Avoidant/Restrictive Food Intake Disorder (ARFID), also known as Selective Eating Disorder (SED), has replaced a previous diagnosis of Feeding Disorder of Infancy and Early Childhood. ARFID can be characterized by a continual disturbance in eating that leads to significant clinical consequences, including nutritional deficiencies, compromised psychosocial functioning, stunted growth, weight loss, and use of external interventions to sustain intakes, such as dietary supplementation or tube feeding. ARFID is not a well-known eating disorder compared to anorexia nervosa, binge eating disorder or bulimia nervosa. As a result, there are many false statements and beliefs associated with ARFID. Below are a handful of ARFID myths and facts:
Myth: ARFID is a disorder of childhood.
Fact: ARFID occurs in childhood, adolescence, and adulthood and is no longer considered a childhood disorder, although it is more common in children. Picky eating can turn into Avoidant Restrictive Food Intake Disorder (ARFID) and can affect a person at any age or developmental level.
Myth: Individuals with ARFID are concerned about weight gain
Fact: Avoidant restrictive food intake disorder is an eating disorder characterized by food avoidance because of an individual’s dislike for the specific texture, smell, and/or flavor of the food, not because an individual is concerned about their weight or body figure.
Unlike individuals with anorexia nervosa, individuals with ARFID do not worry about their weight or shape or becoming fat and therefore do not restrict their diet for this reason. ARFID also does not typically emerge after a history of healthy eating whereas anorexia nervosa and bulimia nervosa both usually transpire after an individual has had normal eating patterns. In fact, to diagnose ARFID, individuals must have an absence of distorted body image and signs and symptoms that are unrelated to another mental illness or eating disorder.
Myth: ARFID is the same as picky eating and individuals will grow out of it.
Fact: ARFID results in weight loss, nutritional deficiencies, deterioration in physical function and an adverse effect on an individual’s personal, professional and social life.
ARFID may start with picky eating however it progresses to the point that the individual will only approximately eat 20 types of foods. Often an individual with ARFID initially has some kind of issue with eating which can stem from difficulty digesting specific foods, food avoidance to various colors or textures of cooking, eating small portions, having little or no appetite, or being afraid to eat after a frightening episode of choking or vomiting. ARFID results in nutritional deficiencies, weight loss and difficulty with social interactions, social functions, and work or school responsibilities due to inadequate dietary needs.
Myth: There is no treatment for ARFID as individuals naturally “grow out of it.”
Fact: Because of the severe implications that may result from nutritional deficiencies and inadequate food intake, professional treatment and intervention are needed early on after diagnosis.
Psychotherapy has been deemed the best treatment option to treat individuals with ARFID. Cognitive behavioral therapy, exposure therapy, and dialectal behavioral therapy are the three main psychotherapy approaches used to treat ARFID. The goal of these therapies is to help with exposure, anxiety, and the thought processes that surround the ARFID. Therapists will work on a hierarchy of fear foods from least fearful to most anxiety-provoking until the individual is comfortable around all feared foods. This type of work includes mental visualization, writing and verbally talking through steps to exposure, practicing distress coping skills and cognitive behavioral therapy to address negative thoughts, and life practice sessions to sensitize clients to various situations and foods.