Finding Help for ARFID

Avoidant/Restrictive Food Intake Disorder (ARFID) is a relatively new (yet very serious) eating disorder that predominantly affects children. If left untreated, ARFID can have long-term, devastating impacts on a person’s physical and mental health and wellbeing. The good news is, there are numerous treatment methods available today to successfully treat ARFID.

What is Avoidant/Restrictive Food Intake Disorder?

Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder that often presents itself as extremely picky eating. While ARFID looks different for every individual, it typically manifests in three different forms:

Sensory Avoidance: avoiding certain foods because of an aversion to/fear of their textures, tastes, smells, or temperatures.
Lack of interest: a sincere lack of interest in food and eating. Individuals with this type of ARFID often get full quickly.
Fear of adverse consequences: avoiding specific foods (or eating in general) due to an intense fear of allergies, choking, nausea, vomiting, illness, etc.

Since ARFID is a relatively new diagnosis (the DSM-5 classified it only in 2013), much is still unknown about the disorder, including how many people it affects and what causes it. Despite its many unknowns, researchers have discovered that ARFID is most prevalent among young children, especially males [1].

Researchers have also discovered that individuals on the autism spectrum, those with an anxiety diagnosis, OCD, ADHD, or other intellectual disabilities seem to be more likely to develop ARFID [2]. In some cases, a traumatic incident (e.g., a severe allergic reaction, an illness, or a choking episode) may have triggered the individual’s food avoidance and fear around food. While ARFID is most prevalent among children and young people, adults can also suffer from the disorder.

One important thing to keep in mind is that, unlike individuals with anorexia or other EDs, individuals with ARFID do not avoid food because they fear fatness or gaining weight. Instead, their fear and avoidance/restriction of food typically stems from one or more of the three reasons mentioned above (sensory issues, lack of interest, or fear of adverse consequences).

Signs & Symptoms of ARFID

The National Eating Disorder Association lists some of the most common warning signs and symptoms of ARFID [3]:

• A very limited list of acceptable foods
• Avoidance of fruits, vegetables, and proteins
• Only wants to eat certain textures, colors, or types of foods
• Exhibits emotional distress around new or unfamiliar foods
• Experiences weight loss and/or stunted growth
• Fears vomiting or choking
• Experiences abdominal pain, constipation, lethargy and/or excessive energy
• Restricts types or amounts of foods eaten
• Lacks an appetite and/or has no interest in food
• Consistently reports vague issues (e.g., feels sick, feels full, has an upset stomach) around mealtimes
• Food/eating limitations restrict normal social life
• Does not fear gaining weight or have body image issues

Finding Help For ARFID

Though ARFID is a lesser-known disorder than anorexia and bulimia, it is just as serious as other eating disorders. In fact, researchers report that individuals with ARFID are more likely to enter the hospital with a lower body weight in relation to their healthy body weight, have longer hospital stays, rely more on tube feeding, struggle more with weight gain during hospitalization, and have a longer duration of illness than individuals with other eating disorders like anorexia [4].

Some of the other complications associated with ARFID include malnutrition, weight loss, vitamin deficiencies, developmental delays, gastrointestinal problems, stalled or stunted weight gain and growth (in children), co-occurring anxiety disorders, and problems with socializing.

In light of the serious complications and side effects associated with ARFID, it is crucial to seek professional help if you think you or a loved one may be suffering from this disorder. Keep in mind that ARFID, like any other eating disorder, is not a choice and is considered a severe illness that can be life-threatening if left untreated. The good news is there are numerous therapies and interventions that are used to successfully treat ARFID. Some of the most effective treatments are listed below.

Family-Based Treatment

Research shows that Family-Based Treatment (FBT) may be one of the best forms of treatment for ARFID, especially when treating children and young people [5]. The FBT approach includes the family as an integral part of helping the child reach his or her nutrition and food/eating goals. FBT helps educate the family about ARFID, empowers family members to let go of guilt and blame, and teaches them to provide compassion and empathy to the patient, all while persistently helping the patient reach his or her nutrition goals [6].

