There’s only one clinical diagnosis for ARFID, but people experience it in different ways. ARFID eating behaviors are related to one or more of the following:

• Sensory sensitivities – A person avoids certain foods because of sensory characteristics, such as texture, smell, taste, temperature or appearance.
• Lack of interest – A person has little interest in food or eating. They may forget to eat, feel full quickly, become easily distracted during meals or have very little appetite.
• Fear of adverse consequences – A person avoids foods because they fear choking, vomiting, nausea, pain, swallowing difficulties or another unpleasant experience related to eating.

There isn't a single cause of ARFID. Rather, it is likely to develop through a combination of psychological, biological and environmental factors.

• Psychological factors – For some people, ARFID develops after a distressing experience involving food, such as choking, vomiting, pain or another uncomfortable consequence of eating. These experiences can create lasting anxiety around food and lead to avoidance behaviors. ARFID is also more common in people with conditions, such as attention-deficit/hyperactivity disorder (ADHD), anxiety disorders, obsessive-compulsive disorder (OCD) and autism spectrum disorder.
• Biological factors – Genetics and temperament may play a role in the development of ARFID. Like other eating disorders, ARFID can run in families, and some people may be naturally more sensitive to sensory experiences like taste, texture, smell or appearance. Certain medical conditions, including gastroesophageal reflux disease (GERD), food allergies and other conditions that make eating uncomfortable, may also contribute to the development of ARFID.

Picky eating is common, especially in young children, and most children gradually become more comfortable trying new foods as they get older. ARFID is a serious eating disorder that typically does not improve on its own and can affect a child's nutrition, growth, health and quality of life.

Some of the key differences between picky eating and ARFID include:

• Fear related to eating – Many children with ARFID avoid food because they fear choking, vomiting, pain, allergic reactions or other unpleasant consequences. A picky eater may strongly dislike certain foods, but they are generally not afraid of food or eating.
• Interest in food – Most picky eaters are excited to eat foods they enjoy. Children with ARFID may have very little interest in food altogether and may regularly skip meals or forget to eat.
• Sensory sensitivities – Children with ARFID are often highly sensitive to certain food textures, tastes, smells, temperatures or appearances. They may only eat foods prepared in a specific way or insist on particular brands or presentations. Unlike typical picky eating, these preferences can become so rigid that they significantly limit food variety and interfere with nutrition, family meals and other daily activities.
• Impact on health and daily life – ARFID is more likely to cause nutritional deficiencies, growth concerns, weight changes and other medical complications. It can also make social situations involving food stressful or difficult. While picky eating can sometimes affect a child's health, the impact of ARFID is usually greater and often requires professional treatment.

In children, ARFID is usually related to sensory sensitivities to food texture, taste, smell or appearances, or a limited interest in eating. Without treatment, these food aversions can continue into adulthood.

ARFID can also develop later in life, and when it does, fears about eating or physical symptoms may play a larger role than sensory sensitivities alone. In some cases, adults trace their eating challenges to a distressing past experience involving food, sometimes called “food trauma,” such as choking, severe illness after eating or another event that created lasting anxiety around meals.

Regardless of when it begins, ARFID can affect physical health, emotional well-being and daily life. The good news is that treatment can help children and adults expand the foods they eat, improve nutrition, reduce anxiety around eating and build confidence at meals.

ARFID and anorexia nervosa can look similar on the surface because both conditions may involve eating very little, significant weight loss, nutritional deficiencies and serious health complications. However, motivation for the eating behaviors is the main difference between these conditions.

People with anorexia nervosa restrict food intake because of an intense fear of gaining weight or becoming fat. Their eating behaviors are closely tied to concerns about body weight, body shape or appearance.

People with ARFID don’t restrict food because they want to lose weight or because of body image concerns. Instead, they may avoid food because of fear, discomfort, sensory sensitivities or disinterest related to eating.

Remember that ARFID isn’t a choice. It’s important that you don’t criticize or blame them for their eating behaviors, and don’t force them to eat. Things you can do if you think your child has an eating disorder:

• Be a good role model by serving and eating a variety of foods
• Have regular meals and snacks, preferably as a family
• Reward positive eating behaviors
• Talk to your child’s doctor or schedule an initial assessment by calling Melrose Center at 952-993-4100

If you’re an existing patient, you can call Melrose Center at 952-993-6200 to make an appointment. We’ll help you make an appointment at the location of your choosing. If you’re not sure if you or someone you love has ARFID, your first step is to schedule an initial assessment by calling 952-993-4100.

During an initial assessment, you’ll talk to one of our licensed psychologists, psychiatrists and/or a primary care clinician about your concerns, symptoms and questions. If you or your child is diagnosed with ARFID or another eating disorder during the assessment, one of our care managers will help you schedule your next appointments.

Most insurance companies have plans that cover some or all of the costs for eating disorder recovery, such as outpatient care, a partial hospitalization program (PHP) and residential care. However, insurance plans differ on the types and amount of care they cover. These differences may relate to the specific diagnosis, the level of care and whether a provider is in-network. To make it easier to get the information you need, we have insurance benefit verification forms that include questions you can ask your insurance provider.