Avoidant restrictive food intake disorder (ARFID)

What is ARFID?

Although it is seen in adulthood, avoidant restrictive food intake disorder (ARFID) usually begins in childhood and is therefore most common in children and younger adolescents. It is characterised by avoiding or restricting foods or food groups for specific reasons that can include an overall lack of interest in eating, a dislike for the sensory effect of the food (texture, taste, smell etc) or because of a previous negative experience such as choking.

Those with ARFID are more likely to have another illness or condition such as autism or attention deficit hyperactivity disorder (ADHD), and the presence of these increase the likelihood of developing ARFID.

Although those suffering with ARFID may exhibit similar behaviours to anorexia in engaging in restriction, ARFID is not characterised by concerns about body weight or image, or fears of gaining weight.

Many children go through a phase of picky eating, but in those with ARFID this becomes an ongoing and severe issue that negatively impacts their development, growth, and bodily functions due to a lack of nutrient absorption. Due to the possibility of electrolyte imbalances, the impact on metabolism, nutrient intake, and digestion, it is important to seek help from a GP.

Signs and symptoms of ARFID

Signs of ARFID include:

  • Will only eat specific and often very limited foods or textures, unconnected to weight loss/restriction. Range of foods eaten may decrease over time.
  • Appears to lack interest in eating and food on a persistent basis
  • Apparent lack of appetite on persistent basis
  • Fears choking or vomiting
  • Presence of food allergies
  • Does not fear gaining weight or not preoccupied with body image concerns

Symptoms of ARFID include:

  • Significant weight loss
  • Significant nutritional deficiency
  • In children, failure to thrive (develop in line with normal expectations for age)
  • Gastrointestinal issues such as constipation, acid reflux, stomach cramps
  • Anxiety, especially generalised anxiety disorder
  • Dizziness and/or fainting
  • Loss of periods or failure to begin post puberty
  • Impaired immune function
  • Problems sleeping and severe lack of energy in the day
Treatment for ARFID

Currently, there are no ARFID-specific treatment programmes, although there are research studies looking into the most effective ways to manage and treat the condition. A study into a form of CBT, called CBT-AR, which is thought to be suitable for those 10 years +, including adults, is currently underway.

In the meantime, please do seek professional help and support if you or a child you care for is experiencing the symptoms of ARFID. It is important to seek help as soon as possible and a mix of psychological and practical treatment options are usually offered. These may include cognitive behavioural therapy and, where required, hospital re-feeding treatment. Family-based therapy may also be used.

If you are concerned that you, or someone you care for, may have ARFID, we are here to help. Please book a 1:1 support call or take a look at our peer support groups. Our team of staff and volunteers have lived experience of eating disorders. They can listen to your worries and provide practical guidance to help you take positive steps towards getting help and recovery.

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