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Avoidant/Restrictive Food Intake Disorder (ARFID)

The ARFID, known as Avoidant/Restrictive Food Intake disorder, is an eating disorder characterised by avoidance and aversion to food and eating leading to failure to meet nutritional needs. Unlike other eating disorders such as anorexia, ARFID does not involve a preoccupation with body shape/weight and no desire for weight loss/fear of weight gain. The fear stems entirely from eating the food itself and fear of consequences that may arise from eating particular foods/food groups.

The ARFID meaning will often get mistaken with ‘picky eating’ and as a result will go undetected. ARFID eating involves very restrictive eating patterns due to a severe fear or avoidance of eating these foods often accompanied by failure to gain/maintain weight. Whereas picky eating involves avoidance of foods leading to inadequate variety in the diet and is most common in childhood. ARFID can affect individuals of all ages, from children to adults.

 

The primary ARFID symptoms include anxiety and fear around food/eating, sensory sensitivities, disinterest in food/eating, inadequate consumption/skipping meals and hypersensitivity to certain food characteristics like taste, texture, smell, or temperature. ARFID manifests in three main types: lack of interest in food, sensory avoidance, and fear of aversive consequences.

 

The best treatment approach for ARFID in children and adolescents Cognitive Behavioural Therapy for ARFID (CBT-AR), which focuses on achieving a healthy weight, establishing regular eating habits, and reducing anxiety around food. In adults, both CBT-AR and Radically Open Dialectical Behaviour Therapy (RO-DBT) are promising frameworks, aiming to address fear foods, promote relaxation, and facilitate changes in eating behaviour.

 

ARFID in adults is becoming increasingly common. For some, they may have presented with challenges of ARFID in childhood and adolescence, bring told it was just ‘picky eating’, when in fact it was ARFID. Whereas, there is also adults who present with ARFID for the first time in adulthood. The presentation of ARFID in adults will overlap greatly with ARFID in children, with a few differences. ARFID symptoms in adults include nausea, bloating, stomach pain, vomiting, significant weight loss, poor appetite, fatigue and high stress/anxiety around meal times.

 

Supporting individuals with ARFID requires encouragement to seek professional help, patience, understanding, and the creation of a supportive eating environment. Celebrating progress is also critical in the treatment of ARFID to attain success in recovery. Resources such as the CBT-AR manual and organizations like Eating Disorders Victoria, the Butterfly Foundation, and the National Eating Disorders Collaboration can be valuable in the treatment for ARFID.

 

Successful treatment stories underscore the importance of professional support in improving quality of life for individuals with ARFID. For example, a 9-year-old girl diagnosed with ARFID, specifically the subtype fear of aversive consequences, made significant progress in overcoming her challenges with food after receiving appropriate treatment and support for a period of four months. This young girl went from being unable to swallow solid foods after a choking incident, to being able to enjoy solid foods again, free of fear. Building trust and rapport with individuals who ARE undergoing ARFID treatment is essential for their success and overall well-being.

 

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