When People Are Afraid of Eating
For many people, eating is a source of comfort, connection, and routine. But for individuals living with Avoidant Restrictive Food Intake Disorder, or ARFID, eating can cause intense fear, anxiety, and distress. Rather than being a pleasurable or neutral activity, food becomes something to be avoided. Although officially recognized as an eating disorder, ARFID is poorly understood and is often dismissed as simple picky eating. Mental health experts warn that this misunderstanding can have serious consequences for diagnosis, treatment and long-term health.
Beyond Picky Eating
ARFID is characterized by restrictive eating that leads to nutritional deficiencies, weight loss, dependence on supplements, or significant impairment of daily functioning. Unlike anorexia nervosa or bulimia, ARFID is not caused by concerns about body image, weight, or shape. Instead, avoidance stems from fear and anxiety about the food itself. Sensory sensitivities, fear of choking or vomiting, gastrointestinal upset, or symptoms of loss of appetite may all play a role. This distinction is very important, but is often overlooked, resulting in delays in appropriate care for those affected.
The Role of Anxiety
Mental health experts emphasize that anxiety is not just a side effect of ARFID, but is often the primary driver of this disorder. Dhara Ghuntla, psychologist and psychotherapist affiliated with Sujay Hospital, 7 Hills Hospital and Criticare Hospital, explains that anxiety often precedes eating in individuals with ARFID. “In ARFID, anxiety often precedes eating and is linked to fears of choking, vomiting, gastrointestinal upset, or sensory overload,” he says. “This anticipatory anxiety leads to avoidance, which temporarily reduces distress and thus reinforces restrictive patterns.”
This cycle of fear and avoidance is deeply ingrained. When avoiding food reduces anxiety, the brain learns to associate food with danger rather than nutrition. Over time, this pattern becomes automatic, making recovery increasingly difficult without professional intervention.
Food For Thought
Aakash Healthcare Psychiatry Assistant Consultant Dr. Pavitra Shankar identifies fear as a factor that both accelerates and perpetuates ARFID. “The fears that individuals experience are not irrational to them,” he notes. “They are perceived as direct dangers that trigger the body’s anxiety mechanism.” Dr. According to Shankar, repeated avoidance teaches the brain to respond to certain foods, textures, smells, or eating situations as threatening.
Although avoidance reduces anxiety in the short term, it prevents individuals from learning that eating may be safe. “Although avoidance temporarily reduces anxiety, it tends to unintentionally reinforce fear,” he explains. This process locks individuals in a self-perpetuating cycle in which anxiety fuels restraint, and restraint increases anxiety.
Physical and Emotional Toll
As ARFID progresses, anxiety may begin long before eating begins. Even the thought of eating can trigger nausea, gagging, or panic. Social situations around food can become overwhelming, leading to isolation and further distress. Dr. Shankar emphasizes that nutritional deficiencies resulting from restricted intake can worsen mood, concentration and emotional regulation. “The cycle of anxiety and limitation becomes a vicious cycle,” he says, warning that without intervention, ARFID can turn into a chronic condition rather than a temporary phase.
misconceptions
One of the biggest obstacles to effective treatment is the common misconception that ARFID is just extreme picky eating. Ghuntla explains that this belief often leads to symptoms being minimized or attributed to stubbornness, immaturity, or poor parenting. “As a result, diagnosis and appropriate intervention are delayed,” he says. “This mislabeling increases shame, disapproval, and family conflict, while untreated anxiety and nutritional deficiencies worsen overall mental health.”
Dr. Shankar adds that another common misconception is that all eating disorders involve body image concerns. Because many people with ARFID do not appear thin, their struggles are often overlooked or misattributed to gastrointestinal issues or general anxiety. These diagnostic delays can lead to long-term health complications and worsened mental health outcomes.
Diagnosis is Important
Experts emphasize that distinguishing ARFID from other eating disorders is essential for effective treatment. Ghuntla explains that ARFID requires anxiety-focused and exposure-based interventions rather than therapies focused on body image. “This distinction is clinically important,” he notes, as using the wrong treatment approach can leave the underlying problem unresolved.
When ARFID is correctly recognized, individuals can receive coordinated care that addresses both nutritional needs and underlying anxiety. Early intervention not only improves physical health but also reduces shame and self-blame, paving the way for recovery.
As awareness grows, mental health experts hope ARFID will no longer be dismissed as a minor or temporary problem. By recognizing ARFID as a serious mental health issue, families, clinicians, and society can move toward earlier diagnosis, compassionate care, and better outcomes for those whose relationship with food is shaped by fear rather than choice.