Exposure Therapy

This type of therapy involves gradually exposing the patient to fear foods, first by mentally visualizing them, writing about them, and then talking about them. Through this gradual exposure practice, patients learn to let go of anxiety and become more comfortable around their fear foods. Exposure therapists may also use cognitive behavioral therapy techniques to reorient the patient’s negative, anxious thought processes surrounding food.

Dialectical Behavioral Therapy (DBT)

DBT is all about teaching patients how to manage their distress and emotions in a healthy, positive way. For patients with ARFID, this typically means focusing on developing healthy coping skills that can be used to address their relationship with food. For example, by learning how to positively cope with negative emotions and distress, the patient can then use those skills when sitting down at the dinner table or trying a new food.

Cognitive Behavioral Therapy (CBT)

CBT is one of the most common therapies used in addiction and eating disorder treatment. The goal of CBT is to target negative behaviors and thought patterns behind the disorder. This means the therapist will work with the patient to uncover the underlying causes behind the disorder and help them discover how and why food and eating triggers a fear response. Once these underlying causes are identified, the therapist will help the patient replace destructive thought patterns and behaviors with positive, healthy ones.

If you think you or a loved one may have ARFID but you’re unsure where to start or how to find a treatment program, begin by talking to your primary care doctor or reach out to an eating disorder specialist or treatment center. For medically at-risk ARFID patients (severe malnourishment or extreme weight loss), the first step in healing may be admittance to a residential or hospitalization program where the patient can be monitored 24/7 and given intravenous nutritional support.

However, if the patient is deemed medically stable by a health professional and has adequate support from family at home, they may enroll in an outpatient program and attend therapy a few times a week (just make sure the treatment program is specifically designed to treat ARFID).

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References:

[1] Understanding and Treating Avoidant Restrictive Food Intake Disorder in Children and Adolescents. Psychiatric Times. https://www.psychiatrictimes.com/view/understanding-and-treating-avoidant-restrictive-food-intake-disorder-children-and-adolescents.
[2] MediLexicon International. ARFID: Symptoms, diagnosis, and treatment. Medical News Today. https://www.medicalnewstoday.com/articles/327240.
[3] Avoidant Restrictive Food Intake Disorder (ARFID). National Eating Disorders Association. (2018, February 22). https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid.
[4] MediLexicon International. ARFID: Symptoms, diagnosis, and treatment. Medical News Today. https://www.medicalnewstoday.com/articles/327240.
[5] Understanding and Treating Avoidant Restrictive Food Intake Disorder in Children and Adolescents. Psychiatric Times. https://www.psychiatrictimes.com/view/understanding-and-treating-avoidant-restrictive-food-intake-disorder-children-and-adolescents.
[6] ibid.

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References:

[1] ScienceDaily. (2020, August 20). Anorexia may stunt young women’s growth. ScienceDaily. https://www.sciencedaily.com/releases/2020/08/200820102450.htm.
[2] ibid.
[3] Eating Disorders Review. (2017, February 13). The Effects of Anorexia Nervosa on Final Height. Eating Disorders Review. https://eatingdisordersreview.com/the-effects-of-anorexia-nervosa-on-final-height/.
[4] ScienceDaily. (2020, August 20). Anorexia may stunt young women’s growth. ScienceDaily. https://www.sciencedaily.com/releases/2020/08/200820102450.htm.
[5] Eating Disorders Review. (2017, February 13). The Effects of Anorexia Nervosa on Final Height. Eating Disorders Review. https://eatingdisordersreview.com/the-effects-of-anorexia-nervosa-on-final-height/.
[6] ibid.
[7] ScienceDaily. (2020, August 20). Anorexia may stunt young women’s growth. ScienceDaily. https://www.sciencedaily.com/releases/2020/08/200820102450.htm.
[8] ibid.

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About the Author:

Sarah Musick is a freelance writer who specializes in eating disorder awareness and education. After battling with a 4-years long eating disorder, she made it her mission to help others find hope and healing in recovery.

Her work has been featured on numerous eating disorder blogs and websites. When she’s not writing, Sarah is off traveling the world with her husband.

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The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a 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.

Published November 27, 2020, on EatingDisorderHope.com
Reviewed & Approved on November 27, 2020, by Jacquelyn Ekern MS, LPC