Many people with ARFID do not experience a “desire to eat less”; rather, they find that their food choices become increasingly narrow over time. What initially appears to be picky eating gradually develops into a massive restriction—often accompanied by significant psychological distress.
ARFID (Avoidant/Restrictive Food Intake Disorder) is a distinct eating disorder in which weight, body image, or calories are not the primary focus. Instead, the decisive factor is the avoidance of specific foods or entire food groups.
When Dietary Variety is Lost
A hallmark of ARFID is the classification of foods into “safe” and “unsafe.” Anything perceived as unsafe is consistently avoided. Over time, many of those affected are left with only five to ten accepted foods.
These foods are often highly processed or one-sided in composition. Fresh meals, fruit, or vegetables are often completely avoided—not due to health considerations, but because of fear, disgust, or sensory overload.
Different Paths to Food Avoidance
ARFID can develop in various ways. In therapeutic practice, two typical progressions are particularly common:
Aversive Experiences: Food avoidance can arise after unpleasant experiences, such as vomiting, choking, severe gagging, or pain while eating. These events can lead to certain foods or textures being permanently perceived as threatening.
Sensory Sensitivity: ARFID can also develop without a specific triggering event. Many affected individuals report a pronounced aversion to certain tastes, textures, smells, or even colors of food. Sensory sensitivity often plays a central role here. Eating is not experienced as neutral or pleasant, but as highly distressing.
Both pathways can lead to an ever-narrowing selection of food.
Early Onset and Long-term Misinterpretation
ARFID often begins in toddlerhood or preschool age. Initially, the behavior is frequently interpreted as a “normal phase” or as particularly picky eating. It is often assumed that the eating behavior will normalize on its own over time.
In reality, however, the opposite is often true: without targeted support, avoidance mechanisms become entrenched, and the restrictions persist into adolescence or adulthood.
Why ARFID is Often Diagnosed Late
ARFID is still relatively unknown. Many doctors and specialists have little experience with this specific eating disorder. Consequently, misassessments are common, often accompanied by reassuring statements that the child will “grow out of it.”
Since sufferers often do not show a distorted body image and their weight is not always conspicuous, the underlying problem remains unrecognized for a long time. The internal distress can be considerable, even if it is hardly visible to the outside world.
When Professional Support is Necessary
A permanently restricted food intake is not only psychologically taxing but can also have physical consequences. If the body is not supplied with sufficient energy, vitamins, and nutrients over a long period, it can lead to deficiencies, physical weakness, concentration problems, or other health complications.
The less variety there is in accepted foods, the greater the risk of malnutrition. In severe cases, ARFID can become physically dangerous—even if body weight initially appears normal.
Professional support is particularly indicated when:
Only a very small number of foods are eaten.
Fear, disgust, or intense internal tension occur during meals.
Meals are avoided or social situations involving food are restricted.
Physical complaints or deficiency symptoms arise.
Psychological pressure increases.
In these cases, ARFID should not be downplayed. Specialized psychotherapeutic treatment is not only helpful but necessary to prevent long-term psychological and physical consequences and to improve quality of life.