Avoidant/Restrictive Food Intake Disorder (ARFID)
If your child is a very selective eater or avoids certain foods altogether, you may wonder if it is more than just “picky eating.”
Avoidant/Restrictive Food Intake Disorder (ARFID) is a real and serious eating disorder that goes beyond typical childhood fussiness. Understanding ARFID can help families get the right support and improve a child’s health and well-being.
What Is Avoidant/Restrictive Food Intake Disorder (ARFID)?
ARFID is a feeding disorder where a person avoids certain foods or restricts how much they eat, not because of body image concerns, but due to reasons like fear of choking, sensory sensitivities, or lack of interest in food.
It can affect children, teens, and adults, and was officially recognised in 2013 to cover a broader range of eating difficulties than a previous diagnostic term.
ARFID can also lead to a number of issues, such as:
- Weight loss or not growing as expected
- Nutritional deficiencies, meaning the body is not getting the vitamins and minerals it needs
- Dependence on feeding tubes or special nutrition drinks
- Problems with social and emotional well-being, like avoiding meals with others or struggling at school because of food issues.
Symptoms Of ARFID
Common signs and symptoms include:
- Dramatic weight loss or not gaining weight as expected
- Nutritional deficiencies (not getting enough vitamins and minerals)
- Needing nutritional supplements or tube feeding
- Avoiding meals with others, or struggling at school or work due to food issues
- Eating only a very limited range of foods (sometimes fewer than 10 “safe” foods)
- Sensitivity to food texture, smell, temperature, or appearance
- Fear of choking, vomiting, or other negative experiences with food
- Lack of interest in eating or missing meals
Causes Of ARFID
ARFID usually develops from a mix of factors:
- Genetics: Family history and certain genetic traits can increase risk.
- Physical health issues: Problems like gastrointestinal discomfort or growth issues can contribute.
- Psychological factors: Anxiety, obsessive-compulsive tendencies, or past traumatic experiences with food (like choking or vomiting) may play a role.
- Lack of appetite cues: Some individuals simply do not feel hungry or do not recognise when they need to eat.
- Food neophobia: Fear of trying new foods is common, leading to a very restricted diet.
ARFID usually develops from a mix of factors, including genetics, physical health issues, psychological factors, and sensory sensitivities. One common challenge is food neophobia, or fear of trying new foods.
When people are afraid of trying new things, like different foods, they often stick to eating the same meals over and over again. This makes the difference between their usual food and any new food feel even bigger.
For example, if someone eats the same peanut butter every day for weeks, switching to a new brand or type of peanut butter can make it feel like a much bigger change than it is. This is because their brain is used to the taste of the old peanut butter, so the new one feels more noticeable.
People with ARFID can find it harder to try new foods because the difference feels much more intense and sometimes overwhelming.
Sometimes, when people eat the same food too many times, they can get tired of it or even find it unappealing—this is called “food fatigue”. When this happens, the food can start to feel overwhelming or boring, and people with ARFID might refuse to eat it. Over time, food choices can get smaller and smaller, making it harder to find something enjoyable.
Complications Of ARFID
Without treatment, ARFID can cause serious health and social problems:
- Malnutrition and vitamin/mineral deficiencies
- Poor growth or delayed puberty in children and teens
- Anaemia, weakened bones, and muscle weakness
- Slow heart rate, low blood pressure, or irregular periods
- Fatigue, trouble concentrating, and poor immune function
- Social isolation, anxiety, and problems at school or work
Therapy Approaches
Individualised therapy plans are essential for ARFID, as its presentation varies widely. Some children with ARFID may also face co-occurring challenges like autism, anxiety, or specific phobias.
A core component of these plans involves a compassionate, caring, and confidence-building approach to encourage individuals to try new foods. Learning relaxation techniques can also be beneficial.
One effective therapy is to gently and incrementally introduces new foods to individuals with food neophobia. This involves gradually expanding the variety of foods eaten, initially by adding small amounts of different foods and then increasing this over time, with the aim of incorporating a new food at each meal or snack within a weekly cycle.
The ultimate goal is to desensitise taste buds to newness. As individuals become more comfortable with new foods, they often develop curiosity and motivation to explore further. Treatment also incorporates positive reinforcement, using rewards and praise to maintain motivation.
Cognitive Behavioural Therapy (CBT)
CBT helps to address fears around eating and gradually introduces new foods in a supportive way
Family Based Therapy (FBT)
Parents and caregivers are often included to support healthy eating habits and reduce stress at mealtimes
Nutritional Support
Dietitians help ensure nutritional needs are met, sometimes using supplements if necessary
Addressing Co-occurring Conditions
Treatment may also focus on related issues like anxiety, autism, or sensory processing challenges
Living With ARFID
Living with ARFID can be challenging, especially when eating feels stressful or when food choices are very limited. Everyday situations like family meals, school lunches, or social gatherings can sometimes cause anxiety or make you feel different from others.
