ARFID
Avoidant restrictive food intake disorder, or ARFID, is a type of eating disorder that sees people avoiding certain foods or restricting their overall intake (or both). Here we will take a closer look at what ARFID is, what treatment can help and how a nutrition professional can support you.
What is ARFID?
While ARFID is an eating disorder, it is somewhat different to other eating disorders. While these conditions are all complex and nuanced, anorexia, bulimia and binge-eating disorder tend to share a trait where people are conscious of their weight and/or want to change it.
For those with ARFID, there isn’t usually a desire to change weight. Those with avoidant restrictive food intake disorder aren’t avoiding or restricting foods in an effort to control their weight. Typically, the driving force behind this type of behaviour is fear. Here are some of the reasons someone with ARFID may avoid or restrict food.
- Sensory issues – the texture, appearance, smell or taste of certain foods may feel overwhelming to some who may choose to avoid these foods and stick to ‘safe’ foods instead.
- Past distressing events – sometimes an event such as choking, vomiting or digestive distress can cause someone to avoid certain foods, for fear of it happening again.
- Generalised fear – for some, the worry about eating and the consequences of eating is difficult to pin down.
- Low interest in eating – some people may struggle to recognise when they are hungry or simply don’t have much of an appetite. This lack of interest can lead to a restricted intake of food overall as it becomes a chore for them.
Someone with ARFID may relate to one of the above or a number of them. Like all eating disorders, ARFID affects everyone differently and may manifest differently from person to person.
A hallmark of the condition is that it has a negative impact, both mentally and physically. The lack of nutrients and calories can lead to physical health problems such as malnourishment and being underweight. Not being able to eat a range of foods can also make socialising and travelling difficult, holding people back from what they want to do in life.
In terms of who is likely to develop ARFID, research currently shows that neurodiverse people are more likely to develop it than neurotypical people. Children who show signs of extreme picky eating and do not grow out of it can also be more likely to develop ARFID. It’s also noted that those with ARFID are likely to have coexisting anxiety conditions. While ARFID is most often diagnosed in young people, adults can also be affected.
Is ARFID just picky eating?
While 'picky eating' can be an initial sign of ARFID, it’s important to note the difference between the two. Picky or ‘fussy’ eating is a normal habit that many children go through. Usually, children are still able to meet their nutritional needs during this, and grow out of the habit.
When a child’s picky eating seems severe, they don’t grow out of it, and/or they’re not growing/gaining weight as expected, it could be a sign of ARFID. If you’re a parent and are unsure, it could be worth speaking to your doctor to learn more and seek a diagnosis and support.
ARFID treatment
If you have been diagnosed with ARFID, you should be offered treatment and support. This may involve a number of people, such as nutrition professionals, speech therapists, CBT therapists and psychiatrists/psychologists.
- Nutrition professionals can recommend supplements to help ensure you’re meeting your nutritional needs while supporting you to broaden the variety in your diet.
- Speech and language therapists can offer support if you struggle with motor skills for eating.
- A cognitive behavioural therapist can help you cope with your feelings about food and make changes.
- A psychologist or psychiatrist can help if you're struggling with any other mental health concerns and may offer other therapies such as dialectical behaviour therapy, exposure therapy or EMDR.
If you are very unwell, you may need to stay in hospital at first until you are strong enough to continue treatment as an out-patient.
How can a nutritionist help with ARFID?
The first thing a nutrition professional is likely to do is assess your current diet to ensure you’re able to meet your body’s nutritional needs. They may recommend nutritional supplements to help you do this, before supporting you with making changes and expanding your diet or habits.
Assessment, advice and support from an appropriately experienced dietitian is key. Your dietitian will be able to identify any nutritional deficiencies, advise how best to correct them given the challenges you face and provide much more detailed and personalised strategies to help.
If you’re seeking support for your child, the dietitian may also work with their school to help and will be able to offer guidance to the family. If you are a parent of a child with ARFID, know that this is not your fault and that support is available. If you’re ready to work with a nutrition professional, use our search tool to find the right nutritionist for you.
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