Understanding Avoidant Restrictive Food Intake Disorder (ARFID)

ARFID, the newest eating disorder on the block, is a psychological disorder characterized by the avoidance of eating food or restricting food intake due to fear, aversion, or disinterest, even in the presence of the need for nourishment to maintain health. Unlike other eating disorders, such as anorexia or bulimia, distorted body image and/or preoccupation with weight, shape, or size are not characteristics of ARFID.

Symptoms of ARFID

Those with ARFID are more likely to be younger, with the average age of onset being 11 years old. Symptoms of ARFID include:

Extreme pickiness with food choices
Avoidance of certain textures, colors, or smells
Refusal to eat specific food groups
Sensory aversions and over-stimulation (e.g. “super tasters” for bitterness, prefer sweet tastes)
Traumatic or fear-based experiences with food, such as choking, nausea, vomiting, pain, swallowing difficulties, or contamination fears
Little interest in feeding or eating (low appetite) or being distractible and forgetful about eating

HAES Positive and Anti-Diet

Embrace a Health at Every Size (HAES) approach with us. We reject restrictive diets and celebrate body diversity, focusing on holistic wellness and positive self-image.

Factors Contributing to ARFID

The exact cause of ARFID is not fully understood, but it may involve a combination of genetic, biological, psychological, and environmental factors. Potential causes include:

1. Sensory Sensitivities or Aversions

Some individuals with ARFID experience sensory sensitivities or aversions that make certain foods intolerable or unpleasant to consume. These sensitivities can involve textures, tastes, smells, or appearances of foods. For example, a person may find the texture of certain foods, such as mushy or crunchy textures, to be overwhelming or uncomfortable. This sensory discomfort can lead to avoidance of these foods and contribute to restrictive eating patterns characteristic of ARFID.

2. Childhood Trauma or Adverse Experiences Related to Food

Adverse experiences during childhood, such as traumatic incidents involving food, can significantly impact an individual’s relationship with eating. Traumatic events such as choking episodes, force-feeding, or food-related accidents may create lasting fear, anxiety, or negative associations with specific foods or eating situations. These experiences can lead to avoidance behaviors and contribute to the development of ARFID later in life.

3. Anxiety Disorders

Anxiety disorders are common comorbidities among individuals with ARFID, with research indicating that approximately 75% of children diagnosed with ARFID also have a co-occurring anxiety disorder. Anxiety disorders can manifest as excessive worry, fear, or apprehension related to various aspects of life, including food and eating. Individuals with ARFID may experience heightened anxiety around mealtimes, social gatherings involving food, or trying new foods, which can exacerbate their avoidance behaviors and reinforce restrictive eating patterns.

4. Neurodivergence

Neurodivergence refers to variations in neurological functioning that diverge from the typical population. Nearly 20% of children diagnosed with ARFID are identified as neurodivergent, meaning they may have conditions such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), sensory processing disorder (SPD), or other developmental disorders. Neurodivergent individuals may experience heightened sensitivities to sensory stimuli, difficulties with social interactions, or challenges with communication, which can impact their eating behaviors and food preferences. These underlying neurodevelopmental differences can contribute to the development and maintenance of ARFID symptoms.

Understanding these diverse factors that contribute to the development of ARFID is crucial for effective assessment, diagnosis, and treatment planning. Addressing the underlying causes and individual needs of each person with ARFID can facilitate personalized interventions and support their journey toward recovery and improved quality of life.

Diagnosis of ARFID

Diagnosing ARFID requires a comprehensive evaluation by a qualified healthcare professional. Diagnosis typically involves:

1. Medical History and Physical Examination

When diagnosing ARFID, healthcare professionals start by having a friendly conversation about your health and eating habits. They’ll ask about any past or current medical conditions and check things like your height, weight, and vital signs during a routine check-up. This helps them understand your overall health and any concerns related to your eating habits. If you’re feeling nervous, don’t worry! There are also neuro-sensitive clinics available for those who prefer a more comfortable and understanding environment.

2. Psychological Assessment

A comprehensive psychological assessment is an essential component of diagnosing ARFID. This assessment involves evaluating the individual’s psychological functioning, emotional well-being, and mental health history. A trained mental health professional will conduct interviews and administer standardized assessments to explore the individual’s thoughts, feelings, and behaviors related to food, eating, and body image. The assessment may also explore any underlying psychological factors, such as anxiety, trauma, or neurodevelopmental conditions, that may contribute to the development or maintenance of ARFID symptoms.

