ARFID, which stands for avoidant/restrictive food intake disorder, may be confused initially with picky eating. However, it is actually an eating disorder that causes a person to avoid or restrict eating certain foods due to a sensory sensitivity to those foods — such as not liking the way certain foods look or feel — or a fear of choking or vomiting when eating certain foods.
ARFID is more common in children, but it also occurs in teens and adults. In fact, a screening of more than 50,000 adults by the National Eating Disorders Association found that 4.7% screened positive for ARFID, according to a 2023 study. Another study showed an ARFID prevalence of 1.98% among more than 5,000 teens.
Depending on how extreme ARFID is, it could lead to stunted growth, weight loss or nutritional deficiencies.
[READ: Orthorexia: The Unhealthy Obsession with Healthy Eating and How to Break Free]
What Is ARFID?
Here’s more information on what ARFID is, including symptoms and the difference between ARFID in adults versus children.
ARFID symptoms
Symptoms of ARFID include:
— Anxiety over trying new foods
— Fear of choking, vomiting or getting sick after eating certain foods
— Feeling less hungry than others or having a low interest in food
— Having food limitations that can affect with enjoyment of life
— Nutritional deficiencies and possibly needing nutritional supplements to make up for those deficiencies
— Significant weight loss
— Strong sensitivities to food colors, smells, tastes and textures
Is ARFID an eating disorder?
Like anorexia, bulimia or binge eating disorder, ARFID is a type of eating disorder that was formally included as a clinical diagnosis in the American Psychiatric Association’s DSM-5 diagnostic manual of mental disorders in 2013.
ARFID in adults vs. children
ARFID is often associated with children or teens, but it can affect adults as well. The symptoms may be the same at any age, but the causes and resulting life changes are often different.
“Teens and adults with ARFID may experience similar difficulties with food intake, such as avoidance of certain textures or fear of specific foods,” says Aja Chavez, national executive director of Mission Prep Healthcare, which provides mental health treatment for teens in California and Virginia. “Adults may develop ARFID symptoms later in life due to factors such as trauma, mental health conditions or other life stressors.”
Because our society is so food-focused, the avoidance of social activities related to food also may be slightly different for children and teens versus adults.
“When people have an extremely limited variety of foods they can eat, they may be unable to travel away from home or to new places where their preferred foods are unavailable,” says Dr. Amy Henke, a psychologist with Children’s Hospital New Orleans. “Teens often feel left out from typical adolescent activities like getting pizza or going to a food court at a mall. Adults may begin to limit their activities and shrink their social circle.”
[SEE: The Benefits of Mindful Eating.]
Causes of ARFID
While the exact of causes of ARFID aren’t certain, experts believe that some things make a person more likely do develop ARFID, including:
— Neurodivergence. This refers to having a brain that functions differently than others, and can include having a condition that affects behavior, communication and social skills, like ADHD and autism spectrum disorder.
— Experiencing a traumatic event. Emotional or physical trauma is more commonly a cause of ARFID in adulthood. Mental health conditions like PTSD and OCD have been linked with ARFID as well.
— Negative experiences with food in the past. For example, if a child goes through the experience of choking on a particular food, they may avoid that food in the future.
“ARFID that starts in adulthood is more likely to be triggered by a traumatic event or a medical condition, whereas selective eating or lack of interest in food is more likely to appear early in life,” Henke says.
However, many adults may have had an eating problem in their childhood or adolescent years and continue their selective eating or lack of eating as an adult, she adds.
[READ: Best Healthy Foods You Should Be Eating]
ARFID Versus Picky Eating
It may initially seem that ARFID and picky eating are the same, but they’re not.
“I always like to clarify that ARFID is more than picky eating, and not all people with ARFID are picky eaters,” says Dr. Jessie Menzel, vice president of program development at Equip, a virtual eating disorders company.
It’s very common for children to go through a phase where they are picky eaters and have strong preferences for foods with certain tastes, textures or brands, Menzel explains. Yet when picky eating starts to result in the following, it could be a sign of ARFID:
— More conflict over meals
— A narrowing of food preferences over time
— Nutritional deficiencies identified through bloodwork
— Poor growth
— Refusal to try new foods
— Weight loss
“While picky eaters may have preferences for certain foods, individuals with ARFID exhibit extreme avoidance that leads to malnutrition or impairment in daily functioning,” Chavez says.
ARFID Diagnosis
There isn’t a specific test to diagnose ARFID. Instead, a health care provider will consider a person’s symptoms as they relate to ARFID or other health conditions. Lab work, such as blood and urine tests, can help determine if someone is low on certain nutrients.
If you think that you or your child has ARFID, schedule an appointment with a health care provider.
“I recommend researching and coming prepared for your visit with information about ARFID in case your provider isn’t familiar with the diagnosis. Because ARFID is a relatively new disorder, many providers still lack education on it,” Menzel says.
The level and type of support you or your child needs may vary depending on your nutrition status and symptoms, says registered dietitian Lauren Sharifi of Framingham, Massachusetts, who specializes in ARFID.
It also would be helpful to obtain a referral to a specialist who is familiar with eating or feeding disorders, Menzel adds. This may include a mental health provider or a feeding therapy specialist, although other health professionals, such as registered dietitians and a primary health care provider, may be involved. With children, other specialists involved may include a pediatric psychologist, occupational therapist and a speech-language pathologist.
ARFID Treatment
Treatment for ARFID often depends on the person’s individual needs. This could be in an inpatient or outpatient setting. Treatment for ARFID may include:
— Cognitive behavioral therapy, a type of talk therapy that involves setting goals and overcoming challenges, for ARFID
— Exposure therapy to gradually increase food variety and acceptance
— Meal planning and support for children and their families
— Nutritional counseling
— Supplemental nutrition or tube feeding if needed
— Sensory integration therapy if there is an issue with sensory sensitivities
Treatment for children may focus more on family-based interventions such as involving parents in meal planning and support, Chavez says. Meal planning for adults may focus more on individual therapy related to psychological reasons that contribute to ARFID.
Tips for Parents of Children With ARFID
Parents of children with ARFID also may need support. “Caring for a child with an eating disorder can take an emotional toll on parents. It’s important to know that you’re not alone,” Menzel says.
Here are some tips if you’re a parent of a child with ARFID:
— Create a support network with family, friends and other caregivers affected by eating disorders. FEAST and Feeding Matters are two groups that can be a great jumping-off point, Menzel says.
— Work on accepting your child’s challenges versus trying to “fix” them. “There’s so much pressure in our society for children to eat a certain way or certain types of food, and this may not be accessible for everyone with ARFID,” Sharifi says. “Instead of forcing kids to eat something, understand their sensory preferences around foods, and offer safe foods and a sensory-safe environment to eat.”
— Work on expanding foods when your child is ready. While this may feel like a slow process, Sharifi says waiting until your child is ready will have a positive outcome.
— Celebrate small victories that help your child. Trying just one new food or a bite of a meal may not seem like great progress, but it’s important to celebrate even these small victories.
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ARFID vs. Picky Eating: What’s the Difference? originally appeared on usnews.com
