Avoidant/Restrictive Food Intake Disorder

ARFID

Avoidant/Restrictive Food Intake Disorder (ARFID) is characterized by a persistent failure to meet appropriate nutritional and/or energy needs as a result of eating or feeding disturbances such as apparent lack of interest in food, avoidance due to the sensory qualities of food, and/or concern over averse consequences of eating or of food.

What is ARFID?

Avoidant/Restrictive Food Intake Disorder (ARFID) is characterized by a persistent failure to meet appropriate nutritional and/or energy needs as a result of eating or feeding disturbances such as apparent lack of interest in food, avoidance due to the sensory qualities of food, and/or concern over averse consequences of eating or of food. These disturbances are not associated with distorted body image or body dissatisfaction, but are associated with significant weight loss or faltering growth/developmental patterns (in children and adolescents); dependence on enteral feeding or oral nutritional supplements; and/or marked interference with psychosocial functioning. These disturbances cannot be better explained by a lack of food, cultural practices, or a concurrent medical condition or mental disorder. Individuals with ARFID may experience extreme emotional dysregulation and anxiety around meal times, have a fear of vomiting or choking, and/or undergo thorough testing for chronic abdominal pain with no satisfactory findings.

What Causes ARFID?

Like all eating disorders, avoidant/restrictive food intake disorder develops over a period of time due to a complicated blend of genetic, biological, and environmental factors. There is no single place to point to and despite common misconceptions, families and communities of support are not to blame. In fact, they are often recovery’s strongest ally. Many individuals have genetic predispositions to ARFID that, depending on environmental influences, may or may not be awakened over the course of their lifetime. The mean age of diagnosis is 11 years, however symptoms may present in infancy or early childhood.

  • Confused Physiological Processes & Altered Hunger and Satiety Signals

  • Experiencing & Surviving a Traumatic Event

  • Genetic Predispositions & Societal Pressures

  • Abnormal Brain Circuitry & Weakened Food-centric Reward Pathways

  • Lack of Environmental Control & Persistent, Extreme Stress or Minority Stress

What to Look For

Being familiar with the signs and symptoms associated with ARFID can help you champion early intervention and recovery. Watch out for dysregulated emotions around meal times, significant weight loss, and a failure to meet nutritional needs and growth trajectories. Comorbidities include: anxiety disorders, autism spectrum disorders, and cognitive disorders.

  • Weight Loss & Nutritional Deficiencies

  • Failure to Meet Growth Trajectories

  • Emotional Dysregulation & High Anxiety around Meal Times

  • Chronic Abdominal Pain Lacking an Apparent Cause

  • Fears or Phobias around Illness, Choking, or Vomiting

  • Neutral or Positive Body Image

Risks of ARFID

  • ARFID can have extreme medical and physiological consequences that may or may not resolve completely during recovery.

  • Impaired Intuitive Decision-Making & Weakened Impulse Control

  • Delayed Puberty or Dysregulation of Reproductive Hormones

  • Impaired Brain Functioning and Signaling

  • Abnormal Brain Circuitry & Weakened Food-centric Reward Pathways

  • Chronic Abdominal Pain, Fatigue & Headaches

Resources

SCOFF: Eating Disorder Assessment Tool

The SCOFF questionnaire is a useful tool to screen for maladaptive eating behaviors. Individuals answering “yes” to two or more questions may be at risk for an eating disorder and…

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What Causes Eating Disorders?

For 15 years I worked as a research scientist examining the neurobiologic and genetic underpinnings of eating disorders. The number one question I heard (and still hear) is: What causes eating disorders? Is…

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Signs Your Adolescent May Have an Eating Disorder

Early adolescence is a tumultuous time for teens and parents. Add a possible eating disorder into the mix, and things can feel downright out of control. Eating disorders are sneaky….

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Understanding the Diagnostic Criteria for Eating Disorders

There are specific behaviors that point to different types of eating disorders. Understanding and identifying these signs and symptoms is critical to providing the most effective individualized course of treatment…

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