What's the difference between Picky eating & ARFID - an Eating Disorder everyone should know more about!
Avoidant Restrictive Food Intake Disorder (ARFID), often characterised as “picky eating”, is an eating disorder impacting the functioning of individuals in many or all areas of life including socially and physically.
Similar to other eating disorders, ARFID has several different types and is dependent on symptoms that are present. ARFID is characterised by an avoidance, aversion or restriction of food that leads to persistent failure to adequately meet nutritional needs and is not attributable to a cultural food practice or food allergy.
3 types of ARFID
Avoidant
Individuals will avoid certain types of foods because of sensory features causing a sensitivity or over stimulation. Sensitivities could be in relation to smells, textures, general appearance or colour.
Aversive
An individual may have a phobia to food or fear consequences of eating. For example, vomiting, choking, allergic reaction, contamination, pain in abdomen.
Restriction
Individuals may lack a biological drive to eat and may not experience hunger cues or show little interest in food and see eating as a chore.
ARFID in many ways presents as Anorexia Nervosa in that some individuals may severely restrict food intake, resulting in inadequate energy consumption and medical complications. However, it is important to note ARFID is NOT due to body image concerns, fear of gaining weight or concern over body weight and shape.
ARFID Risk Factors
Like any other eating disorder the risk factors of ARFID involve biological, psychological and sociocultural aspects, meaning no two disorders are ever the same and can actually be very diverse in their experiences. As ARFID is a relatively new diagnosis research is scarce, however, individuals are at more risk of developing ARFID if:
Individuals have neurodevelopmental disorders such as Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder or an Intellectual disability.
Individuals that do not out-grow normal picky eating in childhood.
There are co-morbid conditions such as anxiety disorder.
Some Symptoms to be aware of with ARFID
Limited range of preferred foods
Inflexible eating behaviours
Fear based food restriction
Lack of interest in food
Significant weight loss
Failing to gain weight
Deficient in nutrients
May require food supplements and special feedings
Experiences substantial impairment in life function as a result of avoidance.
ARFID Treatment Options
Research into effective treatment options for ARFID is ongoing, however, a key aspect of treatment is early identification and intervention. The goals of treatment will be unique to individual clients and will be determined by the underlying reason for avoidance of food. Treatment options based on current research include:
Cognitive behavioural therapy (CBT): Treatment may involve psychoeducation, gradual exposure to feared foods, self-monitoring, relaxation training and behavioural change to eating patterns.
Family Based Therapy (FBT): This involves parents or carers playing a pivotal role by empowering parents to take on the responsibility to establish meal time routines, modelling behaviours at meal times and encouraging the individual to respond to hunger cues.
Acceptance and Commitment Therapy (ACT): This helps the individual to define goals, what they want and how they want to be living in regards to food behaviours. It also encourages the individuals to commit to action that allows them to live a life in line with their values.
Medications for co-morbid conditions: There are no medications specific to treating ARFID, however, if there are co-morbid conditions of anxiety and depression, there are medications that can help with these symptoms.
Inpatient setting: Due to the restrictive nature of ARFID, in some individual’s severe medical conditions can arise in the form of gastrointestinal, cardiac and blood pressure problems. In these cases, hospital admission may be necessary to ensure the individual receives adequate nutritional intake to return to normal body functioning.
Final words
The path to recovery for any eating disorder can be challenging and long. It is possible for individuals to recover from ARFID, even if the individual has been living with the disorder for many years. If you, or someone you know, is be experiencing symptoms of ARFID and would be interested in finding out more, please contact us as we would be more than happy to help!
