Avoidant Restrictive Food Intake Disorder (ARFID)

Avoidant Restrictive Food Intake Disorder (ARFID), is a psychological disorder that causes the affected person to have various feeding and eating problems. This disorder is much more severe than ‘picky’ eating or being ‘health conscious.’ It can cause affected people to have serious physical and medical problems due to nutritional deficiencies. 

ARFID is a newer disorder that was introduced into the DSM-V (formerly known as Selective Eating Disorder). Many people, even healthcare professionals, don’t know much about it as research is limited. In fact, 63% of pediatricians and other medical specialists are unaware of ARFID as a diagnosis for people struggling with feeding and eating problems.

Let’s first review the symptoms of the disorder.

• A lack of interest in eating or in food overall

• An avoidance of food due to sensory characteristics (for example, the texture of food or the way it feels in the mouth, the scent of certain food)

• Concerns about the consequences of eating (for example, weight gain, physical pain, gastrointestinal upset, fear of choking or inability to swallow )

• A failure to meet healthy nutritional and/or calorie needs related to one or more of the following:

  • Significant weight loss

  • Significant nutritional deficiency

  • Dependence on other methods of taking in food (for example, nutritional supplements like shakes or vitamins)

  • The eating problems cause issues in the person’s ability to function on a daily basis

ARFID occurs in both adults and children and although adult onset is common, symptoms can sometimes be detected in early childhood. A total of up to 5% of children can be affected by this disorder and it is more common in males than females.

Treatment

Due to the severity of ARFID, it is best treated by a mental health professional who specializes in feeding and eating disorders. Cognitive Behavioral Therapy (CBT) is an excellent treatment for ARFID. In CBT, the therapist helps to guide the client in identifying thoughts and feelings related to unhealthy and dangerous eating behaviors. Once the client is able to identify and understand their own thought-feeling-behavior pattern related to food and eating, the client is then guided in replacing negative thoughts, feelings, and behaviors with more positive alternatives. CBT also teaches various coping skills to manage co-occurring depression, low self-esteem, obsessions and compulsions, and/or anxiety, which are common among individuals with ARFID.

Exposure therapy is a type of behavioral therapy that is also effective for people struggling with ARFID. This type of therapy, provided by a mental health professional who specializes in treating people with eating disorders, teaches the client relaxation strategies and other important coping skills so that the client can be gradually exposed to feared situations related to food and eating. The exposure occurs as slowly as necessary in order to empower the client to face his/her fears. Exposure can be done in-vivo (i.e., live) or imaginal (i.e., by the client imagining him/herself engaging in certain behaviors related to eating). The purpose of exposure therapy is to gain awareness into the thought process and to lessen the associated fear and anxiety around the particular food. The more often a client endures exposure and sits with the feelings, the more tolerant they become of the food that they fear.

If you suspect you struggle with or have questions about ARFID, feel free to contact my office.

After all, the first step to clarity and peace of mind is to #JustBegin