ARFID – Avoidant Restrictive Food Intake Disorder


Avoiding food and nutrition…


Avoidant restrictive food intake disorder (ARFID) is avoidance of food/nutrition. Still, the avoidance is based on fear of choking or vomiting triggered by smells and textures, not anxiety about weight gain. It results in a loss of weight or a failure to gain weight at the rate expected along the developmental trajectory for a child or adolescent. Sometimes this presentation will transform into behaviors like those of someone with anorexia nervosa. Correctly diagnosing this condition takes significant expertise.



This eating disorder almost always appears in childhood. There is a gradual narrowing in food choices until the child may only eat 2 or 3 foods. With ARFID, any proposed changes to eating patterns are met with rigidity and anxiety.  Consequently, treating this disorder is difficult. Because ARFID has only recently been recognized, there is a great deal we do not know. Initial research suggests that at least 20% of children and adolescents with ARFID would also meet the criteria for an autism spectrum disorder.


ARFID Treatment

If there has been weight loss, the initial goal of treatment is weight restoration using current foods and liquid supplements. We believe that even though the child did not begin restricting themself to be thin, once weight loss occurs, many of the same medical consequences as anorexia nervosa will appear. Specifically, a drop in body temperature and other vital signs, metabolic changes, complaints of stomach aches, and extreme fullness after eating. Young children and adolescents will often stop growing, so the body can conserve calories to protect the body’s vital functions. The hormone changes expected in puberty slow, stop or reverse. Hormones decrease in both females and males, which stops the menstrual cycle and the development of all secondary sex characteristics. ARFID also interrupts the body’s ability to develop strong bones.


Medical Diagnoses ARFID

It is also important to be certain that other medical diagnoses which could contribute to the problem are eliminated or confirmed. A good medical workup, GI tests, and a swallow study are necessary.


Nutritional Variety

Once a person’s weight is restored, the focus is on increasing nutritional variety. This is accomplished through Exposure Response Prevention (ERP) work, done at a pace the child or individual can tolerate. It can be accomplished on an outpatient basis. However, a young child or adolescent will need significant family involvement and support. Some individuals with ARFID present for treatment as young adults when the social consequences of not being able to eat normally increase their motivation to change. This allows them to push through the anxiety interfering with normal eating.





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Eating disorders can occur in individuals of all ages, genders, and body types. At Sanford CTED, we treat both adolescents and adults and offer outpatient (OP), intensive outpatient (IOP), partial hospitalization (PHP), and residential treatment (for adult women). Our continuum of care allows the individuals we treat to enter a program at the level that is appropriate for their symptoms. In-person and telehealth options are available.


Do not be afraid to reach out. At Sanford CTED, we transform lives and offer hope to those with eating disorders. 


Eating Disorder Programs

  • Residential
  • Partial Hospitalization (Day Programs, PHP)
  • Intensive Outpatient (IOP)
  • Outpatient Groups
  • Outpatient Psychiatry
  • In-Person and Telehealth Programs
  • Experiential and Exposure Therapy

What We Treat

  • Anorexia Nervosa
  • Avoidant Restrictive Food and Intake Disorder (ARFID) – we are currently treating ARFID on an outpatient basis.
  • Bulimia Nervosa
  • Binge Eating Disorder
  • Other Specified Feeding and Eating Disorders (OSFED)

Our Team

  • On-site Psychiatrist, Internists, Physician Assistants, Nurse Practitioners, Registered Nurses
  • Executive Director, Doctor of Clinical Nutrition
  • Psychotherapists with specialized training in treating eating disorders
  • Registered Dietitians/Clinical Nutrition Specialists
  • Certified Recreation Therapists
  • Recovery Support Specialists


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Gail Hall is a licensed social worker, certified Eating Disorder Specialist, and Supervisor with the International Association of Eating Disorder Professionals. She has been treating eating disorders for over 30 years. Gail founded Comprehensive Treatment for Eating Disorders which is now Sanford CTED. SCTED provides state-of-the-art treatment in a personalized, intimate setting in Greater Grand Rapids, Michigan, and beyond. In addition, SCTED offers residential, PHP, IOP, Supportive Housing, outpatient, and family support to eating disorder patients.