When it feels like you just can't eat enough food or a range of foods, even though you may really want to.
ARFID
Avoidant and restrictive food intake disorder (ARFID) was recognized as a diagnosable feeding disorder in 2013. Like the eating disorder anorexia nervosa, ARFID involves significant restriction or avoidance of food and significant weight loss or failure to gain weight when weight gain would otherwise be expected. Unlike anorexia, however, ARFID does not involve distress about body shape, size, or fear of fatness.
Many children go through phases of picky or selective eating, however, most of these children will eventually eat when they get hungry enough and will consume enough calories to grow and develop properly. This is not the case for those with ARFID. (Although for some, consuming a limited variety of food consisting primarily of energy dense foods such as cheese and carbohydrates can result in significant weight gain.) ARFID can also result in problems at school or work, due to difficulties eating with others and the extended time needed to eat. Three subtypes of ARFID have been identified although these three types are not exclusive.
ARFID SUBTYPES
SENSORY SENSITIVITY
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Avoidance of foods due to taste, texture, look, smell, temperature, etc.
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Reluctance to try new foods
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Non-preferred foods described as “disgusting” or “gross” and result in gagging or shuddering
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Likely to be super tasters (high concentration of fungiform papillae, which contain our taste buds)
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Experience bitter tastes as particularly strong and aversive.
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Typically prefer a white diet with dry and crunchy textures over those that are soft, mushy, or lumpy
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May be at a higher body weight due to increased reliance on starchy, energy-dense, processed foods
LACK OF
INTEREST
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Born with a predisposition for low homeostatic appetite (physiological hunger) and/or find food less hedonically rewarding (pleasurable)
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Report that they have never had much interest in food, felt pleasure from eating or from the anticipation of eating.
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History of low weight or failure to thrive due to chronic under-eating
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Individual and/or family may believe that there isn’t a problem with appetite/weight because “it has always been like that.”
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Pattern of decreased appetite/intake can become heightened during times of increased stress or illness.
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Individual becomes known socially as a “light” or small eater and social pressure to eat often fades over time.
FEAR OF AVERSIVE CONSEQUENCES
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Associated with a fear of an aversive consequence such as choking, vomiting or an allergic reaction.
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Preexisting anxious temperament
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Preexisting sensitivity to bodily sensations/somatic symptoms
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Avoidance leads to missed opportunities to test negative predictions
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Safety behaviors further maintain anxiety and interfere with opportunities to disprove catastrophic predictions.
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CHOKING: soft or liquid foods that are easier to chew/swallow
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ALLERGIC: foods known not to be associated with allergies
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VOMITING: bread or cracker like food that they think will be easier on their stomachs
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TREATMENT OPTIONS
