Avoidant/Restrictive Food Intake Disorder (ARFID) is a complex eating disorder characterized by an intense avoidance or restriction of certain foods. This comprehensive resource aims to explain the nature of ARFID, describe its signs and symptoms, and discuss potential treatment avenues.
Take our self-test and utilize it as an exploratory tool if you or a loved one have behaviors consistent with ARFID. This test is not a definitive diagnostic tool; professional consultation is advised for accurate diagnosis and treatment.
What is ARFID?
ARFID is a lesser-known eating disorder that goes beyond traditional picky eating. It involves intense aversion or avoidance of certain foods due to their sensory characteristics - such as smell, taste, or texture - or a fear of negative consequences like choking or vomiting. It's crucial to note that, unlike body shape or weight eating disorders, individuals with ARFID do not exhibit concerns about these or engage in behaviors based on these fears.1
The American Psychiatric Association officially recognized ARFID in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013, acknowledging the disorder's significant impact on affected individuals of all age groups.2
What are the Signs of ARFID?
Recognizing the signs and symptoms of ARFID is the first step to seek help and receive treatment. Some indicators of ARFID may include:
- Persistent failure or refusal to eat certain types of food or food groups based on their sensory characteristics
- Significant weight loss or failure to meet growth milestones in children due to insufficient food intake
- Nutritional deficiencies can lead to various health problems, such as anemia or osteoporosis
- Reliance on oral nutritional supplements or enteral feeding to meet nutritional needs
- Disturbance in normal social functioning due to the avoidance of eating situations
Understanding the Causes of ARFID
The exact cause of ARFID still needs to be fully understood. It's likely a complex interplay of genetic, psychological, and socio-environmental factors. Genetic predisposition can play a role, as eating disorders often run in families. This suggests a potential heritable component to ARFID, although more research is needed to identify specific genes involved.3
Psychologically, individuals with ARFID may have heightened sensitivity to food textures, tastes, and smells, which can cause significant distress. This sensory sensitivity could be associated with autism spectrum disorders, ADHD. Environmental factors, including childhood trauma or negative experiences with food, like choking or vomiting, can also contribute to the development of ARFID.4
It's important to remember that these factors alone don't cause ARFID but increase the risk in susceptible individuals. Understanding these underlying causes can help inform personalized treatment approaches.
Impact of ARFID on Health and Quality of Life
ARFID can have significant impacts on both physical health and quality of life. Physically, persistent food intake avoidance or restriction can lead to malnutrition, weight loss, and related health problems, such as anemia, cardiovascular complications, or compromised immune function.
Psychologically, the fear and anxiety associated with food and eating can lead to social isolation, as individuals with ARFID may avoid social situations involving food. This can result in feelings of loneliness and reduced quality of life. There is also a high rate of co-occurring mental health disorders, including anxiety disorders and depression, in people with ARFID.5
The impact of ARFID extends beyond the individual and can also affect family dynamics and relationships. Early identification and intervention can help mitigate these effects and improve overall well-being.
Treatment Options for ARFID
ARFID treatment necessitates a multidisciplinary approach, often involving medical physicians, dietitians, and mental health professionals who tailor a comprehensive plan addressing both the physical and psychological facets of the disorder. Cognitive-Behavioral Therapy (CBT), a form of psychotherapy that assists in recognizing and rectifying maladaptive thought patterns, is a significant intervention for ARFID.
Additionally, structured programs such as Intensive Outpatient Programs (IOP) and Partial Hospitalization Programs (PHP) can be valuable. IOPs offer more support than traditional outpatient care without needing round-the-clock supervision, while PHPs provide the highest level of outpatient care, often utilized by individuals transitioning from inpatient care or those with severe symptoms that do not require inpatient treatment. The choice of treatment hinges on individual symptoms, disorder severity, and personal circumstances.
ARFID Treatment at the Kahm Center
At the Kahm Center for Eating Disorders, located in Burlington, Vermont, we provide comprehensive, evidence-based treatment to individuals grappling with ARFID. Our multidisciplinary team of experienced professionals collaborates to devise personalized treatment plans that address the unique needs and challenges of each individual.
We offer outpatient treatment, including IOP and PHP, which aim to equip individuals with the requisite tools to overcome their fears and anxieties surrounding food and eating. In addition, our approach incorporates meal support, a crucial aspect of ARFID treatment that involves structured guidance during meals to alleviate anxiety and promote healthier eating behaviors.
At the Kahm Center, we aim to foster a healthier relationship with food and restore normal eating behaviors. If you or a loved one shows signs of ARFID, contact the Kahm Center. We're committed to providing the necessary support and guidance on your path toward recovery.
- National Eating Disorders Association. (n.d.). ARFID (Avoidant/Restrictive Food Intake Disorder). Retrieved from https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid
- American Psychiatric Association. (n.d.). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). Retrieved from https://www.psychiatry.org/psychiatrists/practice/dsm
- Norris, M. L., Robinson, A., Obeid, N., & Harrison, M. (2016). Exploring avoidant/restrictive food intake disorder in eating disordered patients: a descriptive study. Journal of Eating Disorders, 4, 36. doi: 10.1186/s40337-016-0119-0
- Udo, T., & Grilo, C. M. (2022). Prevalence and correlates of DSM-5-defined eating disorders in adults in the United States. Frontiers in Psychiatry, 13, 850594. doi: 10.3389/fpsyt.2022.850594
- Sysko, R., Devlin, M. J., Walsh, B. T., & Zimmerli, E. (2017). Sudden gains in outpatient psychotherapy for anorexia nervosa: A process-outcome study. Psychotherapy (Chicago, Ill.), 54(3), 300–306. doi: 10.1037/pst0000118
Clinically Reviewed By
Nick Kahm, PhD
Nick Kahm, a former philosophy faculty member at St. Michael's College in Colchester, VT, transitioned from academia to running the Kahm Clinic with his mother. He started the clinic to train dietitians in using Metabolic Testing and Body Composition Analysis for helping people with eating disorders. Now, he is enthusiastic about expanding eating disorder treatment through the Kahm Center for Eating Disorders in Vermont.