Avoidant Restrictive Food Intake Disorder (ARFID) is recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an eating disorder. It was formerly known as “Selective Eating Disorder”.
Folks living with ARFID may appear to simply be ‘picky’ or selective eaters. It is common for children to be picky or selective eaters, but still consume enough calories to grow and develop properly. The main difference between the two is that children living with ARFID do not consume enough calories to grow and develop properly. Similarly, adults living with ARFID do not consume enough calories to maintain basic body function.
ARFID Subtypes
There are three different subtypes:
- Folks who aren’t interested in eating
- People who avoid eating certain foods because of a sensitivity to particular characteristics of the food
- Folks who are concerned about eating due to a previous bad experience
Although very similar, the three subtypes are unique, and treatment should be tailored to each subtype and child.
ARFID Symptoms
There are both behavioural and physical symptoms that may indicate your child is living with ARFID.
Behavioural:
- Dramatic restriction in foods eaten
- Will only consume foods with specific textures
- Afraid of choking or vomiting
- List of foods consumed grows smaller over time
- No body image concerns
Physical:
- Gastrointestinal (GI) issues
- Menstrual irregularities
- Difficulty concentrating
- Feeling cold all the time
- Dry and brittle nails and hair
- Muscle weakness
- Weight loss or lack of appropriate growth
You may notice that the physical symptoms of ARFID are similar to those of other eating disorders such as anorexia. This is because folks living with both of these eating disorders are undernourished, although for different reasons, and therefore their bodies cannot function properly.
Weight Loss
Children living with ARFID will likely present with (will have) lack of appropriate growth (instead of weight loss) while ARFID in adults will often present with weight loss. Folks living with other eating disorders such as Anorexia Nervosa or Bulimia Nervosa may also present with weight loss or lack of appropriate growth.
The main difference between ARFID and other eating disorders is that folks living with ARFID have no fear of gaining weight or distress about body shape or size. They are not restricting their caloric intake in order to lose weight.
ARFID Diagnosis
ARFID can be tricky to diagnose. As we mentioned above, it is common for children to be selective and picky eaters. This does not mean they are living with ARFID. Folks can be diagnosed with ARFID based on the diagnostic criteria in the DSM-5. Symptoms include:
- An eating or feeding disturbance such as lack of interest in eating, avoidance due to sensory characteristics of food, avoidance due to a bad experience associated with eating (these are also known as the ARFID subtypes) that leads to:
- Weight loss of lack of appropriate growth for age
- Nutritional deficiency
- Dependence on enteral feeding or oral nutritional supplements
- Interference with daily activities
- The feeding disturbance is not due to food insecurity or cultural practices
- Not due to medical condition or another mental disorder
- No evidence of distress regarding body shape or size
- No fear of gaining weight
Possible Health Consequences
The possible health consequences of ARFID are similar to those of anorexia. This is because folks living with both eating disorders are undernourished.
Folks living with ARFID may have electrolyte deficiencies which can lead to cardiac arrest – these are serious medical complications that can cause death. Early intervention is important, as it lowers the risk of developing serious medical complications and increases the chances of eating disorder recovery.
Treatment
ARFID treatment is similar to the treatment of anorexia. If your child is at an extremely low weight and presenting with heart issues (i.e. low blood pressure or irregular heart rate) they will be treated in a hospital. Treatment will begin by focusing on returning your child to the growth curve trend they had before the eating disorder.
If your child is not at an extremely low weight and presenting with heart issues they can be treated in an outpatient setting by a team of healthcare professionals.
Change Creates Change Eating Disorder Care is here for you if you suspect your child is living with ARFID. Click below to book a call with us to find out how we can support you and your child.
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