ARFID
What is Avoidant/Restrictive Food Intake Disorder (ARFID)?
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Learn More About ARFID from
our AVP of Clinical Services, Kate Fisch
ARFID Subtypes: Avoidant, Restrictive, and Aversive
Avoidant ARFID: Individuals with this subtype tend to avoid certain foods due to the taste or texture of it and report experiencing sensitivities or overstimulation in relation to those foods. They also often are found to be biologically more attuned to certain tastes of foods than the average population. Additionally, individuals with the avoidant subtype of ARFID experiencing a higher rate of co-occurring autism spectrum disorder.
Restrictive ARFID: Individuals with this subtype tend to avoid food due to low appetite or misleading hunger and fullness cues. These individuals also tend to be disinterested in food and find it difficult to remember to eat or be motivated to eat. It is believed that these symptoms could be related to abnormalities in the appetite regulating center of the brain, but more research is needed.
Aversive ARFID: Individuals with this subtype also avoid certain foods, but the avoidance tends to be related to fear of experiencing aversive consequences of eating that food such as vomiting, choking, allergic reactions, or stomach upset. This fear is sometimes associated with an actual experience of trauma or witnessing a traumatic event, but not necessarily. It is also common for an individual with this subtype of be more biologically prone to anxiety
ARFID Warning Signs and Symptoms
- Significant weight loss
- Failure to thrive or meet developmental milestones in childhood
- Lack of variety in foods eaten
- Intense fear of choking and/or vomiting
- Picky eating based on the type, texture. and/or other qualities of the food
- Lack of appetite or interest in food
- Recurrent and frequent experience of physical discomfort around mealtimes (i.e., stomach aches, feeling full, nausea, etc.)
- Anxiety and other emotion-driven responses to trying new foods or changes to eating routine
- Increasingly small number of preferred and comfortable foods
- Tendency to have bland or simplistic flavored foods
- Eating foods separately even when intended to be together (i.e., pulling apart sandwiches to each individual components, having foods plated in separate compartments)
- Avoidance or hesitance of social situations that involve food and eating
- Desire to gain weight due to dissatisfaction with low body weight
Overview of ARFID
Health Consequences of ARFID
- GI upset (e.g., constipation, acid reflux, stomach cramps, bloating, etc.)
- Irregular menstruation including delay of first period and missing periods (when applicable)
- Abnormal bloodwork results (i.e., iron, thyroid, potassium, blood cell counts)
- Dizziness
- Fainting
- Cold intolerance
- Sleep problems
- Dry skin
- Dry and brittle nails
- Fine hair on body (lanugo)
- Thinning of hair on head, dry and brittle hair
- Muscle weakness
- Slow heart rate
- Weakened immune system and prolonged healing time for wounds
- Difficulties concentrating
Treatment Approach
Due to the complexity of ARFID, individualized treatment goals that include the use of specific dietary and therapeutic exposures that target the underlying contributors to the eating disorder behaviors is imperative. At Shoreline, we know the importance of identifying ways to improve our clients’ overall lives and supporting an improved relationship with food and body. Our staff engage in continual training and learning to further expertise in treatment eating disorders such as ARFID and the co-occurring conditions that come with it. We utilize Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) along with family based treatment techniques to help both clients are their families.
REVIEWED BY
Sheena Gill, PsyD, CEDS
FAQs
- Avoidant ARFID: Avoidance of foods in relation to features such as taste or texture, that cause sensitivity to overstimulation. Often found to be “supertasters” or have a biologically based heightened sensitivity to certain tastes.
- Restrictive ARFID: Avoidance of food due to low appetite, premature fullness, or lack of hunger cues. Adults will forget to eat or find eating a chore; children will often become distracted during mealtimes.
- Aversive ARFID: Food refusal or avoidance based on fear of aversive consequences such as vomiting, choking, GI pain, or allergic reaction. Sometimes based on an actual traumatic event or witnessing a traumatic event, but not always. Underlying pre-disposition for anxiety disorders and/or feeding disorders.
- Stage 1, Psychoeducation and early change
- Stage 2, Treatment Planning
- Stage 3, Address maintaining mechanisms in each ARFID sub-type
- Stage 4, Relapse prevention