Evaluation and Treatment of Avoidant/Restrictive Food Intake Disorder (ARFID) in Adolescents

  • Kathryn S. Brigham
  • Laurie D. Manzo
  • Kamryn T. Eddy
  • Jennifer J. Thomas
Adolescent Medicine (M Goldstein and L Johnson, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Adolescent Medicine


Purpose of Review

Avoidant/restrictive food intake disorder (ARFID) was added to the psychiatric nomenclature in 2013. However, youth with ARFID often present first to medical—rather than psychiatric—settings, making its evaluation and treatment relevant to pediatricians.

Recent Findings

ARFID is defined by limited volume or variety of food intake motivated by sensory sensitivity, fear of aversive consequences, or lack of interest in food or eating; and associated with medical, nutritional, and/or psychosocial impairment. It appears to be as common as anorexia nervosa and bulimia nervosa and can occur in individuals of all ages. ARFID is heterogeneous in presentation and may require both medical and psychological management.


Pediatricians should be aware of the diagnostic criteria for ARFID and the possibility that these patients may require medical intervention and referral for psychological treatment. The neurobiology underlying ARFID is unknown, and novel treatments are currently being tested.


Avoidant/restrictive food intake disorder ARFID Eating disorder Nutrition deficiencies Cognitive-behavioral therapy CBT-AR 


Compliance with Ethical Standards

Conflict of Interest

Kathryn S. Brigham and Laurie D. Manzo each declare no potential conflicts of interest. Kamryn T. Eddy and Jennifer J. Thomas declare future book royalties from Cambridge University Press.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Kathryn S. Brigham
    • 1
    • 2
  • Laurie D. Manzo
    • 1
    • 3
  • Kamryn T. Eddy
    • 3
    • 4
  • Jennifer J. Thomas
    • 3
    • 4
  1. 1.Division of Adolescent and Young Adult MedicineMassachusetts General HospitalBostonUSA
  2. 2.Department of PediatricsHarvard Medical SchoolBostonUSA
  3. 3.Eating Disorders Clinical and Research ProgramMassachusetts General HospitalBostonUSA
  4. 4.Department of PsychiatryHarvard Medical SchoolBostonUSA

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