex condition as there can be many different and overlapping reasons why someone may avoid or restrict their intake.

Things you may notice in a loved one who has ARFID include:

• A very limited diet, often fewer than ten foods and struggling to accept new foods. In a child with sensory specificity (meaning restrictive eating based on the sensory properties of food) these are likely to be of a similar texture / appearance / smell / temperature and / or with significant brand specificity (e.g. will only eat one brand of chicken nuggets)
• Struggling to eat sociably or flexibly including eating similar foods in different environments.
• Struggling with the food environment such as with noise levels, smell of other food or other people eating food around them.
• An extreme reaction to the sight/presence/smell of a new food. This is known as a disgust response and can include gagging, retching, extreme anxiety, and running away from the table.
• A sudden and extreme avoidance of many foods/fluids, sometimes resulting from a choking or vomiting episode.
• Intense and increasing avoidance of foods due to concerns such as contamination.

These signs or symptoms might look like a slow and persistent elimination or removal of foods, or a more sudden and rapid avoidance.

Source: Beat, eating disorder dietitians Sarah Fuller and Clare Ellison