What is ARFID?

By Lauren Oakes, MBA, RDN, LDN, CEDS
Clinical Supervisor at Healthier Tomorrows

Thank you to our friends at Healthier Tomorrows for this informative post on Avoidant Restrictive Food Intake Disorder, commonly referred to as ARFID. 

Background

If you’re reading this, there’s a good chance that you have a friend, colleague, or family member that you suspect of having a unique relationship with food.  As with anyone who has a habit that we don’t understand, we typically tell ourselves “They’ll grow out of it”, “It’s just a phase”, or even “That’s just the way they are.”  But when dealing with many food-related habits, the root cause driving the behavior or habit can be much deeper than we realize.  One’s relationship with food can be complex. Everyone needs food to survive, but people frequently have different perspectives on important food-related questions, including when to eat, what to eat and how much to eat.

How can you tell if someone is just handling things a little differently than you, or if the person may need help in how they are approaching food and how they eat? As a Registered Dietitian Nutritionist who works with selective eaters as well as those diagnosed with eating disorders, I would like to share common symptoms and signs that I have seen with individuals who are working through Avoidant Restrictive Food Intake Disorder (ARFID).

ARFID Signs & Symptoms

ARFID is the name used to describe a condition where an individual has a constant lack of interest in eating, avoids specific foods due to the texture or consistency, gets visibly anxious when trying new foods (or refuses to try them at all), needs food to be prepared a specific way, is only willing to eat specific brands of food, or has an intense fear of choking, vomiting, or becoming sick from a specific food (Zimmerman & Fisher, 2017).  If you’ve noticed someone struggling with one or more of these symptoms, then that person may have ARFID.

ARFID is seen in all ages but is most common with children and young adults.  If not treated properly at a younger age, ARFID can become more severe as one grows older. It’s important to note that those who are diagnosed with ARFID do not always have body image distress or worries regarding weight gain.  Instead, it is their perception of the food itself that causes the stress and avoidance.  The reasons why someone may have ARFID vary, ranging from changing preferences, taste bud development, to the impact of an unexpected event such as food poisoning.

An individual showing symptoms of ARFID or who has been diagnosed with ARFID may experience a nutritional deficit for their body that can have a number of negative consequences, both physically and mentally, including 

  • Significant weight loss
  • Cold intolerances
  • Limited acceptance of foods and beverages
  • Fatigue
  • Lack of interest in food or no appetite
  • Weakness
  • Gastrointestinal symptoms such as constipation, stomach pain and early satiety

Seeking Treatment for ARFID

If someone is consistently showing these behaviors or symptoms, seeking out medical help through a doctor is the first step to confirm diagnosis and determine treatment. 

ARFID treatment typically involves a team, including a doctor, registered dietitian, and therapist who specialize in eating/feeding disorders.  This team works together to help the individual restore nutritional balance, increase the variety of foods tolerated, and learn to eat without fears.  The treatment of ARFID can take longer than anticipated, and it’s not uncommon that patients can be burnt out in the treatment process, often looking for a quick fix. The best remedy for this is to take periodic pauses and focus on a quantity of diet vs variety.  In any event, the doctor, dietitian, and therapist will be able to provide the appropriate recommendations throughout the process.

I hope this information helps in providing more insights as to what ARFID is, how to recognize if someone you may know may have it, and what to expect from, and the benefits of, treatment.

Reference

Zimmerman, J., MS, RDN, & Fisher, M., MD (2017). Avoidant/Restrictive Food Intake Disorder (ARFID). Current Problems in Pediatric and Adolescent Health Care, 47(4). https://doi.org/https://www.sciencedirect.com/science/article/abs/pii/S1538544217300494

By Lauren Oakes, MBA, RDN, LDN, CEDS

Clinical Supervisor, Healthier Tomorrows​