Avoidant-restrictive food intake disorder, commonly known as ARFID, is an eating disorder characterized by the persistant refusal to eat specific foods or refusal to eat any type of food due to a negative response from certain foods colors, texture or smell. Additionally, individuals may refuse to eat out of fear of becoming sick or the fear of choking on food. This disorder is not characterized by the obsession with body shape or weight; rather, it simply is due to the disinterest and avoidance of foods. This disorder can result in excessive and unhealthy weight loss and malnutrition leading to the need for tube feeds or nutritional impairment. Oftentimes, psychosocial impairments result from this eating disorder as well. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), recognizes avoidant-restrictive food intake disorder as an eating disorder that is clinically distinct from both anorexia nervosa and bulimia nervosa. It most commonly occurs in children and was once considered a disorder of childhood and infancy but it is now known that ARFID in adults can occur.

Why ARFID Is Becoming Common in Adults

ARFID is becoming increasingly common in adults with the increase in specialized diet trends such as vegan diets, gluten-free diets, alternative fasting and other well known-popular diets that eliminate one or more food groups from the diet. Often ARFID in adults tends to have a small range of foods that they will eat, sometimes less than 20 foods. Individuals may often refuse to try new foods, or report higher rates of texture or sensory issues to foods. Picky eating due to weight restriction or dieting is known to lead to ARFID in adults. Picky eating in adults has also been associated with higher rates of depression and obsessive-compulsive disorders as well as lower quality of life versus children and adolescents who are diagnosed with picky eating. This could be due to adults being more hypersensitive about weight and body image than children and therefore picky eating in adults could be linked to possible weight and body type as opposed to the disinterest and avoidance of food. This hypothesis is not yet proven but would make an interesting research study.

Treatment for ARFID in Adults

There are many different treatments for adults with ARFID but the first thing that must be kept in mind are the specific goals that you want to set. For example, some adults would like to be able to eat a larger range of food or be more comfortable eating in public. There are therapies that can help with exposure, anxiety, and the thought processes that surround avoidant restrictive food intake disorder. It is common for therapists to first address the less anxious food fears first and then tackle the more extreme food fears, which is why it is also important for individuals to be open about their food fears in treatment.

Food exposure is a way to lessen the anxiety around certain types of foods. This type of therapy includes mental visualization, writing, and talking about the foods that are feared, then addressing why they are feared. Through exposure therapy, a person with ARFID can learn positive coping skills to overcome these specific fears.

Other therapies that are known to help treat ARFID in adults are cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), two common therapies that are used to treat eating disorders. These therapies give individuals the tools and coping mechanisms that allow them to listen to their bodies rather than listen to their anxiety-provoking thoughts. Other effective treatments include group therapy and group meals to work on sensory issues within a supportive setting. Many times groups will go out into the community and eat in a public place or go grocery shopping together. Within this type of environment, the individual can gain support from other members who struggle with similar issues, as well as learn how to manage live situations with the backing from a member of their treatment team.

Get Help for ARFID

If you or someone you love could be struggling with ARFID, Center for Discovery can help. The unique dietary program involves techniques and therapies that can help adults move past this eating disorder, all in a real-life setting.

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