Being a picky eater is common, but avoidant restrictive food intake disorder (ARFID) goes beyond simple preferences. ARFID occurs when someone limits what they eat to the point that it affects their medical, psychological, or social functioning. This condition can affect people of all ages, including children, teens, and adults, and it appears in many different ways. Treatment is essential and should be tailored for each person.

Avoidant restrictive food intake disorder is a relatively new condition, first introduced in the DSM-5 (the manual of mental disorders) in 2013.

Unlike other eating disorders, ARFID is not related to body image or fear of gaining weight. It does not stem from a lack of available food, cultural practices, or another medical or psychiatric condition. Instead, people with avoidant restrictive food intake disorder may avoid foods due to sensory sensitivities, low interest in eating, or fear of choking or vomiting. Early diagnosis and treatment are crucial for effective management.

Recognizing the warning signs of avoidant restrictive food intake disorder is important. You or your child may be struggling with the disorder if you notice they are:

• Limiting the variety in their diet, often avoiding entire food groups or specific textures, colors, or smells
• Eating very slowly or requiring distractions to complete meals
• Regularly skipping meals, eating very little, or showing no interest in food
• Persistently fearful of choking, vomiting, or other concerns when eating
• Experiencing unexplained weight loss, growing less than average, or failing to gain expected weight (in children)
• Relying on nutritional supplements or tube feeding for adequate nutrition
• Avoiding social situations involving food, such as parties or family meals

If these behaviors are affecting their physical health, mental well-being, or social functioning, professional help may be needed.

People with avoidant restrictive food intake disorder often experience one or more of the following:

• Significant weight loss
• Nutritional deficiencies
• Dependence on tube feeding or oral supplements
• Psychosocial impairment

Treatments We Offer

At the Center of Excellence in Eating and Weight Disorders at Mount Sinai, we use an evidence-based approach to treating avoidant restrictive food intake disorder. We develop a comprehensive, effective, and supportive treatment plan based on the specific needs and circumstances of each person.

Our treatment program emphasizes gradual, sustainable progress tailored to everyone's needs. Key components include:

• Comprehensive assessments: We do a thorough evaluation of each patient to understand their specific concerns.
• Multidisciplinary collaboration: We work closely with doctors and other specialists throughout the Mount Sinai Health System.
• Skill building: We teach patients and families practical skills for managing food aversions and anxiety.
• Exposure-based strategies: We gradually expose patients to feared or avoided foods. Over time, this can help expand the variety of foods they eat.

And we use several approaches to give you or your loved one the best possible care.

Family-Based Interoceptive Exposure Therapy

This therapy involves the entire family, especially when the patient is a child. The goal is to help families create a positive environment that encourages recovery and resilience. We do this by guiding the parents on how to help their child gradually face their avoided or feared foods in a supported and structured way.  

Individual Therapy

Working one-on-one with a therapist helps us identify the underlying problems. It could be sensory aversion, memory of traumatic experiences, or a lack of interest in eating. Our therapists use techniques including cognitive behavioral therapy and exposure therapy to help our patients feel less anxious about eating and about the types of food they are eating.

Parent Support Groups

For parents, understanding how to help your child with avoidant restrictive food intake disorder can be challenging. Our parent support groups connect caregivers with others facing similar issues and provide a network of understanding and guidance. These groups focus on teaching parents about the condition, exploring effective ways to support your child, and offering emotional support.

Adolescent Group Therapy

Teens with ARFID can benefit from connecting with peers who understand their experiences. Group therapy offers a safe, nonjudgmental space for sharing experiences. In the group, teenagers talk about their challenges, learn coping strategies, and work together to address food-related anxiety.

Why Choose Mount Sinai?

The Center of Excellence in Eating and Weight Disorders at Mount Sinai has skilled, experienced, and compassionate staff. What sets us apart is our:

• Specialized expertise: Our clinicians have extensive experience in treating this condition. We are trained in the latest evidence-based approaches.
• Customized care: We tailor each treatment plan to the person’s specific needs. This ensures the best possible outcome.
• Supportive environment: We create a compassionate and judgment-free space for patients and their families. We strive to have everyone feel understood and empowered.
• State-of-the-art research: We use the latest research findings in our care. This means you benefit from the most advanced, innovative, and effective treatments.