Which disorder is characterized by an eating or feeding disturbance with persistent failure to meet nutritional and energy needs, not due to anorexia or bulimia?

• A. Autism Spectrum Disorder
• B. Avoidant/Restrictive Food Intake Disorder
• C. Specific Neurological/Neuromuscular, Structural, or Congenital Disorders and Conditions Associated with Feeding Difficulties
• D. Social Anxiety Disorder

Answer: (B)

Avoidant/Restrictive Food Intake Disorder centers on a pattern of eating that fails to meet nutritional and energy needs, without being driven by concerns about body weight or shape. The key is persistent, restrictive or highly selective eating that leads to problems like weight loss or deficiency, or a need for supplements, or interference with daily functioning. This isn’t about wanting to be thin or about body image; it’s about the eating pattern itself causing harm.

Those who struggle with this may avoid many foods due to disliking textures or sensory features, have a limited range of accepted foods, or fear negative consequences from eating (like choking or vomiting). Over time, the restriction produces measurable nutritional or energy deficits or psychosocial disruption. It’s also important that the eating disturbance isn’t better explained by another medical condition or by another mental disorder, though ARFID can co-occur with other conditions.

Autism spectrum disorder can involve picky eating, but the defining diagnosis isn’t the nutritional shortfall itself. Social anxiety can affect eating in social settings but doesn’t by itself account for persistent nutritional deficits across contexts. The medical-condition–related category applies when a known neurological, neuromuscular, structural, or congenital condition accounts for feeding difficulties; ARFID is identified when the feeding disturbance is not better explained by those medical factors.