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Avoidant/Restrictive Food Intake Disorder (ARFID)

What is Avoidant/Restrictive Food Intake Disorder (ARFID)?

Avoidant Restrictive Food Intake Disorder (ARFID) previously referred to as “Selective Eating Disorder” is similar to anorexia in that both disorders involve limitations in the amount and/or types of food consumed, but unlike anorexia, ARFID does not involve any distress about body shape or size, or fears of fatness.

Although many children go through phases of picky or selective eating, a person with ARFID does not consume enough calories to grow and develop properly and, in adults, to maintain basic body function. In children, this results in stalled weight gain and vertical growth; in adults, this results in weight loss. ARFID can also result in problems at school or work, due to difficulties eating with others and extended times needed to eat.

Warning Signs
  • Dramatic weight loss
  • Dresses in layers to hide weight loss or stay warm
  • Reports constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy
  • Reports consistent, vague gastrointestinal issues (“upset stomach”, feels full, etc.) around mealtimes that have no known cause
  • Dramatic restriction in types or amount of food eaten
  • Will only eat certain textures of food
  • Fears of choking or vomiting
  • Lack of appetite or interest in food
  • Limited range of preferred foods that becomes narrower over time (i.e., picky eating that progressively worsens).
  • No body image disturbance or fear of weight gain
Symptoms

Because both anorexia and ARFID involve an inability to meet nutritional needs, both disorders have similar physical signs and medical consequences.

  • Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)
  • Menstrual irregularities—missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period)
  • Difficulties concentrating
  • Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate)
  • Postpuberty female loses menstrual period
  • Dizziness
  • Fainting/syncope
  • Feeling cold all the time
  • Sleep problems
  • Dry skin
  • Dry and brittle nails
  • Fine hair on body (lanugo)
  • Thinning of hair on head, dry and brittle hair
  • Muscle weakness
  • Cold, mottled hands and feet or swelling of feet
  • Poor wound healing
  • Impaired immune functioning
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