ARFID is Avoidant/Restrictive Food Intake Disorder, a newer eating disorder classification. Read on for information about and help for this diagnosis.
When it comes to children and their eating habits, it’s not uncommon for parents to encounter challenges. For some children, their struggles with food intake go beyond typical picky eating or fussy behaviors. Read on to learn about ARFID and what to do if your child has it.
What is ARFID?
ARFID stands for Avoidant/Restrictive Food Intake Disorder, is a relatively new diagnosis in the field of eating disorders, officially recognized in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).
ARFID is characterized by a limited variety of foods in a child’s diet, often due to sensory sensitivities, fear of certain textures or tastes, or an aversion to eating in certain social situations. Unlike other eating disorders, ARFID is not driven by concerns about body image or weight.
The diagnosis can lead to significant nutritional deficiencies, inadequate growth, and emotional distress for the child and their family.
If you suspect that your child may have Avoidant/Restrictive Food Intake Disorder (ARFID), it’s essential to understand the condition and take appropriate steps to support your child’s well-being.
How is ARFID diagnosed?
ARFID is diagnosed through a comprehensive evaluation by a healthcare professional, such as a pediatrician, psychologist, or registered dietitian.
They will assess the child’s eating habits, medical history, and any related psychological or sensory issues. They might ask about childhood eating habits and thoughts about food.
If the medical professional asks your child, speaking before they get a chance to respond might get you kicked out of the room. Please remember that your child is a human, too, even when/if you’re scared.
What causes ARFID?
The exact causes of ARFID are not fully understood. However, factors such as sensory sensitivities, negative food experiences (choking, vomiting), anxiety, and underlying neurodevelopmental conditions may contribute to its development.
Autistic individuals with sensory sensitivities may be more susceptible to developing ARFID at a young age.
Will they grow out of ARFID?
No. Without treatment, ARFID persists into adolescence and adulthood if left untreated. However, with early intervention and appropriate treatment, many individuals with ARFID can make significant improvements and develop a healthier relationship with food.
Is ARFID related to autism?
ARFID can sometimes co-occur with autism spectrum disorder (ASD), as autistic individuals may experience sensory sensitivities or aversions to certain foods. However, ARFID can also occur independently without a diagnosis of autism.
The two diagnosis are not intrinsically woven to the point that one cannot coexist without the other.
How does ARFID differ from other eating disorders?
It’s important to note that while ARFID is distinct from other eating disorders, it is still a serious condition that requires proper diagnosis and treatment.
If you suspect that you or someone you know may have ARFID or any other eating disorder, it’s crucial to consult with healthcare professionals for a comprehensive evaluation and guidance on appropriate interventions.
Other eating disorders such as anorexia nervosa or bulimia nervosa are primarily driven by concerns about body image, weight, and shape, while ARFID is not.
ARFID is primarily characterized by a limited variety of foods in the diet, often due to sensory issues, aversions to certain textures or tastes, or fear of negative consequences associated with eating (like a stomach ache).
Weight and body image
Unlike anorexia nervosa, individuals with ARFID do not have a distorted body image or an intense fear of gaining weight. Weight loss or inadequate growth may occur in ARFID, but it is not the primary motivator behind the disorder.
While individuals with ARFID may experience anxiety or distress around mealtimes, it is typically related to the fear or aversion associated with certain foods, rather than a desire for thinness or control over their body.
ARFID can lead to significant nutritional deficiencies, inadequate growth, and impaired overall health due to the limited variety of foods consumed.
In other eating disorders, medical consequences may result from extreme caloric restriction, purging behaviors, or excessive exercise.
ARFID can co-occur with other eating disorders, such as anorexia nervosa or bulimia nervosa. In such cases, a person may meet criteria for both disorders simultaneously. However, ARFID can also occur independently without the presence of another eating disorder.
While evidence-based treatments such as cognitive-behavioral therapy (CBT) and family-based therapy (FBT) are commonly used for various eating disorders, specific adaptations may be required for individuals with ARFID. More specific treatment adaptions will have to be made for autistic and similarly neurodivergent individuals, like those who have experienced trauma.
