Avoidant/Restrictive Food Intake Disorder (ARFID)
Health

Avoidant/Restrictive Food Intake Disorder (ARFID)

avoidant-restrictive-food-intake-disorder-arfid

Imagine being in a world where every meal becomes a challenge. Not because you have a fear of calories or dieting but because you feel this sense of excess fear about the food. People afflicted with ARFID find that eating is not a source of pleasure or nourishment but rather a fight against fear, over-sensitiveness, and anxiety. ARFID is an eating disorder that can turn the simplest act of eating into quite an ordeal. Certain textures smells, or past traumatic experiences with foods trigger extreme avoidance.

This condition does not arise out of the same body image concerns as other eating disorders; rather, it’s tied to survival, safety, and manoeuvring around a limited world of “safe” foods. The myth that ARFID is simply picky eating is one to debunk. Instead, this reality appears so much more complex and impactful with such serious health risks combined with social isolation and emotional distress. Knowing ARFID is the way to break through the barriers it creates.

Understanding ARFID

ARFID manifests in different ways for different people. For instance, the relationship with fear of some sort of consequence arising due to eating a particular food item. Such triggers can result in very restricted diets that make eating a very stressful and overwhelming experience. Unlike anorexia or bulimia, ARFID does not necessarily involve an obsessive preoccupation with body image or weight.

A person suffering from ARFID is not typically concerned about losing weight or changing his or her physical appearance. Instead, food is the primary concern. Whatever reason might be related to the threat of getting hurt physically that keeps them from eating and also something that may relate to the taste and texture of food? This makes ARFID rather unique and particularly difficult to diagnose in general, especially for children, who already tend to be restrictive with their diet preferences.

Etiologies of ARFID

The aetiology of ARFID is not known specifically; however, the researchers tend to believe that this condition results from the combined effects of genetic, psychological, and environmental factors. In the case of some individuals, the condition could develop after they have encountered a traumatic incident associated with eating, such as choking or an extremely painful case of gastrointestinal distress. The individual would eventually require calling for a conditioned fear response where they associate eating with discomfort or danger.

Some children with ARFID also suffer from sensory processing problems. For instance, a sensitive child might excessively worry about the mouthfeel, taste, or smell of certain food items. Some researchers claim that ARFID is closely related to neurodevelopmental disorders, specifically autism spectrum disorder (ASD), in which sensory hypersensitivity is much more common than in the general population.

ARFID Symptoms

The symptoms of ARFID can be quite subtle, but usually, it means the limitation or restriction by the person who avoids some foods. Some common symptoms include:

  • Avoidance based on sensory characteristics: People with ARFID will refuse to eat foods based on texture, smell, or colour. For example, they usually prefer soft or bland food, like pasta or bread, and typically avoid foods that have complex flavours.
  • Fear-based avoidance: Some people with ARFID will not eat because they have a fear of choking, vomiting, or allergic reactions where there is no medical reason for the fear.
  • Nutritional deficiencies: People with ARFID miss many necessary nutrients because the variety of food consumed is very limited with vitamin and mineral deficiencies.
  • Weight loss or failure to gain weight: More in children, ARFID can lead to serious weight loss or failure to gain weight sufficiently for their age which in turn challenges growth.

Effects of ARFID on Everyday Living

The effects of ARFID can be dramatic. People suffering from ARFID may suffer malnutrition and other physiological complications due to their diet. Socially, the disorder can also create major problems. The reason behind this is that food often plays a central role in most forms of social gatherings and individuals suffering from ARFID feel isolated or embarrassed by these sorts of eating habits. This can discourage such individuals from dining out or attending events that involve food, thereby intensifying loneliness and anxiety.

ARFID can easily result in problems with emotional and social development in children. The children affected by ARFID will normally have a poor time interacting socially, especially in schools where eating lunch is usually a group process. This isolation usually makes them not perform well in school since they cannot concentrate due to low energy brought about by bad nutrition.

Read More: Deconstructing Pop Culture’s Impact on Eating Disorders

ARFID Diagnosis

A healthcare provider usually makes a diagnosis of ARFID after an overall assessment that includes reviewing the medical history, evaluating the eating pattern, and doing psychological testing. The restricted eating must be ruled out with other potential causes such as food allergies or gastrointestinal disorders.

According to the DSM-5, key diagnostic criteria for ARFID include significant weight loss or failure to meet expected weight gain in children. In adults, this will, of course, less often be an issue, and can also include nutritional deficiencies, dependence on nutritional supplements, and impairment in psychosocial functioning. Importantly, these difficulties must be judged to not be better explained by another specifier that is included in Axis I such as the loss of interest in eating or food due to cultural or religious reasons or another eating disorder focused on body image.

Treatment Options

ARFID can be treated, and a multi-disciplinary treatment usually works best. Such plans usually comprise monitoring, nutritional support, and psychological therapies to deal with the physical and emotional levels that underlie the disorder.

  1. Cognitive Behavioral Therapy (CBT): CBT is offered in the treatment of patients with ARFID to combat and change their negative thought patterns and related behaviours towards food. It is primarily beneficial in reducing fear or anxiety that may be associated with eating.
  2. Exposure Therapy: Gradual exposure of an individual to feared foods within a controlled and supportive environment does reduce the level of anxiety when trying new foods. This is mostly in conjunction with CBT treatment.
  3. Nutritional Counselling: Dietitians will also have a role in ARFID treatment where they enable the individual to gradually open up their diet to various food types while being assured of the intake of all essential nutrients for proper functioning.
  4. Family-Based Therapy: Involving the family in treatment, especially children and adolescents, can be helpful in many situations. Parents may be given techniques to encourage their child to consume more food or reduce stressful phases while taking meals.
  5. Medical Interventions: In extreme situations, it would require hospitalisation to treat physical side effects of ARFID, like malnutrition or very low body weight. The individual might have nutritional supplements and, in extreme cases, a feeding tube. Family and friends’ support plays a primary role in people who are suffering from ARFID.

The creation of a nonjudgmental space that fosters support and not coercing the person to eat more or try new things is very important. Victory, no matter if it is very small, encourages from try a new food to increase portions. No encouragement should add more stress to mealtime.

Conclusion

After looking into the study, I was able to understand that ARFID is an eating disorder that is more complex and serious than just being picky at eating. The condition may seriously impair the physical health, emotional wellness, and social relations of a patient. However, treatment and appropriate support may help a patient diagnosed with ARFID improve and make progress in expanding their diet and improving their overall quality of life. Early diagnosis and intervention may prevent some of the more serious malnutrition consequences and social isolation effects that might occur. Understanding ARFID and the challenges it poses will provide them with informed support and guidance.

References +
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing. Eddy, K. T., Thomas, J. J., Hastings, E., Edkins, K., Lamont, E., Nevins, C. M., & Becker, K. R. (2019). Prevalence of DSM-5 avoidant/restrictive food intake disorder in a paediatric gastroenterology healthcare network. International Journal of Eating Disorders, 52(5), 541–550. https://doi.org/10.1002/eat.23034
  • Nicely, T. A., Lane-Loney, S., Masciulli, E., Hollenbeak, C. S., & Ornstein, R. M. (2014). 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, 2(21). https://doi.org/10.1186/s40337-014-0021-3
  • Thornton, L. M., Welch, E., Munn-Chernoff, M. A., Lichtenstein, P., & Bulik, C. M. (2017). Anorexia nervosa, bulimia nervosa, and ARFID: Stability, heritability, and prospective psychiatric comorbidity in a Swedish twin cohort. Psychological Medicine, 47(2), 281–291. https://doi.org/10.1017/S0033291716002434
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