Skip to Content

Avoidant/Restrictive Food Intake Disorder


Evelyn Attia

, MD, Columbia University Medical Center, New York State Psychiatric Institute;

B. Timothy Walsh

, MD, College of Physicians and Surgeons, Columbia University

Last full review/revision Jun 2020| Content last modified Jun 2020

Avoidant/restrictive food intake disorder is an eating disorder characterized by eating very little food and/or avoiding eating certain foods. It does not include having a distorted body image (as occurs in anorexia nervosa) or being preoccupied with body image (as occurs in bulimia nervosa).

  • Avoidant/restrictive food intake disorder can cause substantial weight loss, slower-than-expected growth in children, difficulty participating in normal social activities, and sometimes life-threatening nutritional deficiencies.
  • Doctors base the diagnosis on the nature of the restricted food intake and its effects after they have ruled out other causes of eating very little.
  • Cognitive-behavioral therapy can help people learn to eat normally and help them feel less anxious about what they eat.

Avoidant/restrictive food intake disorder typically begins during childhood and may initially resemble the picky eating that is common during this phase of life. For example, children may refuse to eat certain foods or foods of a certain color, consistency, or odor. However, picky eating typically involves only a few foods, and children who are picky eaters, unlike those with this disorder, have a normal appetite, eat enough food overall, and grow and develop normally.

People with avoidant/restrictive food intake may not eat because they lose interest in eating or because they think eating has harmful consequences. They may avoid certain foods because of their color, consistency, or odor.


People with avoidant/restrictive food intake disorder eat very little and/or avoid eating certain foods. They may eat so little that they lose a substantial amount of weight. Children with the disorder may not grow as expected.

Nutritional deficiencies are common and may become life threatening.

Because of their problems with eating, people with this disorder may have difficulty participating in normal social activities, such as eating with other people and maintaining relationships with others.


  • A doctor's evaluation
  • Tests to check for physical disorders
  • Evaluation for other mental disorders

Doctors suspect avoidant/restrictive food intake disorder in people who avoid food or eat very little and have one or more of the following:

  • Significant weight loss or, in children, not growing as expected
  • A severe nutritional deficiency
  • The need for tube feeding or for nutritional supplements taken by mouth
  • Great difficulty participating in normal social activities and interacting with others
  • No evidence of a distorted body image

When people eat so little that they lose weight and develop nutritional deficiencies, doctors typically do tests for physical disorders that can cause such problems. Such physical disorders include food allergies, digestive tract disorders that impair food absorption (malabsorption), and cancer.

Doctors also consider other mental disorders that sometimes lead to weight loss, such as other eating disorders (particularly anorexia nervosa or bulimia nervosa), depression, and schizophrenia. Doctors do not diagnose avoidant/restrictive food intake disorder if people restrict their food intake because food is unavailable or is part of a cultural tradition (such as religious fasting).

Usually, doctors also do not diagnose avoidant/restrictive food intake disorder if they identify another disorder or a medical treatment (such as radiation therapy or chemotherapy) as the cause.


  • Cognitive-behavioral therapy

Cognitive-behavioral therapy may be used to help people with avoidant/restrictive food intake disorder learn to eat normally. It can help them feel less anxious about what they eat.

More Information

The following is an English-language resource that may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

  • National Eating Disorders Association (NEDA): Large nonprofit organization that provides access to online screening tools, a helpline, forums, and a variety of support groups (some virtual)

Copyright © 2022 Merck & Co., Inc., known as MSD outside of the US, Kenilworth, New Jersey, USA. All rights reserved. Merck Manual Disclaimer