Avoidant Restrictive Food Intake Disorder (ARFID)

What is ARFID?

ARFID is a relatively new eating disorder diagnosis referenced in the DSM-5.

Previously coined “Selective Eating”, it involves limitations and/or restrictions around food, particularly around the intake of certain types of food or certain amounts.

Unlike other eating disorder diagnoses (like Anorexia, Bulimia or Binge Eating Disorder) it doesn’t typically involve distress around body image or a pursuit of thinness.

Rather, ARFID typically involves avoidance of certain foods often due to a sensitivity in taste, texture, smell, appearance or temperature.

Whilst there’s no single cause, it may be that someone had a distressing experience whilst eating food – such as choking or vomiting – that harmed their relationship to food. It is also common for individuals with Autism Spectrum Disorder to be diagnosed with ARFID due to sensory sensitivity.

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Signs and symptoms of ARFID

There is no ‘one way’ to have ARFID, but there are common behavioural patterns and emotional and cognitive characteristics that help in diagnosing the illness.

Avoiding particular types of food

Fear of phobia of choking or vomiting

Only eating certain textures of food and maintaining a limited range of options

Not eating enough food to be nutritionally healthy and satisfied

Avoiding eating in social scenarios

Anxious around mealtimes

Displaying a lack of interest in food or lack of appetite – sometimes missing meals altogether when distracted

Taking a long time over mealtimes

Weight loss

Stunted growth in children

Developing nutritional deficiencies

ARFID can severely impact someone’s physical and mental health

Someone suffering with ARFID may struggle with socialising and eating around others, and suffer from serious nutritional deficiencies, weight loss in adults and stunted growth in children.

ARFID is unlike other eating disorders

Unlike other eating disorders, there is no concern with body weight or shape. Symptoms, therefore, do not stem from an intension to lose weight or control body shape or size.

Rather, the symptoms people experience can stem from a range of psychological reasons; such as food-related trauma or sensory concerns. 

Similar to other eating disorders, there is no ‘one way’ to have ARFID. Eating, sometimes even touching or smelling something unfamiliar can lead to gagging, vomiting, and anxiety attacks.​

Some consider ARFID to be more of a ‘phobia’, which further differentiates it to other eating disorders where food (or restriction) is used as a means to cope.

For these reasons, treatment must be tailored to the individual and their particular concerns. Approaches to food will differ depending on needs – with some clients needing support with gradual, gentle exposure to find a sense of safety with food. ​

ARFID and neurodiversity

Research estimates that between 12.5% and 33.3% of people with ARFID also have autism.

For this reason, understanding the intricate connections between ARFID and autism is crucial for providing effective and personalised treatment.

Individuals with autism may be more susceptible to developing ARFID due to sensory sensitivities, rigid routines, or challenges with social interactions.

At Orri, our approach involves a careful exploration of these links, tailoring our treatment to address the unique needs of each individual.

We adopt a comprehensive approach that integrates elements of sensory-based interventions, social skill development, and nutritional support, recognising the interplay between these two complex experiences.

By acknowledging the intricate relationship between ARFID and autism, we offer compassionate and effective treatment that addresses the specific challenges individuals may face in their journey towards life in recovery.

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Recovery from ARFID is possible.

Like with other eating disorder diagnoses, we believe that recovery from ARFID is possible and that treatment should heal the individual as a whole; embracing their complexity and unique history.

Often, treatment for ARFID requires a multi-disciplinary approach that combines psychotherapy with sessions with a specialist dietitian who understands the illness and how it can manifest differently in different people.

At Orri, our comprehensive approach recognises that ARFID is a unique and complex diagnosis, requiring tailored interventions that address both the physical and psychological aspects of the eating disorder.

Our team of dedicated professionals – including dietitians, psychotherapists, and occupational therapists – collaborate to create a supportive environment for individuals struggling with ARFID.

Treatment at Orri is centred around fostering a safe and nourishing relationship with food, gradually expanding the variety of accepted foods, and addressing underlying fears and anxieties, or sensory sensitivities.

Through a combination of dietetic and therapeutic support, we empower individuals with kindness and compassion to overcome the limitations imposed by ARFID and embrace a more balanced and fulfilling relationship with food.

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