ARFID: The Misunderstood Eating Disorder

ARFID stands for Avoidant Restrictive Food Intake Disorder and probably isn’t the first thing that comes to mind when you think of eating disorders. Eating disorders you may have heard of like anorexia and bulimia are typically tied to a desire to lose weight. ARFID may mimic anorexia in that it can cause significant weight loss and restrictive eating but typically isn't linked to negative self-image or wanting to change one’s body weight. 

According to The Emily Program, a treatment center network specializing in eating disorders, ARFID can be defined as “an eating disorder marked by avoiding or restricting food intake to the point of substantial weight loss (or, in children, a failure to thrive), nutritional deficiency, or significant impairment in social, academic, or occupational functioning as well as psychological distress. This can be due to sensory sensitivity, traumatic experiences, and/or a lack of interest in eating or food.” Typically, kids and adults with ARFID have “safe foods” that they are comfortable eating. For someone dealing with sensory-related ARFID, safe foods may include those of a certain texture, which often limits many fruits and vegetables. For someone who is experiencing ARFID due to emetophobia, or the fear of vomiting, “unsafe” foods might include those that have previously made them feel sick or that they believe have the potential to upset their stomach. A fear of choking or of having an allergic reaction are other common reasons someone may develop ARFID. ARFID often co-occurs with ADHD, autism spectrum disorder or OCD. With OCD, for example, someone may avoid certain foods or complete rituals surrounding eating time due to fear of contamination. 

Because ARFID is so closely linked to anxiety, Exposure and Response Prevention (ERP) can be an effective treatment. ERP for ARFID might look like tackling a list of foods that would cause the least to highest amount of anxiety or distress. In certain cases, an individual may even start small by just smelling, talking about or looking at a certain food. ERP can also address core fears that may be driving the eating behaviors, or related obsessions/compulsions if OCD is also present.  If sensory sensitivity is the main cause, it may be also helpful to work with an Occupational Therapist (OT) who can provide feeding therapy. OTs focus on functional feeding skills, sensory processing, and adapting activities of daily living. Your therapist and/or OT will help you come up with a treatment plan so you can begin expanding your horizons one bite at a time!