3. Evaluation of Eating Behaviors and Food Aversions

Assessing eating behaviors and food aversions, which is central to a diagnosis, is conducted by our occupational therapist who specializes in ARFID. Healthcare professionals carefully evaluate the individual’s patterns of eating, including the types and amounts of foods consumed, mealtime behaviors, and any difficulties or challenges encountered during mealtimes. This assessment involves gathering detailed information about the individual’s dietary preferences, dislikes, and avoidances, as well as any specific foods or food groups that elicit aversive reactions. Understanding the nature and extent of food aversions helps clinicians identify patterns of avoidance and restriction characteristic of ARFID.

4. Screening for Nutritional Deficiencies

Screening for nutritional deficiencies is an integral part of the diagnostic process for ARFID, and our capable dietitians handle this aspect of the evaluation. Malnutrition and inadequate nutrient intake often result from the restrictive eating patterns associated with ARFID, which can lead to various physical health complications. Our healthcare professionals may conduct laboratory tests, such as blood tests or nutritional assessments, to evaluate your nutritional status and identify any deficiencies or imbalances in essential nutrients. This screening helps guide our treatment planning and interventions aimed at restoring optimal nutritional health and addressing any medical complications associated with ARFID.

Treatment Options for ARFID

Treatment for ARFID often involves a multidisciplinary approach, including:

1. Exposure Therapy

Exposure therapy is a behavioral intervention commonly used in the treatment of ARFID to gradually introduce new foods and expand food variety. Under the guidance of our Occupational Therapist, individuals systematically confront feared foods or eating situations in a controlled and supportive environment. Exposure therapy helps desensitize individuals to food-related anxiety and aversions, allowing them to tolerate and eventually incorporate a wider range of foods into their diet. Over time, exposure therapy can lead to increased flexibility in food choices and reduced avoidance behaviors.

2. Family Support

Supporting parents to understand their child’s experience and how they can best support them around food and meals is a vital aspect of ARFID treatment. ARFID can impact the entire family, causing disruptions in mealtime routines and communication challenges. Our approach involves working closely with parents to address these dynamics, improve communication, and create a supportive mealtime environment. By empowering parents with knowledge and strategies, we aim to enhance understanding, empathy, and family cohesion, which are essential for supporting the child’s recovery from ARFID.

3. Medical Monitoring

Medical monitoring is an essential component of ARFID treatment to address any physical health concerns associated with malnutrition or other medical complications. Healthcare professionals, including those from specialized clinics that support neurodivergent individuals, closely monitor the individual’s physical health and nutritional status throughout the treatment process. This may involve regular medical check-ups, laboratory tests to assess nutritional deficiencies, and monitoring of vital signs and growth parameters. Medical monitoring ensures that any medical issues are promptly identified and addressed, optimizing the individual’s overall health and well-being during recovery from ARFID.

Living with ARFID

By integrating the previous comprehensive treatment options, individuals with ARFID can receive the support and resources they need to address the underlying factors contributing to their eating disorder and work towards sustainable recovery and improved quality of life.

At Alberta Wellness Center, our treatment plans are tailored to the individual’s unique needs and may involve a combination of interventions to address physical, psychological, and relational aspects of ARFID. Collaboration between healthcare professionals, family members, and other support systems is key to promoting successful outcomes and long-term recovery from ARFID.

ARFID is a serious eating disorder that can have significant physical, emotional, and social consequences. However, with early intervention and appropriate treatment, individuals can overcome ARFID and lead fulfilling lives.

If you suspect you or someone you know may have ARFID, don’t hesitate to seek help from a qualified healthcare professional.

Understanding Avoidant Restrictive Food Intake Disorder (ARFID)

Symptoms of ARFID

HAES Positive and Anti-Diet

Embrace a Health at Every Size (HAES) approach with us. We reject restrictive diets and celebrate body diversity, focusing on holistic wellness and positive self-image.

Factors Contributing to ARFID

Diagnosis of ARFID

Treatment Options for ARFID

Living with ARFID

Alberta Wellness Center for Eating Disorders

Our Locations:

Contact Us:

Hours: