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Things to Know About ARFID: Understanding This Selective Eating Disorder

avoidant restrictive food intake disorder

ARFID, or Avoidant/Restrictive Food Intake Disorder, is a relatively new eating disorder that affects both children and adults. Unlike other eating disorders, ARFID is characterized by a limited range of accepted foods and an intense fear or avoidance of certain textures, smells, or tastes.

What is ARFID?

ARFID is not a choice or a result of picky eating habits, but a legitimate medical condition that requires professional intervention and support. ARFID often begins in childhood, with parents noticing their child’s refusal to eat certain foods or food groups. Children with ARFID may exhibit extreme anxiety or distress when presented with new or unfamiliar foods, leading to severe limitations in their diet.

Early intervention is crucial, as ARFID can lead to stunted growth, delayed development, and nutritional deficiencies if left untreated.

Also Read: Eating Disorders In Children

ARFID Vs Picky Eating

Avoidant/Restrictive Food Intake Disorder (ARFID) and picky eating are two distinct but related conditions that involve difficulties with food intake.

  • ARFID is a clinical diagnosis characterized by severe restrictions in the amount or types of food consumed, often leading to nutritional deficiencies and significant impairment in daily functioning. Picky eating, on the other hand, is a less severe and more common behaviour where individuals have strong preferences or aversions to certain foods, but typically still maintain a balanced diet.
  • While picky eating may be a normal part of childhood development, ARFID is a more serious condition that requires professional intervention and treatment. Individuals with ARFID may experience extreme anxiety or fear around certain foods, leading to avoidance and restriction that can impact their physical and mental health. In contrast, picky eaters may simply have strong preferences or sensory sensitivities that influence their food choices.
  • ARFID should be diagnosed and managed by healthcare professionals, while picky eating may be addressed through strategies such as exposure therapy, gradual food introduction, and nutritional education.

Ultimately, both conditions require understanding and support to help individuals develop a healthy relationship with food.

ARFID Vs Anorexia

Avoidant/Restrictive Food Intake Disorder (ARFID) and anorexia are both eating disorders, but they have distinct differences in terms of symptoms and diagnostic criteria.

  • Individuals with ARFID often have a limited range of foods that they are willing to eat, which can lead to severe malnutrition and other health complications. Unlike anorexia nervosa, individuals with ARFID do not necessarily have a distorted body image or a fear of gaining weight.
  • Individuals with anorexia nervosa restrict their food intake to the point of starvation, leading to severe weight loss and malnutrition. They may also engage in excessive exercise or other behaviors to control their weight.

Also Read: Healthy Eating For Kids

Things to Know about ARFID

Here are six things to understand about ARFID.

  1. Symptoms of ARFID
  2. Avoidant restrictive food intake disorder (ARFID) is an eating disorder where individuals limit the kinds and amount of food they eat.

    Common symptoms include :

    • Difficulty digesting food
    • Avoidance of certain food textures, smell or taste
    • Eating at an abnormally slow pace
    • Lack of appetite
    • Failure to gain weight
    • Dependence on nutritional supplements
    • Consuming tiny portions
    • Frequent vomiting or gagging
    • Bouts of fainting
    • Dry skin
    • Brittle nails
    • Muscle weakness
    • Low immunity
  3. ARFID can affect anyone
  4. While commonly associated with children, ARFID can endure into adulthood, affecting approximately 0.5% to 5% of individuals across different age groups.

    Here are some factors that increase the likelihood of occurrence of ARFID:

    • Persistent picky eating
    • Autism
    • Anxiety and spectrum disorders

    Complications associated with AFRID include

    • Malnutrition
    • Low blood pressure
    • Cardiac arrest
    • Anaemia
    • Delayed puberty
    • Irregular menstruation cycles
    • Osteoporosis
    • Poor physical growth in children
  5. Diagnosis requires assessing specific criteria
  6. Recognising ARFID can be a challenge because the symptoms can seem behavioural or just a phase in children.  Behavioural indicators include:

    • Feeling full before meals or having no appetite.
    • Difficulty paying attention.
    • Limiting how much food one eats.
    • Only eating foods with certain textures.
    • Fear of what could happen after eating like vomiting or choking.
    • Picky eating gets worse and limits the range of foods able to be eaten.

