Avoidant Restrictive Food Intake Disorder (also known as ARFID) is an eating and feeding disorder where a person restricts their diet or avoids certain foods.
A person will avoid these foods usually due to fear (for example of choking or becoming unwell), disinterest, sensory sensitivity or sometimes for a mix of these reasons.
Sometimes, people with this eating disorder can be thought of as ‘fussy’ or ‘picky’ eaters. However, there are key differences between ‘picky eaters’ and ARFID; for example, a picky eater may not like green vegetables but an individual with ARFID may only have five foods they will accept.
A key difference with ARFID compared to many other eating disorders is that food restriction and avoidance is not due to concerns around gaining weight or worries about body image.
According to the NHS website, possible reasons for ARFID include:
- Specific sensitivities to food, including the smell, taste, texture and brand of food
- A response to a past experience with food that was upsetting; for example, choking or being sick after eating something
- Not feeling hungry or just a lack of interest in eating, which may mean that you do not recognise when you are hungry
How do I know if my child has Avoidant Restrictive Food Intake Disorder (ARFID)?
Regardless of our age we all have our preferences in food. Some we love and others we would prefer not to eat; ARFID is a lot more serious than that. According to BEAT Eating Disorders, signs of ARFID include:
- Eating a reasonable range of foods but overall having much less food than is needed to stay healthy.
- Finding it difficult to recognise when hungry.
- Feeling full after only a few mouthfuls and struggling to eat more.
- Taking a long time over mealtimes/finding eating a ‘chore.’
- Missing meals completely, especially when busy with something else.
- Sensitivity to aspects of some foods, such as the texture, smell, or temperature.
- Appearing to be a “picky eater.”
- Always having the same meals.
- Always eating something different to everyone else.
- Only eating food of a similar colour (e.g. beige).
- Attempting to avoid social events where food would be present.
- Being very anxious at mealtimes, chewing food very carefully, taking small sips and bites, etc.
- Weight loss (or in children, not gaining weight as expected).
- Developing nutritional deficiencies, such as anaemia through not having enough iron in the diet.
- Needing to take supplements to make sure nutritional and energy needs are met.
This list is not exhaustive, people can display different symptoms to others.
How is ARFID diagnosed and treated?
ARFID can be diagnosed by a medical professional, this would typically be following an assessment to explore the person’s eating habits, the reasons for avoidance /restriction of foods, the impact of this on day-to-day life and exploring whether there are any other possible underlying causes for the concerns.
Treatment for ARFID is designed to the individual’s needs. However, common elements can include exploring sensory needs, establishing regular eating, having a greater variety of foods and managing anxiety.
Some of the helpful therapies for young people with ARFID can include:
- Individual sessions such as Cognitive Behavioural Therapy for ARFID (CBT-AR)
- Therapies that support carers to help the young person, e.g. Family Based Therapy for ARFID (FBT-ARFID).
Treatment should include a variety of professionals to ensure the individual has their support needs met. This may include dietetic, psychological, occupational, and medical support.
What should I do if I am worried about my child?
Support is available if you’re worried about your child. If you have concerns about your child, you should speak to your GP.
Your GP will ask you about your child’s eating patterns, any history of weight change and may ask to check their physical health. They may suggest you have a referral to a Dietician, or in some cases CAMHS.
It is especially important to seek urgent help if your child has rapidly lost weight for longer than a few weeks, lost weight over three months, or you think their eating is out of control. Speak to your Doctor (GP) as soon as possible if any of these are happening to your child or someone you care for.
If you’re in need of urgent help, for example if you or someone else is in immediate danger, call 999 or the Samaritans on 116 123.
- Sensory Play the fun way to help avoidant, picky or fussy eaters
- NHS – Eating disorders advice for parents
- BEAT – Endeavour: Programme manager Lucy talks ARFID Carer support – Beat (beateatingdisorders.org.uk)