ARFID

When people think of eating disorders, anorexia and bulimia often come to mind, but other, lesser-known disorders can be just as damaging. One of these is Avoidant Restrictive Food Intake Disorder or ARFID. It is easy to mistake ARFID for extreme pickiness, but it is much more serious. ARFID is a life-threatening condition that goes beyond simple food preferences. It is a disorder that can deeply affect your physical health and ripple into every other part of your life.

Woman in stomach pain lying on bed

What is ARFID?

ARFID is a condition where certain foods, textures or even the act of eating itself becomes so overwhelming that it severely limits what you can eat. Unlike other eating disorders, ARFID isn’t usually about dieting or worrying about weight; it is a deep-seated fear or aversion that makes eating an incredibly stressful experience.

For some people, the thought of certain foods can trigger intense anxiety, leading them to avoid entire food groups or stick to just a few “safe” foods. This can cause some of the most dangerous symptoms of ARFID, such as nutritional deficiencies, weight loss and a constant battle with fatigue.

ARFID can affect anyone, but it is most commonly seen in children and adolescents. The term Avoidant Restrictive Food Intake Disorder replaced Eating Disorder Not Otherwise Specified in the DSM-V in 2013 when it was recognised as a distinct condition.

What are the types of ARFID?

ARFID eating disorder comes in different forms, each with its own unique challenges. Understanding these types can help with diagnosis and allow healthcare providers to tailor effective treatment:

Avoidance based on sensory sensitivity

Some people with ARFID avoid certain foods because of their texture, smell, taste or appearance. This type is often seen in people who are sensitive in general, such as those with autism. In fact, one study found that up to 55% of children diagnosed with ARFID had coexisting autism.

Fear of negative consequences

This type of ARFID eating disorder develops when someone avoids food because they are afraid of choking, vomiting or having an allergic reaction. Even if there’s no real risk, the fear can be overwhelming and lead to extreme food avoidance. This fear sometimes comes from a traumatic past experience with food.

Lack of interest in eating

For some people, eating just could be more appealing. They may feel full quickly, have a low appetite or find food uninteresting. This lack of interest can lead to insufficient eating, causing significant weight loss and nutritional deficiencies.

What are the symptoms of ARFID?

ARFID is not always easy to spot. On the surface, it might look like someone with ARFID is just an extremely picky eater, but the signs of ARFID can go much deeper than that.

Noticeable signs of ARFID eating disorder include:

  • Eating only a limited variety of foods
  • Avoidance of certain food textures or colours
  • Noticeable weight loss or lack of growth
  • Difficulty eating in social situations

More hidden symptoms of ARFID may involve:

  • Rituals around food, such as only eating foods that are prepared in a certain way or only eating at specific times
  • Irrational fear of choking or vomiting
  • Anxiety or depression because of the problems ARFID causes

Recognising these ARFID symptoms early can be key to getting the right help.

What causes ARFID?

ARFID eating disorder usually develops gradually. It might start in childhood as a strong preference for certain foods, but over time, these preferences can become more rigid and limiting. As people age, the range of foods they are willing to eat can shrink, leading to nutritional deficiencies and a growing fear or anxiety around eating.

However, ARFID doesn’t just come out of nowhere. It is usually the result of a mix of factors that build up over time. As well as the sensory sensitivities explained above, these can include:

Traumatic experiences

Another potential cause is a traumatic experience related to food. This could be something like choking, vomiting or a severe allergic reaction. The fear of that experience happening again can then lead to an avoidance of the culprit food or even food altogether.

Anxiety or OCD

For some people, ARFID is linked to anxiety disorders or obsessive-compulsive disorder (OCD). The fear of contamination, the worry about how food will affect the body or the need to stick to rigid routines around eating can make food seem like an enemy.

Medical conditions

ARFID can also develop in people who have had a history of medical conditions that made eating difficult or painful. These can include conditions like gastrointestinal issues or chronic illnesses which affect digestion.

Woman eating junk food

What are the dangers of ARFID?

