Avoidant Restrictive Food Intake Disorder (ARFID) stands out amongst other eating disorders due to its unique characteristics and diagnostic criteria. In this blog post, we delve deeper into ARFID, how it differs from other eating disorders, and its prevalence.
ARFID is a serious eating disorder characterised by avoidant or restrictive behaviours with food that result nutritional deficiency, weight loss, or significant interference with day-to-day life and functioning.
There is no ‘one way’ to have ARFID, but someone’s symptoms tend to fall within one of three categories:
- Sensory issues
- Fear of aversive consequences (such as choking or vomiting), or
- Lack of interest in eating
An intense fear of adverse consequences from eating, such as choking, vomiting, or an allergic reaction, can lead to avoidance or restriction of certain foods. This results in a limited food intake that doesn’t meet someone’s nutritional needs and impacts their ability to enjoy social events or family meals.
Others develop ARFID due to heightened sensitivities with food texture, colour or smell. They may experience significant aversion to certain foods, finding them repulsive and almost impossible to eat or swallow. Sometimes, an individual with this type of ARFID may have a co-occurring diagnosis of Autism.
Importantly, ARFID does not involve concerns with body image or a desire for weight loss or thinness
Body image or weight loss factors are often significant features of other eating disorders like anorexia, bulimia, binge eating disorder or diabulimia.
This difference has crucial implications for treatment, as a “typical” approach to eating disorder treatment, that addresses body image concerns and weight loss behaviours, may not be applicable to someone with ARFID. Instead, treatment must be tailored to the individual and involve a multi-disciplinary approach of dietetic sessions and psychotherapy, and often include exposure therapy or behavioural techniques that support someone with developing a sense of safety around food.
Having only been added to the DSM in 2013, there is little research to understand the prevalence of ARFID
Sadly, the prevalence of ARFID is not as well-documented as other eating disorders because it was only recently recognised as a medical condition in 2013. That said, research suggests that ARFID may be more common than previously thought, particularly among children and adolescents – and persisting into adulthood.
A study published in the Journal of Adolescent Health found that among adolescents seeking treatment for an eating disorder, approximately 14% met the criteria for ARFID, making it the second most common diagnosis after anorexia. Another study published in the International Journal of Eating Disorders found that ARFID accounted for about 22% of eating disorder diagnoses in children aged 8-13 years who were referred to a specialist eating disorder program. These studies indicate that ARFID is not as rare as people may think and highlights the importance of early detection and specialist intervention.
In summary, ARFID has unique characteristics that differ markedly from other eating disorders like anorexia, bulimia or binge eating disorder. For this reason, it is vital that an individual receives specialist support that addresses their unique relationship to food, and the underlying causes, to ensure that recovery becomes possible for all.
