Avoidant Restrictive Food Intake Disorder (ARFID)

What are the signs and symptoms of ARFID? 

ARFID most often develops in people with long-standing narrow food preferences or extreme selectivity around food. However, the onset can also be more sudden and caused by a specific fear or event.  

Symptoms and factors that can lead to ARFID include: 

• Food avoidance due to narrow preferences that are based on taste, texture, smell or appearance 
• Concerns about the consequences of eating, including stomach pain, fullness, vomiting or choking 
• Lack of interest in food or persistent low appetite, not caused by depression or other mental health conditions
• Being consistently below the growth curve for weight and height, sometimes lasting for many years, due to poor nutrition 
• Tantrums or other avoidant behaviors around mealtimes
• Neurodevelopmental disorders such as autism and ADHD

How is ARFID treated?   

Our approach to treatment gives families the support and education they need to manage an eating disorder and work toward recovery while minimizing time out of school and away from home. Learn more about our treatment approach for eating disorders.  

For patients with significant medical concerns, we may recommend an inpatient medical stay to stabilize them before we can safely begin family-based treatments.  

We offer treatment plans tailored to each family's specific needs.  

We offer two program options: 

• Day Treatment Program: Also known as the Partial Hospitalization Program, this is designed for children and teens who need intensive support through eating disorder recovery but do not require 24-hour care. This program typically takes place between five and seven days, with some or all meals eaten with the care team. A specialized care team guides families and children in developing healthy coping skills and supporting nutrition needs in their recovery process. Learn more about the Day Treatment Program. 
• Outpatient Clinic: This includes individual, family and group therapy, as well as psychiatric medication management, as needed. If you’re not sure if outpatient services are right for your child, call us at 720-777-6200 to speak with our team. Learn more about the Outpatient Clinic. 

Helpful resources 

Whether you suspect ARFID, anorexia or bulimia, it’s important to remember that the person with an eating disorder needs professional help. There is no single cause for a child to develop an eating disorder. Early identification and treatment improve chances of recovery, so discuss your concerns openly with your child and seek professional help as soon as you notice concerning behaviors. Most families start by contacting their pediatrician or primary care provider.  

For more information about the Children's Hospital Colorado Eating Disorders Treatment Program, please call 720-777-6200. 

The Family Health Library 

Children's Hospital Colorado's Anschutz Medical Campus location offers a Family Health Library with information on parenting, child development, medical diagnosis in children and more. Families are welcome to visit and use this resource at any time. 

Recommended books and podcasts 

• Podcast: ARFID in Children | Children's Hospital Colorado 
• “ARFID: Avoidant Restrictive Food Intake Disorder” by Rachel Bryant-Waugh (2019) 
• "What Causes Eating Disorders – And What Do They Cause?" by Guido Frank, MD (2016) 
• "Off the C.U.F.F. (Calm, Unwavering, Firm and Funny)" by Nancy Zucker, Ph.D., a parent skills manual that provides the curriculum taught to parents in group programs. Duke University Eating Disorders Program. (2008) 
• "Unlocking the Mysteries of Eating Disorders" by David B. Herzog, M.D., Debra L. Franko, PH.D., and Pat Cable, RN (2007) 
• "Skills-Based Learning for Caring for a Loved One with an Eating Disorder. The New Maudsley Method" by Janet Treasure, Grainne Smith and Anna Crane. Routledge Taylor and Francis Group, London and New York (2007) 
• "Help your Teenager Beat an Eating Disorder" by Jim Lock, MD, PhD, and Daniel LeGrange, PhD.  The Guilford Press, New York and London (2005) 
• “Survive FBT: Skills Manual for Parents Undertaking Family Based Treatment (FBT) for Child and Adolescent Anorexia Nervosa” by Maria Ganci. LMD Publishing (2016) 

Organizations and recommended websites 

• National Association of Anorexia Nervosa & Associated Disorders 
• National Eating Disorders Association (NEDA) 
• The Academy of Eating Disorders