How to Overcome Avoidant/Restrictive Food Intake Disorder (ARFID)

Definition of ARFID

Avoidant/Restrictive Food Intake Disorder (commonly known as ARFID) is an eating disorder characterized by an individual’s avoidance and/restriction of many foods leading to the intake of a limited variety and volume of food. It was recently added to the DSM-5 to replace and expand upon the previous diagnosis of feeding disorder in infancy and early childhood. It is more commonly present in childhood and adolescence. But it can also occur in people of any age, gender, and background. Due to its symptoms resembling “picky eating” it is often left undiagnosed. 

While more research on ARFID must be done, the prevalence is between 0.5% to 5% among the general population. Today, we’ll take a deeper look at ARFID, the signs to look out for, and the steps to overcoming it.

Causes

Unlike other eating disorders, those suffering from ARFID typically do not limit their food intake due to body image-related issues.  Instead, common triggers for ARFID may include lack of interest for food and sensory sensitivities that cause strong aversions to the food’s characteristics such as the food’s texture, smell, and/or taste.

Another possibility is that a past trauma related to or involving a certain type of food occurred. For example, becoming ill, vomiting, or choking while eating a specific food.  Due to this, an intense fear of eating that food may develop.  

Warning Signs and Consequences of ARFID

A person with ARFID may experience serious physical and psychological consequences.

Those warning signs and symptoms may include:

• Lack of appetite and interest in food
• Anxiety when presented with “fear” foods
• Weight loss 
• Growth failure in children and adolescents 
• Avoiding particular foods- can be for several reasons (Smell, taste, color, texture etc.)
• Frequent gagging or vomiting when exposed to certain foods
• Fear of eating due to the possibility of choking and vomiting 

• Nutritional deficiencies including anemia and vitamins B and C deficiencies
• Fatigue, dizziness, difficulty concentrating, being cold all the time
• Gastrointestinal issues such as bloating and constipation 
• Electrolyte imbalances resulting in irregular heart beat, low blood pressure and kidney issues
• Social anxiety especially when food and meals are served
• Low self-esteem and depression
• A low food intake resulting from selective eating can also result in an irregular menstrual cycle or the loss of menses.

Steps to Overcoming ARFID

Once ARFID has been diagnosed, early intervention has been shown to play a key role in the treatment’s success.  The goal of which, is to ensure the individual meets their nutritional needs to optimize their physical health.  Another goal of the treatment is to decrease the anxiety and stress around food. 

Treatment

Treatment will differ on a case-by-case basis.  As we mentioned above, the cause(s) of the disorder will vary for each person.  As such, the treatment should be catered to each person’s needs.  Forcing the foods will not have a positive effect.  It is important to respect the level at which the person desires to try new foods.  

The process of overcoming ARFID requires a multi-disciplinary team, as there are mental, medical, and nutritional components involved. Among this team, would be a doctor to first address any weight and vital signs issues and nutrient deficiencies. A psychologist/therapist who specializes in eating disorders and a nutritionist who also specializes in eating disorders will also be involved.  

They will decide which approach will be best depending on the individual and those interventions may include:

• Cognitive Behavioral Therapy for ARFID

This is done by digging deeper to identify the beliefs and thoughts associated with the fear foods and replacing them with less anxiety-provoking thoughts. 

 

• Family-Based Therapy for ARFID (FBT-ARFID) 

This approach teaches the family how to best support the individual suffering from ARFID. Meal planning strategies can be discussed to decrease stress that comes with the unpredictability of unplanned meals. Also, talking about how to offer meals in a positive eating environment can be helpful.

 

• Gradual Food Exposure

The food exposure can be done in a gradual manner starting with the least fearful foods and focusing on one food at a time to make it less anxiety-provoking for the individual. This is also done at the pace of the latter in a non-pressure way. As the individual becomes less fearful and anxious around that specific food, the focus can be shifted to another food that the they feel comfortable trying. 

 

• Addressing Sensory Sensitivities

It is an option to work with an occupational therapist to improve tolerance of certain textures, smells, or tastes. 

It is first important to fully understand the disorder so as not to invalidate the struggles of those suffering.  Doing so will only make it more difficult for them to willingly expose themselves to their fear foods.  Overcoming ARFID is possible with the proper guidance, care, and patience. 

At NutriVie Santé, our nutritionists who specialize in ARFID will help you or your loved ones have a healthier relationship with food. 

This begins by helping you to understand them better. We will then work with you to help you meet your nutritional needs first with your safe foods and stabilize and maintain a healthy weight if weight restoration is needed. If the individual is ready to explore new foods, the nutritionist will use exposure therapy to help the individual try new foods at their pace and in the least anxiety-provoking way possible.  

Our eating disorder dietitians also provide parents with the proper tools and advice to help them navigate the issue.  Thus, enabling every parent to better support their child by removing the pressure to try new foods which could ultimately reinforce the issue.  Whether for yourself or a loved one, recovery from ARFID is possible.

Our eating disorder nutritionists are available to help you at our treatment clinic. Feel free to contact us here or by calling one of our locations in Westmount (514-965-5175) or Dollard-des-Ormeaux (514-965-5175).