Condition Basics
What is avoidant/restrictive food intake disorder (ARFID)?
Avoidant/restrictive food intake disorder (ARFID) is an eating disorder in which a person eats a limited variety or amount of food. Eating a small range of foods can affect their health if they don't get the nutrition they need. It can also make it hard for them to function in social settings, such as school or work.
Unlike other eating disorders, ARFID is not due to concerns about body shape or weight. Instead, it's connected to experiences such as sensory sensitivities (like taste or texture), fear related to eating (for example, fear of choking), or naturally lower appetite.
ARFID often starts in childhood but can also affect people throughout their teens and into adulthood. Symptoms may change or get worse over time. Treatment can help shift eating patterns before they become set. If it's not treated, this disorder can last for many years.
What are the symptoms?
People can experience ARFID in different ways and not everyone has the same reasons for eating a small range of foods. This isn't because they're concerned about their weight or don't have access to food. Instead:
- Some of them may have a strong dislike of the texture, taste, or smell of many foods.
- Some may be fearful because of a scary experience when eating, such as choking or vomiting.
- Some may not feel hungry or have little interest in eating.
Because of their limited food choices, they may not get the nutrition they need. Children who have ARFID may weigh less and be smaller than other children their age. In adults, ARFID can lead to low energy, nutrient deficiencies, or difficulty managing daily activities.
Having a very limited range of foods can be stressful. People might skip things like parties, travel, or meals out if their preferred foods are not available, which can make them feel left out or isolated.
How is it diagnosed?
ARFID can be hard to diagnose. Your doctor will need to rule out other conditions, including other eating disorders. The doctor will do a physical examination and ask about eating habits and the social impact of these habits. Tests may be done to check for problems like food allergies and nutritional deficiencies.
What causes it?
The cause of ARFID is unclear. For some people, it may begin after a stressful event like choking or vomiting. ARFID may be due to factors such as genetics. It often happens along with other conditions such as anxiety disorders, autism spectrum disorder (ASD), or attention deficit hyperactivity disorder (ADHD).
How is ARFID treated?
Be sure to look for a doctor or program that treats people who have ARFID. What works for other eating disorders may not work as well for ARFID. Treatment may involve a team of people. You can work together with your care providers to become more comfortable with eating and eating more foods at a pace that feels right for you.
In general, treatment focuses on improving nutrition and increasing the variety and amount of food you eat. You may work with:
- A doctor. They will treat any medical conditions that have been caused by ARFID, such as heart problems or bone loss (osteoporosis). They may also prescribe vitamins or other supplements to help with nutrition.
- A counsellor or other mental health professional. They can help you overcome the things that keep you from eating a varied diet. One type of cognitive behavioural therapy (CBT) that can help with ARFID is called CBT-AR. Another type of therapy that can help is family-based treatment for ARFID, or FBT-ARFID.
- A registered dietitian. They can help you learn about nutrition, help you explore new foods, and support you in building eating habits that work for you.
If ARFID has caused health problems, you may need to be treated in a hospital.
How can you care for yourself at home?
Here are some things you can do to take care of yourself during recovery from an eating disorder.
- Try to stick to your treatment plan. Try to follow the steps in your treatment plan, and let your team know if something feels too fast or too hard. Treatment can be adjusted.
- Work on healthy eating habits that support your nutrition needs. Follow the guidance of your counsellor and dietitian and make a plan with them to eat a wider variety of foods at a pace that feels manageable to you. Find ways to manage stress that support your progress with eating. This might include calming activities, routines, or supports that help you feel grounded. Get support from others. This might be from caring family members or friends or an eating disorders support group.
- Take it easy on yourself. Focus on your good qualities. Don't blame yourself for your disorder. And remember that recovery takes time and that you can make progress one goal at a time.
