ARFID: The anxiety-related eating disorder you've probably never heard of

According to the National Eating Disorder Association (NEDA), around 20 million women and 10 million men will experience difficulties with an eating disorder at some point in their life. Over the last few years, the prevalence of eating disorders has become an increasingly widespread concern, causing more fatalities than any other mental health condition across the UK and worldwide.

Although there is growing recognition of eating disorders, a general perception of what they are and the appearance of those affected by them remains pervasive. While many know about conditions such as anorexia and bulimia, there are many other types of eating disorders that can impact people’s mental and physical wellbeing.

One of these is known as Avoidant Restrictive Food Intake Disorder, or ARFID. Many people are still unfamiliar with this condition given it’s a relatively newly defined disorder, only being officially recognised as an eating disorder in the past decade.

What is ARFID?

ARFID is characterised by an extreme avoidance or inability to consume certain foods due to fear of choking or lack of appetite. Formally recognised in 2013 in the Diagnostic and Statistical Manual of Mental Disorders, the term was previously identified as a selective eating disorder and "describes a feeding and eating disorder characterised by the restriction of adequate nutritional intake".

Often confused with ‘picky eating’, ARFID is continually misdiagnosed or not diagnosed at all because of its unique symptoms and lack of focus on body image or weight, says Dr Sophie Mort, Clinical Psychologist & UK Mental Health Expert at Headspace. 'One of the biggest misconceptions about ARFID is that it's just a phase or a matter of fussy eating, especially in children. ARFID is a severe eating disorder similar to anorexia nervosa that can lead to serious health concerns if not properly treated.'

The link between ARFID and autism

Individuals with ARFID eat only a very limited range of foods, often having a fear of vomiting or experiencing considerable anxiety when trying new foods. Additionally, someone with developmental disabilities like autism may experience aversions to certain types of foods, textures, or flavours. More common in children and adolescents, ARFID can continue into adulthood and be tied to other psychological conditions like OCD or anxiety.

While ARFID may share similarities with other eating disorders, individuals with this condition are not necessarily as motivated by a desire to control their body shape and size. According to Dr Mort, 'ARFID is not driven by body image or weight concerns. It can look different from one person to the next - while someone might only eat foods of a certain temperature or texture due to sensory sensitivities, another may only eat "safe" foods due to fear of choking, vomiting or stomach pain.' However, they may frequently lose weight due to insufficient calorie intake, resulting in developmental delays.

'ARFID can have a significant impact on both physical and mental health. Physically, individuals with ARFID may suffer from malnutrition, weight loss, and developmental problems, particularly in children. Hair loss, fatigue and dry nails and hair are also common. Mentally, ARFID can cause anxiety and distress, often related to eating or mealtime, and disrupt social interactions and daily life', says Mort.

Although the exact cause of ARFID is unknown, it is associated with a combination of genetic, psychological, and sociocultural factors. 'There is no single cause of ARFID. Some of the many reasons include sensory sensitivities, appetite differences and co-morbid conditions such as autism, anxiety, and OCD. Environment and traumatic experiences with food can also be linked to ARFID,' she says.

Treatment and support

While there is no one size fits all approach, the recommended treatment for ARFID involves cognitive-behavioural therapy and graded exposure, focused on increasing the variety of foods eaten and decreasing the anxiety associated with eating.

When supporting someone with ARFID on their path to recovery, it is important not to pressure them to eat certain foods or criticise their eating habits. Instead, offer emotional support, encourage them to seek professional help if they haven't already, and educate yourself about their disorder. 'When people experience ARFID, they may have had a lifetime of being told they are "just being picky", and this can be extremely shaming. If this is you, it is important that you know you are not just being fussy. This is a real disorder, which you can overcome with the right support and serious self-compassion,' says Dr Mort.

If you need help with your, or someone else's, eating disorder:

  • Get in touch with your GP and explain what's going on, so you can be referred for specialist help

  • Contact Beat, the UK's eating disorder charity, on 0808 801 0677 or

  • Get in touch with eating disorder support service Seed on 01482 718130 or

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