Avoidant/Restrictive Food Intake Disorder (ARFID)
Avoidant restrictive food intake disorder (ARFID) previously referred to as “selective eating disorder” is like anorexia in that both disorders involve limitations in the amount and/or types of food consumed. However, unlike anorexia, ARFID doesn’t involve any distress about body shape or size or fears of weight gain.
Although many children go through phases of picky or selective eating, a person with ARFID doesn’t consume enough calories to grow and develop properly and, in adults, to maintain basic body function. In children, this results in stalled weight gain and vertical growth; in adults, this results in weight loss and severe medical complications associated with malnutrition. ARFID can also result in problems at school or work, due to difficulties eating with others and extended times needed to eat.
Overview of Avoidant/Restrictive Food Intake Disorder (ARFID)
Types of ARFID
There are four different types of ARFID, including:
- Avoidant Type: In this type, an individual avoids certain types of food based on the food’s sensory features. They may feel sensitive to the smell of food, texture of food, or general appearance of food, like color.
- Aversive Type: In this type, an individual refuses specific food because of a fear-based reaction. For example, someone may have a vomiting phobia that leads to them avoiding waffles because of a bad experience.
- ARFID Plus: In this type, an individual has more than one type of ARFID and/or has a co-occurring eating disorder. For example, someone may have a choking phobia, they won’t eat anything but soft foods in addition to restricting food intake out of a fear of weight gain.
- Restrictive Type: In this type, an individual has little or no interest in food, no appetite, or no hunger cues.
Signs and Symptoms of ARFID
Symptoms of ARFID include:
- Dramatic weight loss
- Dresses in layers to hide weight loss or stay warm
- Reports constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy
- Reports consistent, vague gastrointestinal issues (upset stomach, feels full, etc.) around mealtimes that have no known cause
- Dramatic restriction in types or amount of food eaten
- Will only eat certain textures of food
- Fears of choking or vomiting
- Lack of appetite or interest in food
- Limited range of preferred foods that becomes narrower over time (i.e., picky eating that progressively worsens)
- No body image disturbance or fear of weight gain
Health Consequences of ARFID
Because both anorexia and ARFID involve an inability to meet nutritional needs, both disorders have similar health consequences, including:
- Stomach cramps and other non-specific gastrointestinal complaints – constipation, acid reflux, etc.
- Menstrual irregularities – missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period
- Abnormal laboratory findings – anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate.
- Difficulty concentrating
- Dizziness
- Fainting/syncope
- Fine hair on body (lanugo)
- Thinning of hair on head, dry and brittle hair
- Impaired immune functioning
How We Treat ARFID
To treat ARFID, our clinicians create an individualized treatment plan for each client based on their specific needs and diagnosis. Some of the evidence-based clinical treatment modalities we utilize to treat ARFID include:
