ARFID Is More Than Picky Eating: Signs, Symptoms, and Treatment

Most people have an understanding of eating disorders such as anorexia and bulimia. What they do not know is that a often misunderstood disorder tied to challenges with eating normally has more than tripled recently. Read for the details about ARFID, its symptoms, and recommended treatments and strategies to combat this form of disordered eating.

Understanding What Makes ARFID Different From Other Eating Disorders

The avoidant/restrictive food intake disorder (ARFID) is being diagnosed more frequently. What is this specific type of eating disorder? According to Christina Ni, MD, a psychiatrist and interventional psychiatry medical director at Mindpath Health, “ARFID is an eating disorder where someone significantly limits food intake, not because of body image concerns, but due to sensory sensitivities, fear of consequences such as choking or vomiting, or low interest in eating."

ARFID presents itself in a number of different ways, depending on the patient. For instance, while some people might have problems with textures, others might stick to foods that do not have a high risk of choking.

In addition, eating disorder experts note that it is not necessarily that ARFID is becoming more common but that it is simply being recognized and diagnosed more. In the past, sufferers were just said to be picky eaters for no medical reason. ARFID had long been viewed as a condition that most people grow out of when they reach adulthood. However, this is also changing as awareness of the issue grows and adult sufferers are more likely to self-advocate.

Current estimates detail that ARFID impacts approximately 1 to 5% of the general population. The highest rates are found in children and teens, as well as people with autism, anxiety, obsessive-compulsive disorder (OCD), and attention-deficit/hyperactivity disorder (ADHD). People who have experienced an allergic reaction to food, reflux, or choking also display higher rates of diagnosis.

ARFID Signs and Symptoms

It is important to note that simply being a picky eater or having strong food preferences does not translate to an ARFID diagnosis. True ARFID sufferers tend to have severe nutritional deficiencies blamed on their eating habits. These patients also often have other medical complications and high levels of stress. The telltale sign of an ARFID patient is how severely the eating difficulties disrupt everyday life.

Those with ARFID also generally have just a small group of foods that they will eat. The options are typically limited to specific textures, food temperatures, or brands.

The impacts of ARFID go beyond food selection. Those with the condition often struggle greatly with situations that revolve around food. For example, going out to eat at a restaurant, eating in front of co-workers or at school, or attending social events can feel impossible for ARFID patients. It is this degree of life disruption that distinguishes the disorder from run-of-the-mill picky eating.

Because of all of the gray area surrounding this disorder, it can be challenging for doctors to arrive at the diagnosis. A medical doctor will look at nutritional deficiencies, overall health patterns, and any other underlying conditions that may be exacerbating the eating challenges. In addition to being examined by a medical doctor, most ARFID diagnosis tools lean on evaluations from a therapist or psychiatrist trained to recognize the symptoms.

Tips for Dealing with ARFID

Treating ARFID should not be a one-size-fits-all approach. The recommended line of treatment is largely driven by what is triggering the food avoidance. For example, patients who avoid foods because of a fear of choking will need a different approach than someone grappling with sensory sensitivities.

Exposure-based cognitive behavioral therapy has shown great promise in treating ARFID. By helping patients build comfort through small and manageable steps, they are more likely to find success in tackling what is making it difficult for them to enjoy food normally.

A good treatment plan should be tailored to that person's individual experiences and fears. The goal is to help build tolerance so that more foods can be introduced. The food should never be forced. Instead, exposure therapy aims to help the brain to relearn healthy eating habits through low-pressure but consistent exposure.

Some patients may also find success in combining exposure therapy with anti-anxiety medication and therapy. This is especially true when the disordered eating is rooted in fear.

Lastly, experts recommend the use of supportive strategies that encourage comfort while eating. Good ideas include leaning on predictable meal routines, joining a support group, and surrounding yourself with people who are supportive of the struggles and the treatment.

For some sufferers, simply having a definitive diagnosis can go a long way in helping them to affirm their struggles and put a name to them. Just knowing what the issue is and having employable strategies can mean the difference between suffering in silence or being empowered to treat the disordered eating.

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