When you were growing up, you probably knew someone who was a picky eater. Maybe it was a friend, or a sibling — or maybe it was you. If you were a picky eater, your parents or friends may have made good natured jokes. They would needle you about your unwillingness to eat anything but chicken nuggets and macaroni & cheese. They probably viewed it more as an inconvenience, than a problem.

But, when picky eating becomes extreme, it can turn into a dangerous eating disorder called Avoidant/Restrictive Food Intake Disorder, or ARFID. You’ve probably not heard of this particular eating disorder. But, it’s a real thing, and as serious as other eating disorders. In fact, ARFID is dangerous because it can cause malnutrition, and failure to gain weight.

Is ARFID An Eating Disorder?

Yes. It’s diagnosed by mental health professionals under the same category as other eating disorders, like anorexia and bulimia (Learn More). An estimated 3% of people suffer from ARFID each year, with up to 5% being children.

Like the well known eating disorders, it often affects young people. However, ARFID differs from anorexia and bulimia. People don’t get hung up on weight loss or body image issues. People with ARFID avoid specific foods for their textures, colors, and smells. They may suffer digestion problems by not eating enough, or having a messed up appetite.

Even though ARFID doesn’t present like prominent eating disorders, it’s still an eating disorder. It generates fear of food. ARFID can severely disrupt a person’s life by causing significant distress around food, and interrupting their psychosocial functioning. ARFID can cause mental and physical suffering.

How Autism Plays A Part

This disorder is especially common among children and individuals with autism spectrum disorders (ASD). Feeding and eating problems affect those with autism because of the sensory challenges that go with ASD. People with autism are more likely to experience fear or distress around food. This is because of difficulties tolerating certain textures, tastes, colors, and smells. So, people with autism frequently develop ARFID. It’s important for mental health professionals to work with patients on both of these disorders.

Can This Become Anorexia?

There are many similarities between ARFID and anorexia nervosa, like avoidance and fear surrounding certain foods, and dramatic weight loss. Naturally then, many people wonder if it can become anorexia, or vice-versa.

People can lose weight as a consequence of food avoidance, but they don’t feel a compulsion to change their appearance. Due to the similarities between the two disorders, it is essential for mental health professionals to carefully evaluate individuals with ARFID, and/or anorexia nervosa, to ensure that patients get properly diagnosed and treated.

What Is The Treatment For ARFID?

People who are underweight or malnourished due to ARFID will require medical treatment and weight restoration before they can focus on the psychological treatment. Children require immediate and acute treatment. Those that have fallen off the growth curve can suffer serious long-term health consequences, and stunted development.

This is a fairly new disorder that was introduced in the fifth, most recent edition of the DSM. Much is still being learned about the disorder. Effective treatment programs have already developed to help restore weight and nutrition, as well as to help patients broaden the number of foods they are willing to eat.

With children, it’s especially important to involve families in their treatment, since parents typically control what children eat. Family therapy for ARFID can help empower parents to take charge of their children’s nutrition, while still empathizing with their children’s anxiety around food.

Other strategies are often used to help alleviate anxiety around food in both children and adults suffering with this disorder. For example, patients may be asked to keep a food diary. Exposure therapy, used to treat fear of flying, is showing success. Patients are gently exposed to new foods that frighten them, and counseled on overcoming the irrational fear they experience.

Cognitive-behavioral therapy, or CBT, is a proven treatment for anxiety. ARFID shares many characteristics with anxiety, and CBT can help change anxious thought patterns surrounding food in individuals with ARFID.

Knowledge Is Power

I hope to empower everyone who reads this to join in the fight against all eating disorders. I’ve been monitoring them for many years, and their incidents continue to grow. Your best tool is awareness. Pay attention to what you see, and your gut feelings. If it seems to be more than just picky eating, don’t dismiss it. Take notes on your observations, and seek out a qualified eating disorder specialist.

If you would like more information about our programs, or need help:

Jennifer L. Zauner, LCSWR
Clinical Director

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