ARFID is more than just picky eating.
It is a type of eating disorder that can be puzzling and distressing for both the individual impacted and those caring for them.
As caregivers, it is crucial to comprehend the nuances of this disorder and recognize the impact it can have on your loved one’s physical and mental well-being.
In this blog, we discuss the prevalence, warning signs and symptoms, causes and nutrition treatment options. Our goal is to equip you with the knowledge, tips and understanding so you can provide the best possible care and support for your loved one.
Let’s get started!
What is ARFID Eating Disorder?
First things first, what is ARFID? ARFID stands for avoidant/restrictive food intake disorder.
It is an eating disorder characterized by an extreme avoidance or restriction of certain foods based on sensory properties such as taste, texture, color or smell.
Unlike other types of eating disorders, ARFID is not driven by body image issues or even a desire for weight loss.
Instead, individuals struggling may experience severe anxiety or discomfort when in the presence of certain foods. Unfortunately, this can lead to limited or inadequate nourishment.
Prevalence of ARFID
Individuals with ARFID are typically children or adolescents when diagnosed. However, ARFID can also occur in individuals of all ages. Studies also show that ARFID was more common among males than females.
Warning Signs and Symptoms
It is important to know that warning signs and symptoms will vary from person to person.
Understanding the most common ones can allow for early identification and intervention. That can be instrumental in helping your loved one overcome ARFID and ultimately their relationship with food.
Severe food avoidance
Individuals may limit their food intake, have a very narrow list of foods they will eat or avoid entire food groups, textures, colors or smells.
For example, your loved one avoids all red vegetables, chicken dishes or soft fruits at meals.
Weight loss or failure to gain weight
While desired weight loss isn’t a driver of this type of eating disorder, your loved one may still experience significant weight loss or struggle to gain weight. This is due to the lack of nutrients or inadequate intakes.
This sign is especially evident in children and teens and can lead to growth issues.
Nutritional deficiencies
The restricted diet may result in various nutritional deficiencies depending on the types of foods that are limited or avoided. This can cause a range of long-term health issues such as anemia, compromised immune function or weakened bones.
You can discuss with your healthcare provider appropriate labs to draw to detect things like iron deficiency anemia, vitamin D and/or B-vitamin deficiencies.
Fear of choking or vomiting
As mentioned, individuals with ARFID either show minimal interest in food or avoid certain foods. For some, there is a fear or a phobia as a consequence of eating such as choking or vomiting.
This can cause an aversion to certain foods and result in behaviors such as your loved one cutting their food into extremely small pieces to prevent choking/vomiting.
Limited variety
If your loved one has little willingness to try new foods, only eats consistent foods or has strict rules around eating, these can also be warning signs of ARFID.
An example would be your child or teen only consumes foods that are pureed or mashed and rejects any food that is crunchy or chewy.
Emotional distress around food
Individuals might avoid eating in front of others due to embarrassment or anxiety around their limited food choices. This can result in social isolation or limited participation in activities involving food.
It is important to note that your loved one does not have to present with one of these specific warning signs or symptoms for there to be a concern or further support needed.
What is the main cause of ARFID?
There is not a single cause that leads to someone developing ARFID. In fact, it is believed that this type of eating disorder arises from a combination of biological, psychological and environmental factors.
It could arise because of a child’s genes, sensory issues, history of vomiting/choking, food allergies or generalized anxiety.
Here at Anyone’s Journey, we emphasize understanding why the behaviors are happening in the first place. With the assistance of other providers that make up a client’s team (ex. therapist, medical doctor and/or psychiatrist), we can start implementing small, incremental nutrition interventions to shift the client away from the disordered lens.
How is ARFID Diagnosed?
According to The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition or DSM-5, ARFD is diagnosed when:
- Eating or feeding disturbance is present such as
- Significant weight loss or a failure to gain weight as expected
- Nutrition deficiencies due to inadequate food intake
- Dependent on enteral feeding or oral nutritional supplements to maintain adequate nourishment
- The eating or feeding disturbance is not due to inadequate food availability
- The eating or feeding disturbance does not occur alongside another eating disorder such as anorexia nervosa or bulimia. Negative body image is not present.
- The eating or feeding disturbance is not a result of other medical illnesses.
How is ARFID Treated?
A multidisciplinary approach is typically recommended for treatment as this team involves professionals such as doctors, registered dietitians, psychologists, therapists.
Nutrition counseling helps to address any potential nutrition deficiencies while creating a personalized plan to accommodate preferences and aversions.
Our ultimate goal is to create an individualized treatment plan and to do this, requires a deep understanding of the client’s thoughts and feelings around food and their body.
In our experience, working at a pace that is comfortable for each client is essential. It’s important to recognize, though, when a client requires that extra push to reach their recovery goals.
The accessibility of health information available to our clients can certainly be a contributor to some disordered thoughts and actions. Our job is to provide accurate nutrition information, backed up by science, so the client can start developing their own food philosophy that provides and nourishes their body appropriately.
At Anyone’s Journey, we strictly offer outpatient treatment; however, we are skilled at referring clients to higher levels of care and helping individuals or families determine the appropriate level of care.
Caregiver Support for ARFID
Support for ARFID is essential to help individuals manage and overcome the challenges, especially family support.
It is crucial treatment involves caregivers and they are provided the knowledge and education necessary to create a supportive environment throughout recovery.
Here are some tips for caregivers:
- Keep yourself educated about the disorder, symptoms and variety of treatment option.
- Lean on a healthcare team and work with professionals that you trust.
- Celebrate even the smallest achievements as this will help build confidence around eating.
- Offer a variety at meals while respecting the choice if your loved one doesn’t explore the new tastes or textures.
- Avoid food based rewards or punishments as this can reinforce unhealthy associations with food.
- Seek support for yourself because caregiving can be mentally draining but counseling or support groups can help you too cope with the challenges of ARFID.
All Eating Disorders Require a Personalized Approach
Overall, the information shared in this blog is meant for educational purposes and to help you gain a better understanding on the complexity of ARFID. It is critical to remember that every eating disorder is different and requires an individualized approach.
Anyone’s Journey specializes in eating disorders and disordered eating with the approach that short strides result in long term possibilities. Our clinicians are also experienced in helping individuals that desire weight loss or are navigating chronic diseases. It is also never too early, nor too late, to seek guidance on how to help someone with an eating disorder. Contact us by calling 612-638-2778, emailing contact@anyonesjourney.com or completing our Referral Form.