The dangers of ARFID run deep and can have serious consequences for both physical and mental health. Understanding these dangers is crucial to grasping why ARFID is a condition that requires attention and care:

Nutritional deficiencies

One of the biggest dangers of ARFID is not getting the nutrients your body needs. When your diet is very limited, you might miss out on important vitamins and minerals. This can lead to problems like feeling chronic tiredness, getting sick more often and even issues with growth and development in children and teenagers.

Physical health problems

Not eating enough of the right foods can cause your body to become very weak. You may lose a lot of weight, feel dizzy or have trouble staying awake because you have no energy. Over time, your bones can get weaker, your skin can become dry, and your hair can start to thin or fall out.

Mental health challenges

ARFID can also affect your mental health. Worrying about food all the time can lead to anxiety, depression or obsessive thoughts. You might feel scared to eat certain foods, making you feel stressed and alone.

Social isolation

Because ARFID makes eating so difficult, you might start avoiding social situations where food is involved. This can make it hard to be with friends or family, leading to extreme loneliness.

Long-term consequences

If ARFID isn’t treated, it can lead to long-term health problems that might be hard to resolve later on. The longer you struggle with ARFID, the more difficult it can be to recover, both physically and mentally.

How to recover from ARFID?

At Banbury Lodge, Oasis’s sister centre, ARFID treatment is designed to help you regain a healthy relationship with food while addressing the underlying issues that contribute to the disorder.

This usually involves a tailored meal plan that gradually introduces new foods in a safe and supportive way. Nutritional counselling is a key part of this process, helping you to understand the importance of a balanced diet and how to achieve it without overwhelming yourself.

Rehab treatment then plays a vital role in providing a space to explore the fears, anxieties or past experiences that have contributed to ARFID. Through various forms of traditional and holistic therapy, you will begin to challenge and change negative thought patterns related to food so you can begin to broaden your horizons.

Aftercare is essential for maintaining the progress you make during treatment. Banbury Lodge offers ongoing support through weekly group therapy sessions and continued access to our team, ensuring you have the tools you need to stay on track.

Get help for ARFID today

If ARFID makes life a daily struggle, Banbury Lodge is here to help. ARFID can be tough to face alone, but with the right support, you can rediscover the joy of food and life itself. Don’t let ARFID keep you from living fully – reach out today and start your journey to recovery.

Frequently Asked Questions

How can I help someone with ARFID?
Supporting someone with ARFID starts with understanding and patience. They are not just being picky, so avoid pressuring them to eat or dismiss their fears. Instead, encourage them to seek professional help and offer to be there every step of the way. Joining them for appointments, helping with meal plans and simply listening without judgement can make a big difference.
Can ARFID be fatal?
Yes, ARFID can be life-threatening if left untreated. The severe nutritional deficiencies caused by avoiding so many foods can lead to dangerous health problems like extreme weight loss, weakened immune system, heart issues and even organ failure. The longer ARFID goes unchecked, the more serious the risks become, but with proper treatment and support, recovery is possible.
Can ARFID co-exist with other conditions?
ARFID often co-exists with other conditions. People with ARFID might also struggle with anxiety, depression, obsessive-compulsive disorder (OCD), autism spectrum disorder or even other eating disorders. These conditions can intensify the challenges of ARFID, making it even harder to manage without the right support. Addressing ARFID in conjunction with these other conditions is crucial for a successful recovery.

(Click here to see works cited)

  • UK Rehab. “ARFID | Eating Disorders | Causes, Symptoms and Diagnosis.” UK Rehab, https://www.uk-rehab.com/eating-disorders/arfid/. Accessed 22 August 2024.
  • Beat. “ARFID – Beat.” Beat Eating Disorders, https://www.beateatingdisorders.org.uk/get-information-and-support/about-eating-disorders/types/arfid/. Accessed 22 August 2024.
  • National Eating Disorders Association. “Avoidant Restrictive Food Intake Disorder (ARFID).” National Eating Disorders Association, 2022, https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid. Accessed 22 August 2024.
  • Substance Abuse and Mental Health Services Administration. “Table 22, DSM-IV to DSM-5 Avoidant/Restrictive Food Intake Disorder Comparison – DSM-5 Changes.” NCBI, 2016, https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t18/. Accessed 22 August 2024.