Because few people are aware of avoidant restrictive food intake disorder, separating myth from fact is crucial to reducing stigma and helping people seek treatment.
Avoidant restrictive food intake disorder (ARFID) is a condition in which a person has no interest in food or avoids food because of a dislike of the taste or smell of it. People with this condition eat so little that they are often unable to meet basic their bodily needs, which can lead to nutritional deficiencies, failure to maintain a healthy weight and problems with psychological functioning. There are some ARFID myths, but they can be debunked with proper facts and education.
Myth 1: ARFID is just picky eating.
Fact: ARFID is recognized as a mental health disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
There is more to ARFID than picky eating. The difference with ARFID vs. picky eating is that picky eating is generally a phase and does not produce any significant long-term consequences. With ARFID, a person avoids food to the point that he or she is unable to grow properly, maintain a healthy weight or carry out basic bodily functions. According to the National Eating Disorders Association (NEDA), some children who have significant difficulty with picky eating may go on to develop ARFID.
ARFID is considerably more disruptive to a person’s life than picky eating is, as it is associated with significant physical and mental symptoms. For example, a person with ARFID may have such a strong aversion to food that he or she will choke or gag when attempting to eat. ARFID can also create anxiety and cause a person to avoid social settings where food will be served.
Myth 2: ARFID is a childhood disorder.
Fact: ARFID can affect both children and adults.
NEDA reports that ARFID is more common in children and teenagers, but adults can also receive an ARFID diagnosis. ARFID in adults may be a result of untreated childhood feeding issues or a lengthy history of aversion to sensory aspects of food, such as taste, texture or smell.
One study assessed the occurrence of food avoidance behaviors in adults receiving treatment at both an immunology clinic and a general practice setting. The results showed that behaviors consistent with ARFID were common in the adult population, with allergies and food intolerances perhaps being responsible for food avoidance.
Myth 3: Individuals with ARFID are concerned about weight gain.
Fact: Unlike those with other eating disorders like anorexia nervosa, individuals with ARFID are not preoccupied with weight.
ARFID is different from eating disorders in which a person is excessively concerned with weight. With ARFID, an individual avoids food because of an aversion to its taste, smell or texture, not because of a fear of gaining weight.
Despite the fact that people with ARFID are not concerned about weight gain, they often lose weight due to food avoidance. NEDA reports that significant weight loss and using oversized clothing to mask low body weight are common symptoms of ARFID, which can make this disorder appear similar to anorexia nervosa. That being said, one of the diagnostic criteria for ARFID is that it cannot involve a disturbance in body image and cannot be a manifestation of anorexia or bulimia.
Myth 4: People with ARFID will eventually outgrow it.
Fact: ARFID is a diagnosable eating disorder that requires treatment.
ARFID is recognized as a serious eating disorder that can result in significant physical and psychological consequences, making treatment necessary. Without treatment, ARFID does not simply resolve on its own. In fact, with continued food restriction, ARFID can create serious consequences, such as malnutrition and electrolyte imbalances, which may eventually lead to death.
In addition, ARFID often involves anxiety around eating and an irrational fear or aversion to the texture or taste of food. These symptoms represent a mental health condition that a person cannot simply outgrow. One study found that individuals in treatment for ARFID were fearful of vomiting or choking when eating, and they demonstrated high rates of anxiety, learning and developmental disorders. These are conditions that require treatment.
Myth 5: There is no treatment for ARFID.
Fact: ARFID treatment is available and can be effective.
ARFID can be treated, just like other eating disorders and mental health conditions, and experts have conducted studies to determine what works for treating ARFID. A review of current research shows that ARFID treatment can help to increase food consumption, reduce behavioral issues during mealtimes and create lasting benefits. The most common treatments in the review included behavioral interventions and weaning from tube feeding.
NEDA reports that cognitive behavioral therapy (CBT) and exposure interventions can also be effective treatments for ARFID. During CBT, individuals learn to replace distressing thoughts with more rational thoughts.
If you or a loved one is living with ARFID and a co-occurring substance use disorder, The Recovery Village has comprehensive treatment services to meet your needs. Reach out to an admissions specialist today to begin your journey toward recovery.
National Eating Disorders Association. “Avoidant restrictive food intake disorder (ARFID).” 2018. Accessed May 28, 2019.
National Eating Disorders Association. “More than picky eating-7 things to know about ARFID.” October 2018. Accessed May 29, 2019.
Fitzgerald, Michael, and Frankum, Brad. “Food avoidance and restriction in adults: a cross-sectional pilot study comparing patients from an immunology clinic to a general practice.” Journal of Eating Disorders, September 18, 2017. Accessed May 29, 2019.
Nicely, Terri, et al. “Prevalence and characteristics of avoidant/restrictive food intake disorder in a cohort of young patients in day treatment for eating disorders.” Journal of Eating Disorders, August 2, 2014. Accessed May 29, 2019.
Sharp, William, et al. “A systematic review and meta-analysis of intensive multidisciplinary intervention for pediatric feeding disorders: How standard is the standard of care?” The Journal of Pediatrics, February 2017. Accessed May 30, 2019.
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