Avoidant/Restrictive Food Intake Disorder (ARFID) Treatment

Beyond Therapy and Nutrition Center can support you if you're looking

for treatment for ARFID!

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Have you ever wondered if ARFID is an eating disorder?

 

Here's the official Diagnostic Criteria for ARFID:

 

Avoidant/Restrictive Food Intake Disorder or ARFID is an eating disorder characterized by selective eating habits that result in failure to meet nutritional and/or energy needs and is accompanied by one or more of the following:

1. Significant weight loss or failure to meet expected growth milestones in children

2. Significant nutritional deficiency

3. Dependence on supplemental nutritional sources

4. Interference with functioning in daily life and/or psychological distress

 

Subtypes

 

There are three main ARFID subtypes:

 

1. Restrictive- This subtype includes symptoms of low appetite, lack of interest in eating or food, premature fullness, lack of hunger cues, forgetting to eat, finding eating to be a chore, or distractibility during mealtimes. 

2. Avoidant- This subtype includes avoidance of foods based on the sensory characteristics of food including smells, textures, colors, appearances, etc.

3. Aversive- This subtype includes avoiding food due to concern about negative consequences related to consuming food, such as choking, illness, food poisoning, allergies, etc. 

 

A fourth and newly recognized subtype of ARFID is ARFID plus, which can occur in any of the above subtypes and includes concern about body shape/size and/or weight. ARFID differs from other eating disorders, because it is not driven by body image distress; however, due to societal beauty standards and normative dieting practices, individuals with ARFID are not exempt from experiencing body image concerns. 

 

It is possible to experience more than one subtype of ARFID. For example, someone may experience the restrictive subtype and develop features of avoidant or aversive subtypes.

 

Risk Factors

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While the exact causes of ARFID are not fully understood, a combination of genetics, psychological factors, and environmental influences can contribute to development of the disorder. Risk factors for ARFID include anxiety disorders, obsessive-compulsive disorders, and neurodevelopmental disorders (ASD, ADHD, and intellectual disability), traumatic experiences, and sensory sensitivities. ARFID tends to present itself younger than other eating disorders and symptoms can be observed as young as infancy/toddlerhood but typically lasts into adulthood. Other risk factors include Celiac disease, food allergies, and other gastrointestinal issues.

 

Signs/Symptoms

 

Some signs you or you child may have ARFID are: 

 

• Limited food intake (in children, this can look like extreme pickiness and can be accompanied by refusal to eat or try new foods and/or distress at mealtimes)

• Lack of interest in eating or food

• Inability to recognize when you’re hungry or full

• Forgetting to eat or becoming distracted during mealtimes and not finishing a meal

• Nutritional deficiencies related to limited food intake

• Significant weight loss or a child not meeting expected growth milestones

• Anxiety and fear around food or mealtimes or distress around planning meals or social events that include food

• Significant sensitivities to smells, colors, textures, food appearances that prevent you from consuming foods

• Intense fear about negative consequences of eating that interfere with eating

 

*Pickiness in eating can be normal in childhood. ARFID differs from picky eating, because it can be accompanied by weight loss, failure to meet growth milestones, and includes significant distress or anxiety around eating. While many children with picky eating will ultimately choose a food to avoid hunger, children and people with ARFID will often choose to be hungry over eating foods that can cause them distress. 

 

Beyond's Treatment Approaches for ARFID

 

At Beyond, we have both eating disorder dietitians and eating disorder therapists who specialize and have a special interest in treating ARFID. Depending on your needs and preference, you can work with either a therapist or dietitian, however many clients benefit from a team approach! All of our therapists and dietitians are neuro-affirming. Your eating disorder therapist and/or eating disorder dietitian will work with you to set goals for your individual treatment, including but not limited to addressing nutritional and energy deficiencies, decreasing psychosocial limitations, enhancing self-sufficiency with eating and feeding, and increasing self-regulation abilities. Having a supportive and specialized treatment team is important for your care. While many children and adolescents seek treatment for ARFID, many adults also seek treatment for ARFID as well!

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