National Eating Disorders Association

The chance for recovery increases the earlier an eating disorder is detected. Therefore, it is important to be aware of some of the warning signs of an eating disorder. 

An individual with ARFID generally won’t have all of these signs and symptoms at once, and warning signs and symptoms vary across eating disorders, so this isn’t intended as a checklist. Rather, it is intended as a general overview of the types of behaviors that may indicate an eating disorder. If you have any concerns about yourself or a loved one, please seek additional medical help.

Behavioral and psychological signs of ARFID

  • Dramatic weight loss
  • Dresses in layers to hide weight loss or stay warm
  • Complains of constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy
  • Consistent, vague gastrointestinal complaints (“upset stomach”, feels full, etc) around mealtimes that have no known cause
  • Postpuberty female loses menstrual period
  • Dramatic restriction in types or amount of food eaten
  • Will only eat certain textures of food
  • Fears of choking or vomiting
  • Lack of appetite or interest in food
  • Limited range of preferred foods that becomes narrower over time (i.e., picky eating that progressively worsens).
  • No body image disturbance or fear of weight gain

Physical signs of ARFID

Because both anorexia and ARFID involve an inability to meet nutritional needs, both disorders have similar physical signs and medical consequences.

  • Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid
  • reflux, etc.)
  • Menstrual irregularities—missing periods or only having a period while on hormonal
  • contraceptives (this is not considered a “true” period)
  • Difficulties concentrating
  • Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate)
  • Dizziness
  • Fainting/syncope
  • Feeling cold all the time
  • Sleep problems
  • Dry skin
  • Dry and brittle nails
  • Fine hair on body
  • Thinning of hair on head, dry and brittle hair (lanugo)
  • Muscle weakness
  • Cold, mottled hands and feet or swelling of feet
  • Poor wound healing
  • Impaired immune functioning

References:

Steinglass, J., Mayer, L., & Attia, E. (2015). 13 Treatment of Restrictive Eating and. Handbook of Assessment and Treatment of Eating Disorders, 3.