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1295 Bandana Boulevard West
Suite 310 & 210
St. Paul, MN 55108
P: 651-645-5323
F: 651-621-8490
Toll-Free: 1-888-364-5977

Eating Disorders We Treat

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 an apparent lack of interest in food, avoidance due to the sensory qualities of food, and/or concern over adverse consequences of eating 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. ARFID differs from most other eating disorders in that the physiological effects of the food are not the primary concern, in as much as the food itself is the concern for those suffering from the disorder. 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 mealtimes, have a fear of vomiting or choking, and/or undergo thorough testing for chronic abdominal pain with no satisfactory findings.

Call 855-875-5812 to get help with an eating disorder.

Types of Avoidant/Restrictive Food Intake Disorder (ARFID)

  • Avoidant ARFID: Avoidance based on the sensory characteristics of food, such as its texture, taste, smell, or appearance
  • Aversive ARFID: Avoiding food due to a fear of negative consequences (e.g., choking, nausea, vomiting)
  • Restrictive ARFID: Characterized by general apathy or lack of interest in eating. This lack of interest in food and eating can manifest in behaviors like forgetting to eat, distraction during mealtimes, and/or extreme pickiness.
  • Mixed ARFID: Includes features of avoidance, aversion, and restriction. Usually starts with features of one type but then acquires features of the other types.  
  • ARFID “Plus”: Includes exhibiting behaviors from multiple types of ARFID. This leads to anorexia symptoms like body image concerns, fear of weight gain, and/or obsession with calories.

ARFID in Children

Origin & Recognition

Avoidant/Restrictive Food Intake Disorder (ARFID) can develop in children as young as six years old. It might initially be dismissed as typical picky eating, but over time, it becomes evident that the child’s food avoidance is more persistent and severe. Parents or caregivers may also notice that the child develops specific rituals or behaviors around food, such as only eating foods of a particular color or texture. They might also rely heavily on comfort objects or routines.

Social Implications

The social implications of ARFID often revolve around school and family settings. Children might avoid school lunches, birthday parties, and/or family gatherings due to their food aversions, leading to potential isolation or peer teasing.

Health Concerns

The primary health concerns of ARFID are related to growth and development. Prolonged restrictive eating can lead to nutritional deficiencies, impacting a child’s physical development, cognitive function, and overall health. The following are some examples of the health complications of ARFID: 

  • Malnutrition
  • Failure to gain weight and meet growth trajectories
  • Fatigue and sluggishness 
  • Gastrointestinal complications, such as bloating and constipation
  • Brittle nails, hair loss, or dry hair
  • Electrolyte imbalances
  • Anemia
  • Low blood sugar

Treatment Approach

Treatment of ARFID often involves a combination of psychoeducation, nutritional counseling, structured mealtimes, exposure therapy, family therapy, and behavioral interventions. Parents or caregivers play a crucial role in the child’s treatment, helping to implement dietary changes and provide support.

ARFID in Adults

Origins & Recognition

ARFID in adults can be a continuation of childhood ARFID or emerge due to a traumatic event or other triggers in adulthood. Adults might be more self-aware of their condition but might also face societal judgment or misconceptions, making them hesitant to seek help. 

Social Implications

The social implications of AFRID in adults can be more complex. Adults might avoid dates, work lunches, or social gatherings, impacting their relationships and professional lives. They might also face challenges when traveling or in situations where food choices are limited. These situations may lead them to research restaurants in advance, prepare their own meals when traveling, and find discreet ways to avoid certain foods in social settings. 

Health Concerns

While growth is not a concern in adults with ARFID, malnutrition has harmful effects on adults and children alike. Malnutrition can cause health issues like bone density loss, fertility issues, or cardiac complications. Adults with ARFID might also have coexisting health conditions that require dietary management, complicating the illness.

Treatment Approach

The focus of ARFID treatment in adults is the specific triggers and implications of the disorder in their lives. Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) can be particularly effective in helping adults address underlying fears or beliefs about food. Psychoeducation, nutritional counseling, structured mealtimes, exposure therapy, and behavioral interventions are also components of treatment.

