ARFID: It's Not a Choice - It's Biology! (Post 2 of 5)

Causes of ARFID

ARFID can arise from a combination of physiological and behavioral factors, and it typically falls into one or more of the following three subtypes:

1. Sensory Sensitivity

People with this subtype are highly sensitive to the taste, texture, smell, or appearance of certain foods. This can lead to an extremely limited range of acceptable foods — for example, only eating bland, soft, or beige-colored foods. The aversion is often so strong that the person may gag or feel nauseated when trying new or disliked foods. This sensory-based avoidance is thought to be linked to differences in the way the brain processes sensory information.

2. Fear of Aversive Consequences

This subtype develops after a negative food-related experience, such as choking, vomiting, or severe abdominal pain. The person becomes intensely fearful that eating certain foods — or even eating in general — will lead to the same distressing outcome. This fear can escalate into full-blown avoidance, even when there’s no ongoing medical reason to be concerned.

3. Low Interest in Eating

Some individuals with ARFID simply don’t experience hunger cues or find food appealing. They may feel full quickly or describe eating as a chore rather than something enjoyable. This can stem from underlying differences in appetite regulation or brain signaling related to food and reward.

It’s Not a Choice – It’s Biology!

Research suggests that individuals with ARFID patterns have differences in gut function, sensory processing, or even hormonal regulation of hunger and fullness. Additionally, the brain’s reward system may play a role as the brain may not reinforce the pleasant feelings of eating with a burst of dopamine when we eat, which means eating feels like a chore and a bother.

Studies also show that different subtypes are commonly linked to co-occurrence of other mental health and health issues.

1. Autism

2. Sensory Processing Disorder

3. Anxiety Disorders and OCD

4. ADHD

5. Food allergies

6. Gastrointestinal disorders such as Chron's, IBS, GERD, and EoE

Biology Leads to Behavior

These biological factors lead a person to begin avoiding eating or developing poor routines around food, which then exacerbate and reinforce the problem.

1.      Avoiding leads to more avoiding.  As a person avoids a feared or uncomfortable food and experiences immediate relief, the brain reinforces that behavior.  As their range of foods becomes smaller, they have less exposure to different textures, tastes, and smells which reinforces their rigid preferences and further shrinks their pallet. 

2.      Avoiding leads to poor metabolic signaling.  It’s typical for a person with ARFID to develop irregular eating patterns like eating very small meals, snacking constantly through the day, taking an hour or more to eat a meal, skipping meals, or making up for a calorie deficit with a very large meal every few meals (or every few days).  The body’s metabolic and hunger/fullness signaling gets thrown off which exacerbates the issue further.

3.      Avoiding leads to strong habit loops.  Over time, this creates a strong habit loop — avoidance feels more comfortable, so the behavior becomes increasingly automatic, making it even harder to break the cycle.  Eating can feel inconvenient or bothersome, or a person just may not develop the skills and habits to build food preparation and breaks into their day.

Over time, these become self-reinforcing vicious cycles – but there is a way out!  It’s important to understand this isn’t a choice, and it isn’t your child being willfully stubborn.  Eating just isn’t the same for them. With the right support — including medical, nutritional, and therapeutic interventions — individuals with ARFID can gradually expand their diet and reclaim the parts of life that their eating challenges have taken away.

Read on to discover more, or feel free to reach out to us to start your journey to healthy eating habits that work for you and your family! 

Read the First Post in this Series:

Is it ARFID?

Up Next:

Signs of ARFID

Spectrum of ARFID presentation

Misunderstandings about ARFID

Effective ARFID Treatment and Recovery