    A healthcare provider will also look for the following criteria when diagnosing ARFID:

    • Significant weight loss and growth difficulties in children
    • Nutritional deficiencies as a result of low food intake
    • Reliance on supplements or tube feeding to maintain nutritional health
    • Disturbed eating is not due to an explainable factor
    • The person does not have a distorted body image
    • Food restrictions are not due to other physical or mental illnesses
    • Weight loss (adults) or failure to gain weight (children)
  7. Causes of ARFID are varied
  8. ARFID is not about body image or weight loss worries. It happens due to a mix of genes, psychological, and social factors. Anxiety, especially the fear of choking or getting sick, is a big part of it. It is advised to visit a physician if you:

    • Find it difficult to eat or drink
    • Feel anxious eating certain foods
    • Have lost interest in eating
    • Have lost a significant amount of weight
    • Experience any other signs of AFRID
  9. Treatment requires a holistic approach
  10. Treatment of ARFID requires a mix of modalities

    • Nutritional counselling
    • Weight restoration
    • Family/caregiver counselling
    • Therapy for underlying anxiety or phobias
    • Medication, in some cases
    • Exposure therapy for reintroducing feared foods

    The treatment focuses on:

    • Helping one gain weight or maintain their weight
    • Preventing complications due to nutritional deficiencies
    • Handling sensory aversions towards food
    • Recognising fear patterns
    • Ensuring less anxiety around food

    In many cases, therapists have borrowed concepts from Cognitive behavioural therapy(CBT) for treatment. CBT focuses on the beliefs, values and the cognitive process that control food intake. Studies have found CBT for ARFID effective in reducing the symptoms in adolescents.

    The relaxation techniques used in CBT have been found especially useful for many ARFID patients with anxiety disorders.

    The recommended treatment plan for ARFID includes the following:

    • Understanding the patient’s developmental history and stage of development
    • Knowing the internal and external motivators as well as goals and values
    • Gathering the family dynamics & family involvement
    • Aligning a multidisciplinary treatment team for the patient
    • Creating a seamless treatment plan including meal support

    A meal support plan helps the patient:

    • Develop a healthy relationship with food
    • Enjoy varieties of food in moderation
    • Eat in a balanced way

    They are further educated on the food portions and nutritional fundamentals. Medications may include drugs that stimulate appetite.

    A key component of treating ARFID is the continuous education of patients and caregivers about the interventions and the expectations from the ongoing treatment.

  11. Individuals can recover from ARFID
  12. For an individual to overcome the challenges associated with ARFID, one needs:

    • An appropriate diagnosis
    • A tailored treatment plan
    • A supportive network of caregivers
    • Expert therapists, and medical professionals

    The right care team for AFRID would comprise of

    • A physician for primary care
    • A mental health professional
    • A cognitive behavioural therapist
    • A gastroenterologist
    • A speech and language pathologist
    • A specialist to treat other complications

Also Read: The Importance Of Eating A Variety Of Fruits For Kids Health

While recovery may take time and patience as with any other condition, however, over time most people with ARFID can lead healthy, balanced lives without being limited by their selective eating habits.

Understanding the complexity and breadth of ARFID is the first step toward recognizing and addressing it in affected individuals. Early identification and intervention are paramount to ensure that those with ARFID can access the treatment and support required to navigate their condition and ultimately lead a healthier, unrestricted life.

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The information provided on this website is not a substitute for professional medical advice. EuroSchool encourages you to consult with a qualified healthcare professional for any health concerns you may have. The information on this website is not intended to diagnose, treat, cure, or prevent any disease.

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