Treatment for ARFID often focuses on expanding the variety of foods accepted by the individual, addressing sensory sensitivities, and addressing any underlying anxiety or aversion-related issues.
Treatment may also include occupational therapy for feeding therapy to increase the child’s tolerance of food textures.
Signs of ARFID
Parents play a crucial role in identifying potential signs of ARFID in their child.
Keep an eye out for behaviors such as:
- consistently avoiding certain food groups
- extreme selectivity when it comes to food choices
- difficulty accepting new foods
- chewing and then spitting out food
- experiencing anxiety or distress around mealtimes
Also watch for warning signs of ARFID which include:
- weight loss
- lack of energy
- poor growth
- decline in overall well-being
If you notice these signs persistently, it’s important to consult with a healthcare professional for a comprehensive evaluation.
All behavior is communication, even if they struggle to articulate it to you right now.
What to do if a loved one has ARFID
If your child or someone you love has ARFID, here are your next steps.
Create a supportive environment
Building a supportive and understanding environment around your child is essential in their journey towards recovery. Encourage open communication, allowing your child to express their feelings and concerns about food without judgment.
Avoid pressuring or forcing them to eat, as this can exacerbate their anxiety. Instead, focus on creating a positive atmosphere during mealtime, offering a variety of foods, and allowing your child to take small steps towards trying new foods at their own pace.
Seeking professional help
If you suspect your child may have ARFID, it is vital to seek professional help from healthcare providers experienced in pediatric eating disorders.
Start by consulting your child’s pediatrician, who can provide a referral to a specialist, such as a registered dietitian or child psychologist specializing in eating disorders. These professionals can conduct a thorough assessment, rule out any underlying medical conditions, and guide you in developing a comprehensive treatment plan tailored to your child’s specific needs.
Eating disorders require the help and attention of medical professionals and should not be attempted to remedy on your own without serious repercussions.
Collaborate with professionals
Collaboration with healthcare professionals is crucial in effectively managing ARFID.
The treatment plan may involve a multidisciplinary approach, including nutritional counseling, cognitive-behavioral therapy (CBT), occupational therapy, and family therapy. Please note that CBT is known as a harmful therapy in the autistic community and likened to ABA.
These interventions aim to address the underlying sensory and emotional aspects of ARFID, gradually expanding your child’s food repertoire and improving their relationship with food.
Do not let ED (Eating Disorder) professionals talk over you when it comes to what’s best for your child.
Be patient and persistent
Recovery from ARFID takes time and patience. It is important to remember that progress may be slow, and setbacks can occur along the way.
Celebrate small victories and milestones, and remain supportive even during challenging times. Consistency and a nurturing environment are key in helping your child overcome their fears and develop a healthier relationship with food.
Create a reward at the end of the journey — like dyeing one’s hair, getting a tattoo, taking a small trip etc. The ED recovery reward should be simple, yet something they don’t have access all the time (like taking a small trip).
What can parents do to support their kids with ARFID?
Parents can support a child with ARFID by creating a positive and supportive mealtime environment, encouraging open communication about food-related fears or concerns, seeking professional help, and working closely with healthcare providers to develop a personalized treatment plan.
Reminder: If you suspect that your child has ARFID, it’s crucial to take action and seek professional help. By understanding the signs, collaborating with healthcare providers, creating a support system, and advocating for your child, you can both make it through this.
Autistic people with ARFID may struggle to eat food due to sensory sensitivities and interoception struggles. They may fall behind on nutrients.
CBT is often compared to ABA in the autistic community because the “treatments” are so similar to each other.
Moreover autistic burnout may allow for eating disorder behaviors to fester, but it won’t respond to CBT. If you fix the eating disorder without fixing the issues surrounding why the eating disorder was developed in the fist place, ED treatment won’t help in the long run.
Your child might go into remission from their ED, but they will ultimately return right back to it — especially if that cause is within their home environment to begin with.
More often than not, the entire family has to endure therapy, or eating disorder education, so they can learn how to better support their loved one. Please don’t fight it or treatment will be difficult for the disordered eater.
ED recovery doesn’t look like a pretty, slanted line on a graph. It’s more like a scribble tornado with a line coming out on each side. While at the time it might feel like stressful misery, it’s ultimately worth it in the end.