Avoidant/Restrictive Food Intake Disorder: Signs and Symptoms

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Young woman needing Treatment For ARFID

With the more well-known eating disorders gaining headlines in the mainstream, it can be easy to forget that there are several other eating and feeding disorders outside of anorexia nervosa, bulimia nervosa, and binge eating disorder. Regardless of what the disorder itself is, individuals who struggle with these types of diseases typically face enormous challenges in their daily lives and require professional help for overcoming and finding recovery.

A Closer Look at Avoidant/Restrictive Food Intake Disorder

Perhaps one of the lesser-known feeding disorders is Avoidant Restrictive Food Intake Disorder, or ARFID. This selective eating disorder was previously classified as “Feeding Disorder of Infancy or Early Childhood” and recently changed in the the most updated revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Previously, this condition was thought to be something that exclusively developed in children and adolescents; however, ARFID has broadened the defining criteria of this condition to also include adults who limited their eating and may also be impacted by a related psychological and/or physiological issue.

ARFID is defined by the following criteria according to the DSM-5 [1]:

  • Disturbance in feeding and/or eating patterns as evidenced by dependence on external feeding sources (such as a feeding tube or dietary supplements), significant weight loss or the absence of expected growth/gain in children, the presence of nutritional deficiencies, and/or significant psychosocial interferences.
  • Disturbances in feeding and/or eating patterns that are not related to unavailability of food or cultural norms
  • Disturbances in feeding and/or eating patterns that are not related to anorexia or bulimia nervosa
  • Disturbances in feeding and/or eating patterns that are not explainable by another mental disorder or medical condition

Signs and Symptoms of Avoidant/Restrictive Food Intake Disorder

Understanding the criteria for ARFID may be helpful, but what might this actually look like in a person who is presenting with this eating disorder? Typically, in individuals with ARFID, whether child, adolescent or adult, there is an inability to eat certain foods, which is characteristic of this disorder.

Young woman eating breakfastThis may be due to a particular taste, smell, texture, color, or temperature of the food, and sufferers may avoid certain food types or entire food groups, such as meats, fruits, and/or vegetables. Some individuals with ARFID may experience such adverse reactions to foods that gastrointestinal upsets are triggered, such as gagging, choking, or vomiting.

On the outside, ARFID may appear a case of picky eating, where individuals avoid particular foods and food groups. However, with ARFID, there is often a comorbidity, meaning that other mental or developmental disorders may develop alongside this eating disorder. Research has found that an estimated eighty percent of children with developmental disabilities also have some form of a feeding disorder [2].

ARFID is not necessarily recognizable by physical manifestations, as individuals who struggle with ARFID are usually of normal body weight. Because of the complex criteria and factors involved with ARFID, it is important to seek out professional diagnosis and assessment.

Treatment Options For ARFID

Man in deep in thoughtComprehensive treatment for ARFID is important, particularly if another disorder is present, such as autism, obsessive-compulsive disorder, an anxiety disorder, or so forth. Many forms of therapy can be effective in helping individuals overcome anxiety associated with certain foods or the eating experience in general.

Working with a registered dietitian as part of treatment and alongside a therapist can also be helpful in addressing nutrient deficiencies and for meal planning purposes. Medication management may also be appropriate in some cases for treatment as well.

If you or someone you care for is dealing with ARFID, be sure to seek out the care of a specialist who can help address the complexity of issues involved with this eating disorder. Recovery is possible with appropriate treatment and care.

Crystal Headshot 2About the Author: Crystal is a Masters-level Registered Dietitian Nutritionist (RDN) with a specialty focus in eating disorders, maternal/child health and wellness, and intuitive eating. Combining clinical experience with a love of social media and writing.

As a Certified Intuitive Eating Counselor, Crystal has dedicated her career to helping others establish a healthy relationship with food and body through her work with EDH/AH and nutrition private practice.

References:

[1]: American Psychiatric Association. (2013). Highlights of Changes from DSM-IV-TR to DSM-5
[2]: Chatoor,I., Hamburger, E., Fullard, R., & Fivera, Y. (1994). A survey of picky eating and pica behaviors in toddlers. Scientific Proceedings of the Annual Meeting of American Academy of Child and Adolescent Psychiatry, 10′, 50.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Reviewed By: Jacquelyn Ekern, MS, LPC on March 23, 2016
Published on EatingDisorderHope.com