What is ARFID?: Signs & Symptoms

 

Written by CCTC Staff Writer

Picky eating is not uncommon. But when does picky eating go too far? Avoidant and restrictive behaviors around food can be a sign of ARFID. ARFID is an eating disorder that stands for Avoidant/Restrictive Food Intake Disorder. While this eating disorder has potentially dangerous consequences, recovery is possible with the right care. Read on to learn more about ARFID. 


In this blog we will cover:

  • What ARFID is

  • Who is most likely at risk for struggling with ARFID

  • The physical and psychological signs of ARFID

  • The difference between ARFID and picky eating

  • What the dangers or ARFID are 

  • Whether or not those suffering with ARFID experience preoccupation with body image and weight

  • What recovery entails for ARFID 

What does ARFID stand for?

ARFID stands for Avoidant/Restrictive Food Intake Disorder. ARFID is a new addition to the DSM-5, the official list of psychiatric diagnoses used by mental health professionals in 2013.

What is ARFID?

ARFID is characterized by disturbances in eating or feeding behaviors. These behaviors may result in weight loss, nutritional deficiencies, and overall well being and functioning.

ARFID, like any eating disorder, can impact individuals of all ages, races and genders. ARFID is more often diagnosed in children and adolescents, but can occur in adults. Once in treatment, it is typical for adults with ARFID to connect their current behaviors to ones they struggled with since early childhood. A negative food related experience that resulted in choking or vomiting may also trigger the development of avoidant or restrictive behaviors.

Parents of children struggling with ARFID may have experienced challenges in their child’s range of intake such as refusal to eat specific foods or displaying strong food preferences as early as one year of age.

How someone experiences ARFID will vary person to person. Below are some signs and symptoms to look out for.

Psychological signs of ARFID:

  • Fears of vomiting or choking while eating or drinking

  • Lacks interest in food or appetite

  • Picky eating habits increase

  • Limiting food intake based on texture preferences

  • Frequent complaints of upset stomach or feeling full at times of eating

  • Difficulty eating with or around other people

Physical signs can include:

  • Stomach cramping

  • Intolerance to cold temperatures

  • Menstrual irregularities

  • Difficulty concentrating and focusing

  • Experiencing dizziness or fainting

  • Brittle hair and nails

  • Sleep-related issues

  • Fatigue

To meet diagnostic criteria, food restriction cannot be explained by lack of food, a culturally sanctioned practice (ie: religion), or another medical issue that if treated would solve the eating problem. The avoidant and restrictive behaviors must also lead to one of the following:

  • Dependence on tube feeding or oral nutritional supplements

  • Difficulty engaging in daily life due to shame, anxiety or inconvenience

  • Significant nutritional deficiency

  • Significant weight loss (or failure to make expected weight gain in children)

What causes ARFID?

The exact cause of ARFID is unknown, but it is thought to be a combination of biological, psychological, and social factors. Like all eating disorders and mental health problems, it is important to remember that ARFID is not the person’s fault.

Is ARFID just picky eating?

Most kids may avoid or dislike trying new foods due to appearance, taste, smell and texture. In fact, between 13% and 22% of children between the ages of three and eleven are considered picky eaters. Many wonder, is ARFID really just picky eating? The short answer is no. While ARFID and normal picky eating share some similarities, ARFID often leads to physical consequences and mental distress.

What are the dangers of ARFID?

ARFID can be dangerous, especially when it interferes with weight, growth and functioning.

ARFID can lead to malnutrition, which can in turn lead to a number of serious health complications. Additionally, people with ARFID may also be at risk for developing other mental health disorders, such as anxiety or depression.

Do those struggling with ARFID worry about weight and body image?

Unlike other eating disorders such as anorexia, bulimia, or binge eating disorder, those suffering with ARFID typically do not have concerns about weight or body image. While weight loss may result from avoidant and restrictive behaviors, weight and body image concerns are not motivating the disordered behaviors.

What does recovery from ARFID entail?

There is no single “right” way to recover from an eating disorder. However, treatment for ARFID typically includes some combination of nutritional counseling, therapy, and support groups.

Evaluating the severity of malnourishment is an essential first step to determining the right level of care for someone struggling with ARFID. Oftentimes, a more intensive setting such as a residential facility or hospital is necessary to stabilize any medical issues before stepping down to an outpatient treatment programming or partial hospitalization programming.

It is not uncommon for those diagnosed with ARFID to struggle with other mental health conditions such as anxiety, mood disorder, ADHD, or another condition such as autism spectrum disorder. Addressing these co-occurring conditions and underlying issues is important as they may be contributing to the eating behaviors.   

Treatment or ARFID will typically include a focus on exposure therapy. Exposure Therapy is one of the earliest psychotherapy techniques developed. Originally it was used to help those with anxiety disorders to overcome the things, activities or situations that are avoided or feared. These exposures will help break avoidance and ease anxiety to decrease disordered behaviors.

Is full recovery from ARFID possible?

Full recovery from any eating disorder is possible with proper treatment and support. ARFID is no different. With the help of mental health professionals, it is possible to develop healthy eating habits and coping mechanisms to deal with fears. There are many people living healthy lives after overcoming ARFID.

If you are worried that you or a loved one may be struggling with ARFID, it is important to seek professional help.

If you are ready to seek treatment for yourself or your loved one, learn more about our eating disorder programs today and contact us for more information. We are here to support your journey to recovery.

 
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