However, with understanding, support, and the right strategies, it is possible to improve your relationship with food and enjoy a fuller life. Progress may be gradual, and there can be ups and downs, but small steps—like trying new foods at your own pace and celebrating each success—can make a big difference.
Remember, you are not alone, and help is available to guide you and your family along the way.
When To Seek Help?
Seek professional help for yourself, your child or loved one:
- Is losing weight or not growing as expected
- Has a very limited diet or avoids entire food groups
- Shows signs of malnutrition or fatigue
- Avoids eating with others or has anxiety around food
- Needs supplements or tube feeding to meet nutritional needs
Early intervention can prevent serious health complications and improve quality of life
How Can Us Help You?
Experienced Therapists
Our processes and quality assurance is led by Dr.Emma Waddington, a UK-trained senior clinician psychologist and Founder of Us Therapy, with over 20+ years of experience in helping individuals in Singapore.
Holistic & Personalised Approach
Our clinicians draw from various therapeutic models to create a holistic approach. At Us, we have seen hundreds of clients and we recognise that each individual is unique. Our approach is tailored to you but always includes customised treatment plans and integrative techniques.
Thorough Assessment
At Us, we pride ourselves on our comprehensive assessment processes. We will undergo a thorough assessment process with you in your first sessions before we come up with a plan for your therapy.
What To Expect
Initial Consultation – A Space to Be Heard
The first session is all about getting to know you. It is a conversation—one where you can share what is been on your mind, what has been feeling difficult, and what you would like support with. Your therapist will ask questions about your background, experiences, and goals, but there is no pressure to answer any questions—just a safe space to begin.
Questionnaires & Onboarding Surveys – Understanding the Full Picture
To help tailor therapy to your needs, you may be asked to fill out some brief questionnaires before or after your first session. These can give insight into things like mood, stress levels, relationship patterns, or coping strategies. They are not tests—just tools to help your therapist understand how best to support you.
Individual Therapy Sessions – Your Journey at Your Own Pace
Each session is a step forward in your journey. Therapy is not just about talking—it is about discovering new ways to navigate life’s challenges, make sense of emotions, and feel like you are getting the most out of your life. Depending on your needs, sessions may focus on:
- Exploring patterns of thought and behavior
- Understanding past experiences and their impact on the present
- Developing practical coping tools
- Strengthening emotional resilience
Feedback Sessions – Reflecting and Adjusting
After the first few sessions (or after assessments), a feedback session provides space to reflect on how therapy is going. This is a chance to talk about what has been helpful, what you would like more of, and how therapy can continue to best serve you.
Intervention – The Heart of Therapy
Intervention is where meaningful change happens. Every therapy journey is unique, and the approach will be shaped around what works best for you. Some common approaches include:
🌱 Cognitive Behavioral Therapy (CBT) – Helping to identify and shift unhelpful thought patterns, reduce anxiety, and develop healthier ways to cope and new patterns of behaviour.
🧠 Schema Therapy – Deep, transformational work to uncover long-standing patterns that might be keeping you stuck, often rooted in early life experiences.
💙 Acceptance and Commitment Therapy (ACT) – Learning to handle difficult emotions with self-compassion and move towards what truly matters in life.
🌊 Eye Movement Desensitization and Reprocessing (EMDR) – A powerful approach for healing trauma and distressing memories, helping the brain reprocess them in a way that feels less overwhelming.
🧘 Mindfulness-Based Approaches – Building self-awareness, grounding techniques, and ways to manage stress and emotions with greater ease.
Fees
Individual Counselling Rates
Clinician type
Fees and Duration
Clinic Founder
$310
Principal Psychologist
$290
Senior Clinical Psychologist
$262
Educational Psychologist
$262
Clinical Psychologist
$236
Counsellor
$170
Expressive Arts Therapist
$170
Associate Psychologist
$130
Phone calls / Emails
Clinicians rate pro-rata (10 Mins)
FAQs About ARFID
How do I tell if I have ARFID?
You might have ARFID if you avoid certain foods or restrict how much you eat, leading to weight loss, poor growth, nutritional deficiencies, dependence on supplements, or social problems. Diagnosis is made by a healthcare professional using a set of criteria.
Does ARFID ever go away?
Yes, with the right support and treatment, many people recover from ARFID and no longer meet the criteria for the disorder.
Is ARFID just autism?
No, ARFID is not the same as autism, but they can occur together. Children with autism are more likely to have ARFID due to sensory sensitivities and rigid routines, but ARFID can affect anyone.
What foods do kids with ARFID eat?
Kids with ARFID often stick to a small number of “safe” foods, which might be chosen for their familiarity.
What happens if ARFID is left untreated?
People can have health and social problems, as per the diagnostic criteria.