Avoidant/Restrictive Food Intake Disorder (ARFID): Mechanisms, Interventions, and Developmental Trajectories Across Contexts

Avoidant/Restrictive Food Intake Disorder (ARFID) represents a rapidly evolving area in eating behavior and disorder research, with increasing attention since its inclusion in the DSM-5 in 2013. ARFID is distinct from other eating disorders, as sensory sensitivities, fears surrounding adverse experiences with food, or lack of interest in eating, lead to considerable nutritional, physical, and psychosocial impacts rather than weight/shape concerns. Recent studies have highlighted complex neurobiological processes, atypical interoceptive awareness, and strong associations with neurodevelopmental and anxiety conditions underlying ARFID, yet its etiology, maintenance mechanisms, public health impact, treatment response, and presentation variation require further research exploration. Despite advances in assessment and the development of specialized interventions, further insight into understanding the unique neurobiological underpinnings of avoidant/restrictive eating, refining subtypes of ARFID, and determining effective, personalized treatment approaches is needed.Equally, ARFID does not occur in a vacuum. How disordered eating is perceived, recognized, and assessed varies significantly across socio-cultural and geographic contexts, shaping both clinical pathways and lived experience. Diagnostic frameworks developed largely in Western settings may not adequately capture presentations in other populations, contributing to under-recognition, delayed intervention, or misclassification. Likewise, ARFID intersects with specific life contexts and demands. For example, athletic populations, where restrictive eating patterns may be unclear, conflated with, or compounded by the nutritional and psychological pressures of sport. A more contextually attuned, multidisciplinary, and culturally informed evidence base is needed to support equitable recognition and care. A further priority area is the overlap between ARFID and neurodivergence, particularly autism and ADHD. Shared features such as sensory differences, interoceptive variation, and detail-focused attentional styles can lead to ARFID being overlooked in neurodivergent individuals, with appropriate treatment delayed or withheld. There is growing consensus on the need for tailored, neuroaffirmative approaches to assessment, diagnosis, and treatment that recognize ARFID across the full range of neurotypes and account for co-occurring physical and mental health conditions.This Research Topic aims to expand knowledge on ARFID by integrating emerging evidence on its underlying mechanisms, exploring dimensional and tailored assessment strategies, and evaluating innovative interventions. The topic seeks to address how neurobiological factors and sensory processing play a role, how individual profiles affect presentation, and types of interventions across varied developmental stages, cultural contexts and populations. By consolidating research spanning the lifespan and diverse clinical, sociocultural and performance-related presentations, this collection seeks to enhance a further, more globally representative understanding of ARFID’s origins, trajectories, and best practices for clinical approaches and management. Recognizing the need for comprehensive and multidimensional insight, this collection welcomes articles addressing, but not limited to, the following themes:• Mechanistic and etiological factors of ARFID: neurobiological underpinnings, sensory and interoceptive processing, emotional regulation, anxiety, and neurodevelopmental profiles.• ARFID assessment and classification approaches: novel psychometrics (including parent- and self-report measures and large-scale screening tools), dimensional perspectives, data-driven and idiographic classification, and subtype refinement.•Treatment innovation and outcomes: cognitive-behavioral therapy adaptations, exposure and family-based therapies, occupational therapy and functional approaches, virtual reality, interoceptive approaches, multidisciplinary models that reduce barriers to care, and pharmacological adjuncts; including naturalistic and long-term follow-up outcomes.• Lifespan and developmental trajectories: ARFID across pediatric, adolescent, and adult populations, including longitudinal studies and late identification.• Neurodivergence and ARFID: overlap with autism and ADHD, diagnostic inconsistencies, support pathways, and neuroaffirmative care approaches.• Specific populations and comorbidities: presentations in the context of athletic performance and implications for performance, recovery and long-term health; food allergy; gastrointestinal symptoms; gut–brain interaction; anxiety disorders; and other co-occurring medical and mental health conditions.• Sociocultural and contextual perspectives: cross-cultural differences in how ARFID is conceptualized, recognized, and assessed; geographic and demographic diversity in clinical presentation; and equity in access to diagnosis and care.Original research articles, systematic reviews, meta-analyses, case studies, and perspective pieces are welcome to advance the psychological, behavioral, developmental, sociocultural, and therapeutic understanding of ARFID.Topic editor Dr. Kendra R. Becker practices at a private clinical practice, is a consultant for Emerge EQ Inc, expert witness for King and Spalding LLP and receives royalties from Cambridge University Press. The other Topic Editors report no competing interests related to this Research Topic. Topic editors: Valerie Volkert, Kendra R Becker, Evelyna Kambanis Source: https://www.frontiersin.org/research-topics/83214/avoidantrestrictive-food-intake-disorder-arfid-mechanisms-interventions-and-developmental-trajectories-across-contexts