Avoidant/Restrictive Food Intake Disorder (ARFID)

Avoidant/Restrictive Food Intake Disorder (ARFID) is a disorder in which people have difficulty eating or restrict their diets to specific types of food. However, ARFID is different than anorexia and bulimia because ARFID sufferers are not trying to lose weight. Instead, they often suffer from sensory sensitivities that cause them to avoid certain textures or tastes. ARFID can be treated with individualized therapies that work on the symptoms of ARFID unique to each person.

What is ARFID?

Individuals with ARFID have no specific body image dissatisfaction or fears of weight gain.  Instead, they avoid food for other reasons, including:

  • Lack of interest
  • Dislike of certain sensory characteristics like “crunchy” or “mushy”
  • Preoccupation with the potential for choking or vomiting after eating

ARFID can be distinguished from normal “picky eating” by assessing the consequences of the behavior. The individual might suffer serious nutritional deficits or weight loss or have a need for nutritional supplements as a result of their food restrictions.  The individual may have impaired social functioning, require frequent food accommodation from others, avoid activities related to food, and/or experience conflict with others because of their food behaviors.  In these instances, whether the difficulty is physical or social, a diagnosis of ARFID should be considered.

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Diagnosis

ARFID can be diagnosed by using the criteria in the DSM-5, explained below:

  • Inability or refusal to eat no matter what food source it comes from
  • Focusing on one specific kind of food exclusively
  • Emotional responsivity upon ingestion/swallowing any type and amount (strong negative emotions).

A lack of appropriate nutrition can lead to a person not meeting their energy needs. If left untreated, ARFID may result in:

-Weight loss or pause in growth development due to low caloric intake

-Physical delays including developmental regression and alterations at the psychomotor level

Symptoms and warning signs

ARFID has several associated warning signs that parents and caregivers may identify. These include:

  • weight loss
  • dressing in layers
  • digestive issues
  • restricting types of food
  • limited food intake
  • eating foods with specific textures
  • feeling sick before mealtimes
  • weakness or excessive energy
  • fear of choking/vomiting

Who Develops ARFID?

Individuals with ARFID often have symptoms beginning in infancy or childhood.  Most individuals have symptoms that begin prior to age 5, and some much younger.  Adults can develop ARFID too although this is less common. All genders are equally impacted.  Many individuals have other psychological conditions such as depression or anxiety that occur together. 

Treatment Options

SpringSource Psychological Center has an intensive assessment process in which the ARFID symptoms will be identified and a treatment plan created to target presenting symptoms.  Individuals are guided through progressively more challenging exposures to feared foods or eating experiences and provided with support and skills to manage negative reactions.  Over the course of the exposures, distress is decreased.  Treatment is focused on restoring an individual’s nutrition and in some cases, weight, to safe levels.  Therapy and medication can be combined to target additional mental health concerns such as low mood or high anxiety.

Although the term ARFID may be relatively new, treatments draw from well-established therapeutic techniques (CBT, DBT, Exposure Therapy).  At SpringSource, therapists are trained in these modalities and provide a targeted approach to symptoms.

Summary

“ARFID” is a condition caused by restrictive eating patterns, but those with ARFID are much more than  “picky eaters.” People with this disorder might develop delays in their development or growth. They also have long-term effects on health and well-being as they grow up.

It’s a good idea to talk to the experts at SpringSource Psychological Center about ARFID. You can’t just ignore this condition and hope for the best because ARFID is a dangerous disorder that requires treatment. ARFID is an actual, serious condition, and the earlier it is treated, the faster you can get back on track with your life.

We look forward to hearing from you. 

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