Avoidant/Restrictive Food Intake Disorder (ARFID)

Definition, Warning Signs, Treatment

Avoidant/Restrictive Food Intake Disorder (ARFID), previously known as Selective Eating Disorder, is a condition characterized by a persistent failure to meet appropriate nutritional and/or energy needs. It distinguishes itself from more well-known eating disorders like anorexia nervosa and bulimia nervosa in that it doesn't necessarily involve distress about body shape or size, or a pursuit of thinness. Instead, individuals with ARFID may avoid or restrict food intake due to a lack of interest in eating; aversion to certain colors, textures, or smells of food; or a fear of aversive consequences, such as choking or vomiting.

Understanding ARFID

ARFID goes beyond picky eating in childhood. It can persist into adulthood and may significantly impair an individual's health, growth, and development due to nutritional deficiencies. Individuals with ARFID might also experience social difficulties, such as avoiding social events where food is involved due to their eating restrictions or fears.

Warning Signs of ARFID

Recognizing ARFID can be challenging, as symptoms can be mistaken for normal pickiness or a phase in children. However, signs that may indicate a more serious issue include:

  • Dramatic restriction in types or amounts of food eaten: This might include eating only foods of certain textures or colors, or avoiding entire food groups.

  • Significant weight loss or failure to achieve expected weight gain in children: This can be a sign of not getting enough nutrients to support healthy growth.

  • Nutritional deficiencies leading to health problems: Such as anemia, digestive issues, or developmental delays.

  • Psychological distress related to food intake: Anxiety or fear around eating that leads to avoidance of certain foods or eating situations.

  • Dependency on nutritional supplements or tube feeding: In more severe cases, individuals might rely on these for adequate nutrition.

  • Avoidance of social situations involving food: Due to embarrassment or anxiety about eating habits.

Treatment Options

Treating ARFID typically requires a multidisciplinary approach tailored to the specific reasons behind the food avoidance or restriction. Treatment may involve:

  • Nutritional counseling: A registered dietitian can help develop a plan to address nutritional deficiencies and gradually expand the variety of foods eaten.

  • Cognitive-behavioral therapy (CBT): Especially adapted for ARFID, CBT can help individuals change their thoughts and behaviors related to food and eating.

  • Exposure therapy: Gradually exposing the individual to feared foods in a structured and supportive environment can reduce anxiety and increase the variety of foods tolerated.

  • Family therapy: Involving family members in treatment can be especially helpful for children and adolescents, providing them with support and understanding from their loved ones.

  • Occupational therapy: If sensory sensitivities are present, occupational therapy can help individuals become more accustomed to different food textures and types.

Moving Forward

Recovery from ARFID is a gradual process of relearning and expanding the range of foods one is willing to eat, addressing nutritional deficiencies, and overcoming the anxiety or fear associated with eating. It requires patience, support, and professional guidance. With the right treatment plan and support system, individuals with ARFID can achieve a balanced diet and improve their quality of life. Remember, taking the first step toward seeking help is a brave and critical move toward recovery.