What is Avoidant Restrictive Intake Disorder?

Avoidant Restrictive Intake Disorder (ARFID) is an eating disorder characterized by a severely reduced intake of food that isn’t motivated by body image concerns. This disorder can present in a variety of ways. People with ARFID may feel comfortable eating only a few select foods, and/or they may have an intense aversion to the sensory aspects of many foods. Still others may simply lack a normal interest in and appetite for food in general.

The DSM-5 defines ARFID as:

- An eating disturbance (a lack of interest in eating; avoidance of foods with certain sensory characteristics; concerns about vomiting or choking on food) that leads to a failure to meet appropriate nutritional/energy needs and results in one or more of the following:

  • Significant weight loss (or failure to achieve expected weight gain or growth in children).

  • Significant nutritional deficiency.

  • Dependence on enteral feeding or oral nutritional supplements.

  • Marked interference with psychosocial functioning.

- The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice.

- The eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of body image disturbance.

-The eating disturbance is not solely attributable to a medical condition.

In the cultural discussion of eating disorders, ARFID is seldom discussed. This is unfortunate, because it leaves sufferers vulnerable to being misunderstood or even judged for their symptoms. For example, research has demonstrated that there may be genetic variants in those with ARFID that make them especially sensitive to tastes and textures. Such information is invaluable in understanding their diagnosis and preventing dismissive labels like “picky eater.” Because many important events and celebrations involve food, those with ARFID may have compromised social functioning; avoiding events altogether may seem preferable to fielding questions from others about their unique eating habits.

While there is still much to learn about ARFID, there are effective treatments available. A well known treatment called Cognitive Behavioral Therapy (CBT) has been adapted for the treatment of ARFID. This treatment involves challenging the fearful and distorted thoughts that the patient has about food, as well as exposures and tastings of their “fear foods.” Over time, these exercises can shape new beliefs and behaviors toward food that are more adaptive. Establishing a more regular eating schedule can also reform the patient’s hunger cues and increase the intake of nutrients their body needs.

If you suspect that you or a loved one is suffering from ARFID, there is professional help available. An admissions professional or counselor can help you determine the appropriate level of care for you or your loved one.

 Contributed by Carina Pearson, MA, Eating Disorder IOP Counselor at Focus Treatment Centers, Chattanooga, TN

 

Citations

Thomas, J. J. (2019). Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder (Children, Adolescents, and Adults) (1st ed.). Cambridge University Press.

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5(5th ed.). American Psychiatric Publishing.

 

Archive

Categories

Lauren Sterritt