(Credit: AlexandrMusuc/Shutterstock)
Avoidant/restrictive food intake disorder (ARFID) is a newly recognized eating disorder that limits food intake. It isn’t the result of someone wanting to lose weight or change their body image. Instead, it’s created by anxiety and fear about food or by fearing the consequences of eating, like choking on food.
ARFID can cause an individual to lose interest in eating or to avoid foods that have undesirable colors, tastes, textures, or smells. A healthcare provider may call ARFID a “selective eating disorder” because the individual only chooses a few things that they’re willing to eat.
They may create rituals of behavior around eating, like consuming food in a certain order. It can also affect their nutrient intake and general health. Without treatment, ARFID can cause life-threatening complications.
ARFID is different from picky eating. Kids may avoid some foods because they don’t like their look, smell, feel, or texture. With picky eating, children dislike a few foods, but it doesn’t affect their growth and development. Also, kids often grow out of it. With ARFID, however, the disorder can adversely affect appetite and even a child’s growth and development. It must be treated; a child doesn’t grow out of it.
Since ARFID is a newer diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), there isn’t much data available to estimate how often it occurs, the relative frequency of symptoms, or other features of the disease.
The cause or causes of ARFID are still unknown. Research suggests that anxiety, fear, or trauma may be the source. Research also suggests that it may be affected by social, environmental, and cultural influences. Genetic changes may have a role.
Anyone could be at risk
ARFID can affect anyone of any age, although it’s most common during childhood. Someone may be more at risk if they had a traumatic experience, especially involving food, such as force-feeding or food insecurity. Having a neurological or developmental condition such as ADHD or depression may increase the risk as well. Other risk factors include having an aversion to some food textures, a fear that food will harm you in some way, and a family history of eating disorders.
What are the signs and symptoms of ARFID?
Abdominal pain, including cramping, upset stomach, or constipation, is common. Patients with ARFID also experience significant weight loss. Other common symptoms may include lethargy, weakness, low body temperature, fainting, and dizziness. Menstrual cycles may become irregular or stop, and fine hair may appear on the body (lanugo).
Additionally, ARFID could lead to behavioral changes, like a loss of appetite or feeling full before meals, and a fear of what could happen with eating, like choking or vomiting. ARFID patients can have difficulty paying attention, which limits how much food they eat, or they only eat foods with certain textures.
This eating disorder can even affect someone’s ability to socialize. An individual may avoid events where there is food and avoid people they love. It can also be a distraction from work and school responsibilities.
ARFID can cause fatal complications
The complications of ARFID can be life-threatening. They include malnutrition, dehydration, electrolyte imbalances, low blood pressure, and even cardiac arrest. Osteoporosis and anemia are potential complications as well. For younger patients, physical growth may be stunted, and puberty may be delayed.
How do you treat ARFID?
The main components of treatment include gaining weight, maintaining a healthy weight, and preventing complications that threaten good health. It requires managing sensory aversions and fears about food.
One type of treatment used for ARFID is cognitive behavioral theory (CBT), which distinguishes problematic thoughts and behaviors, works to lessen fear and anxiety about food, and teaches relaxation for sensory challenges.
Medications are sometimes used, including antidepressants or antipsychotics. At times, a temporary feeding tube is necessary.
If you or someone you know has symptoms or signs of ARFID, start by seeing or recommending a primary care provider. They may recommend a mental health care provider, a gastroenterologist, a speech-language pathologist, or other specialists.
With all the contaminants and allergens in foods, there’s good reason to be food avoidant. And with all the food safety and other nutritional and diet articles saying how this food and that food are bad for you, it’s a wonder why everyone doesn’t have this problem.
Not to worry. It will sort itself out when they die. Some genes shouldn’t be passed on for the integrity of the herd.