07/09/2025
ARFID Petition
Please sign the Petition advocating for individuals with a diagnosis of Avoidant/Restrictive Food Intake Disorder (ARFID) to be eligible for rebated eating disorder care.
Why the Petition?
ARFID is characterised by persistent difficulty eating sufficient amounts or varieties of food, leading to significant weight loss, nutritional deficiencies, dependence on supplements or enteral feeding, and/or low psychosocial wellbeing. Unlike anorexia nervosa or bulimia nervosa, ARFID is not driven by concerns about weight or body shape but rather by sensory sensitivities, fear of aversive consequences (e.g., choking, vomiting), or low interest in food (Ramirez & Gunturu, 2024; Fonseca et al., 2024).
According to meta-analytic investigations, ARFID has an estimated pooled community point prevalence of up to 11% (Nicholls-Clow et al., 2024), compared to 3% for anorexia nervosa (Galmiche et al., 2019). Autistic children are disproportionately represented among those diagnosed with ARFID. Recent evidence shows that up to 54.8% of children with ARFID are autistic while 21% of autistic children are deemed at risk of ARFID according to a genetic study (Cobbaert et al., 2024).
ARFID-specific screening and diagnostic tools should be incorporated into Medicare eligibility assessments for eating disorder care (Eating Disorder Treatment and Management Plan, EDP). While ARFID is predominantly conceptualised in the context of childhood, the medical literature highlights that it is a chronic and lifelong disability that also impacts adults (Ruiz Fischer & Starr, 2024; MacDonald et al., 2024). Therefore, ARFID care must extend beyond childhood and include autistic adults as well. At present, the exclusive reliance on the Eating Disorder Examination Questionnaire (EDE-Q) to assess eligibility for an EDP excludes those with a diagnosis of ARFID, rendering them unable to access rebated eating disorder care. Indeed, the EDE-Q primarily focuses on anorexia nervosa and bulimia nervosa and is not intended to assess ARFID. Expanding assessment criteria to include validated tools such as the Nine Item ARFID Screener (NIAS) (Zickgraf & Ellis, 2018) would help ensure that autistic children and adults with ARFID are not systematically excluded from essential care pathways.
ARFID is a severe eating disorder with a higher estimated prevalence than anorexia nervosa and disproportionately affects autistic individuals. ARFID has serious consequences ranging from malnutrition and cognitive difficulties to permanent organ damage (blindness, osteoporosis) and death (Schimansky et al., 2024; Bourke et al., 2025; Birmingham Mail, 2024).The serious medical, nutritional, psychosocial, and cognitive consequences of ARFID are well-documented in the academic literature (James et al., 2024; Fonseca et al., 2024; Ramirez & Gunturu, 2024). The exclusion of ARFID from current Medicare eating disorder care urgently needs to be addressed to ensure affected individuals receive the multidisciplinary and lifesaving support they require.
References
Birmingham Mail. (2024, January 13). Mum’s warning after boy died after battling undiagnosed eating disorder. Birmingham Mail. Retrieved September 5, 2025, from https://www.birminghammail.co.uk/news/uk-news/mums-warning-after-happy-schoolboy-28440516
Bourke, C., Panteli, V., Marmoy, O. R., Thompson, D. A., Mankad, K., Sudhakar, S., James, G., Garnham, J., Connor, A., Cheung, M. S., & Bowman, R. (2025). Optic neuropathy associated with vitamin A deficiency in children: A case series. Journal of AAPOS. https://doi.org/10.1016/j.jaapos.2025.104277
Cobbaert, L., Millichamp, A. R., Elwyn, R., Silverstein, S., Schweizer, K., Thomas, E., & Miskovic-Wheatley, J. (2024). Neurodivergence, intersectionality, and eating disorders: A lived experience-led narrative review. Journal of Eating Disorders, 12(1), 187. https://doi.org/10.1186/s40337-024-01126-5
Fonseca, N. K. O., Curtarelli, V. D., Bertoletti, J., Azevedo, K., Cardinal, T. M., Moreira, J. D., & Antunes, L. C. (2024). Avoidant restrictive food intake disorder: recent advances in neurobiology and treatment. Journal of Eating Disorders, 12(1), 74. https://doi.org/10.1186/s40337-024-01021-z
Galmiche, M., Déchelotte, P., Lambert, G., & Tavolacci, M. P. (2019). Prevalence of eating disorders over the 2000-2018 period: a systematic literature review. The American journal of clinical nutrition, 109(5), 1402–1413. https://doi.org/10.1093/ajcn/nqy342
James, R. M., O'Shea, J., Micali, N., Russell, S. J., & Hudson, L. D. (2024). Physical health complications in children and young people with avoidant restrictive food intake disorder (ARFID): a systematic review and meta-analysis. BMJ Paediatrics Open, 8(1), e002595. https://doi.org/10.1136/bmjpo-2024-002595
MacDonald, D. E., Liebman, R., & Trottier, K. (2024). Clinical characteristics, treatment course and outcome of adults treated for avoidant/restrictive food intake disorder (ARFID) at a tertiary care eating disorders program. Journal of Eating Disorders, 12(1), 15. https://doi.org/10.1186/s40337-024-00973-6
Nicholls-Clow, R., Simmonds-Buckley, M., & Waller, G. (2024). Avoidant/restrictive food intake disorder: Systematic review and meta-analysis demonstrating the impact of study quality on prevalence rates. Clinical Psychology Review, 114, 102502. https://doi.org/10.1016/j.cpr.2024.102502
Ramirez, Z., & Gunturu, S. (2024). Avoidant restrictive food intake disorder. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK603710/
Ruiz Fischer, M. M., & Starr, R. A. (2024). A tradeoff between safety and freedom: Adults' lived experiences of ARFID. Journal of Eating Disorders, 12(1), 107. https://doi.org/10.1186/s40337-024-01071-3
Schimansky, S., Jasim, H., Pope, L., Hinds, P., Fernandez, D., Choleva, P., Dev Borman, A., Sharples, P. M., Smallbone, T., & Atan, D. (2024). Nutritional blindness from avoidant-restrictive food intake disorder - recommendations for the early diagnosis and multidisciplinary management of children at risk from restrictive eating. Archives of Disease in Childhood, 109(3), 181–187. https://doi.org/10.1136/archdischild-2022-325189
Zickgraf, H. F., & Ellis, J. M. (2018). Initial validation of the Nine Item Avoidant/Restrictive Food Intake disorder screen (NIAS): A measure of three restrictive eating patterns. Appetite, 123, 32–42.https://doi.org/10.1016/j.appet.2017.11.111
Credit: Eating Disorders Neurodiversity Australia (EDNA)
https://www.aph.gov.au/e-petitions/petition/EN7379
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