Understanding avoidant/restrictive food intake disorder (ARFID)

Around one in 50 young people develop some level of avoidant/restrictive food intake disorder (ARFID), which is a disorder where they eat very little or are completely unwilling to eat certain foods. In this article, we'll take a look at everything you need to know about ARFID, how it affects people and how you can support someone living with the condition.


What is ARFID?

ARFID stands for avoidant/restrictive food intake disorder. It is a relatively new diagnosis in comparison to other eating difficulties that describes a pattern of disordered eating. People with ARFID may have a strong fear of choking or vomiting, and so they avoid certain foods or types of food. They may also avoid foods because of their appearance, texture, smell, or taste aversion. 

ARFID can lead to weight loss or failure to gain weight. It can also cause nutrient deficiencies if someone avoids foods that are high in certain nutrients. People with ARFID may also have other mental health conditions, such as anxiety or depression. 

There is currently no specific treatment protocol for ARFID, but therapy can help people manage their symptoms and learn to cope with their fears. If you think you or someone you know may have ARFID, it's essential to talk to a doctor or therapist who can help diagnose and treat the condition.

ARFID risk factors

A lot of people think that anorexia nervosa and ARFID are one and the same, but they’re actually quite different. Anorexia nervosa is an eating disorder characterised by self-starvation and an intense fear of gaining weight, while ARFID is characterised by a lack of interest in food or avoidance of certain foods due to a bad experience. People with ARFID may be underweight, but not because they’re deliberately starving themselves.

There is no single cause of ARFID. Instead, it seems to be a combination of genetic, psychological, and environmental factors. For some people, ARFID may be triggered by a traumatic event such as being involved in an accident, witnessing a distressing situation or being the victim of a violent crime. For others, it may be the result of a negative experience with food, such as choking or vomiting. Some experts believe that ‘picky’ eating in childhood may also be a risk factor for developing ARFID.

Symptoms of ARFID

It is estimated that one in 20 people suffer from ARFID, which is a relatively new eating disorder that is not yet well-known. People with ARFID are often reluctant to seek help because they may not be aware that their eating habits are abnormal.

Here are some common symptoms of ARFID:

  • avoiding certain foods due to a fear of choking or vomiting
  • unusual food preferences or an aversion to certain textures or smells
  • persistent discomfort or distress after eating
  • significant weight loss or problems with growth and development

ARFID treatment

ARFID, or avoidant/restrictive food intake disorder, is a new diagnosis that was added to the mental health diagnostic manual (DSM-5) in 2013. ARFID is, in some ways, similar to anorexia in that both disorders involve avoidance of food. However, unlike anorexia, ARFID is not driven by a fear of gaining weight. Instead, people with ARFID may avoid certain foods because of a texture aversion, a fear of choking, or gastrointestinal issues. 

There is no one-size-fits-all approach to treating ARFID. Treatment will vary depending on the individual’s symptoms and causes. However, most treatment plans will likely involve some combination of individual therapy, family therapy, and medical intervention. 

Individual therapy including cognitive behavioural therapy (CBT) can help people with ARFID understand their disorder and develop coping mechanisms for dealing with their symptoms. CBT is also beneficial in identifying and changing self-destructive patterns of thought and behaviour that may perpetuate difficulties surrounding eating.

Family therapy can help families learn how to support their loved one with ARFID and make necessary changes to the household environment. While medical intervention may be necessary for people with ARFID who are malnourished or, at risk of becoming malnourished.

How to support someone living with ARFID

If you know someone who is living with ARFID, there are many ways you can support them. Here are some tips:

1. Educate yourself about ARFID. This will help you better understand what your friend or loved one is going through and how you can best support them.

2. Be patient and understanding. ARFID can be a difficult condition to deal with, both for the person affected and those around them. Try to be as understanding and supportive as possible.

3. Offer practical help. If your friend or loved one is struggling to manage their condition, offer to help out where you can. This could include things like cooking meals, helping with grocery shopping, or providing moral support.

4. Encourage treatment. If your friend or loved one is not receiving treatment for their ARFID, encourage them to seek help from a professional. Treatment can make a big difference in managing the condition and improving quality of life.

5. Be there for them. Let your friend or loved one know that you are there for them and that they can come to you with anything they need, whether it’s just to talk or for practical assistance.

If you are seeking support with ARFID, it’s important that your therapist understands how to work with behavioural difficulties as well as thoughts and emotions. With the correct support, many people have overcome ARFID and regained control of their eating, and their lives.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Birmingham, West Midlands, B15
Written by Michael Swift, Integrative Psychotherapist | BSc(Hon), MSc, MBACP
Birmingham, West Midlands, B15

Michael is a Senior Integrative Psychotherapist specializing in the treatment of Anxiety Disorders, OCD, Long-Term Health, and Acute Mental Health Conditions. He has over 10 years of experience working in private healthcare organizations and holds advanced dual qualifications in both Cognitive Behavioural Therapy and Health Psychology.

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