Difficult Diagnosis: AN or ARFID

Is this ARFID or anorexia nervosa?

ARFID and Anorexia Nervosa presentations can be difficult to distinguish.

ARFID is somewhat similar to anorexia nervosa, in the sense that it involves extreme restriction of dietary intake. This can make the two diagnoses difficult to distinguish.  

However, when someone has ARFID, food restriction is not based on a fear of weight gain, but rather of the consequence of eating a specific type of food (i.e. fear of choking, vomiting), or an aversion to a particular type of food. Such aversions can be to a food itself, its texture, colour, smell or food group. 

About Avoidant/Restrictive Food Intake Disorder (ARFID) 

ARFID is characterised by:

An eating problem that results in failure to meet nutritional and/or energy requirements such as: 

  • Avoidance of sensory characteristics of food
  • Lack of appetite
  • Concern about aversive consequence of eating

Usually, individuals with ARFID will refuse to consume specific foods and sometimes will use physical measures, such as constricting their throats, to prevent the consumption of food.  

It can be difficult to distinguish between ARFID and regular picky eating behaviours. However, regular picky eaters typically meet their nutritional requirements, but those with ARFID struggle to meet these requirements and demonstrate a much stronger and pervasive refusal to eat specific foods.