  

adolescent boy smiling at camera

ARFID in Different Cultures

ARFID is not confined to any one culture, society, or demographic. This illness transcends borders, affecting individuals from diverse backgrounds. However, the way ARFID manifests and is perceived can vary significantly across cultures.

Manifestation Across Cultures

  • Dietary practices and preferences: In some cultures, specific foods are staples, while others might be considered taboo. Recognizing these cultural nuances is crucial for effective diagnosis and treatment.
  • Ritualistic eating: Certain cultures have ritualistic eating practices, such as communal feasting or fasting during religious events. Individuals with ARFID might find these rituals particularly challenging, leading to heightened anxiety or avoidance behaviors.
  • Sensory sensitivities: The textures, smells, and flavors that are predominant in one culture might be absent in another. An individual with ARFID might be more sensitive to the spices in Indian cuisine or the textures in African dishes, for instance.

Cultural Myths and Misconceptions

  • “It’s just picky eating”: In many cultures, especially where food scarcity is a concern, ARFID might be dismissed as mere pickiness or a phase that a child will outgrow. This misconception can delay essential interventions and support.
  • Spiritual or supernatural beliefs: In some societies, eating disorders, including ARFID, might be attributed to spiritual or supernatural causes, such as possession or a curse. Such beliefs can stigmatize the individual and hinder access to medical care.
  • Gendered misconceptions: While eating disorders are often stereotypically associated with young women, ARFID affects individuals regardless of gender. In fact, boys are diagnosed with ARFID about as often as girls. In cultures with rigid gender roles, males with ARFID might face additional challenges in seeking help due to societal expectations.

What are the causes of ARFID?

Like all eating disorders, avoidant/restrictive food intake disorder develops over a period of time as a result of a complicated blend of genetic, biological, and environmental factors. There is no single cause 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.

For those suffering from ARFID, early treatment is paramount to a renewed healthy relationship with food and nutrition. Common causes of ARFID include:

Malnutrition-Induced Changes in Physiological Processes and Altered Hunger and Fullness Signals

Malnutrition can occur for reasons unrelated to ARFID (e.g., gastrointestinal issues, not enough variety of food in one’s diet, and an increase in energy expenditure) and this can prompt the development of the illness. Malnutrition can lead to significant changes in the body’s physiological processes. Over time, the body may adapt to being undernourished by altering hunger and fullness signals. This can create a vicious cycle where an individual feels less hungry, leading to selective eating or a lack of interest in food. Additionally, malnutrition can impact metabolic rates, hormone levels, and overall energy balance, further complicating the individual’s relationship with food.

Experiencing a Traumatic Event

Traumatic events, especially those related to food or eating, can be a significant trigger for ARFID. For instance, a choking incident, a severe allergic reaction, or a painful medical procedure involving the throat can lead to a heightened fear of eating certain foods or eating in general. The emotional aftermath of such events can manifest as avoidance behaviors, making it challenging to confront and overcome the trauma.

Genetic Predisposition

As with other eating disorders, genetic factors can play a role in the development and maintenance of ARFID. In fact, the genetic component of ARFID may even be compared to other eating disorders. According to a study, 79% of the risk of developing ARFID is explained by genetic factors. This study demonstrates that many individuals have a genetic predisposition that makes them more susceptible to developing ARFID. 

Temperamental Traits

Temperamental traits like cautiousness, fearfulness, or sensitivity to external stimuli can predispose an individual to develop ARFID. For instance, a child who is naturally more sensitive to textures, tastes, or smells might be more prone to avoid certain foods, leading to a pattern of restrictive eating as they grow.

Anxiety

Anxiety plays a significant role in ARFID. Fear of trying new foods, worry about potential allergic reactions, or anxiety stemming from a past negative experience with food can all contribute to the development and persistence of ARFID. It’s also worth noting that individuals with ARFID often have coexisting anxiety disorders, further highlighting the intricate relationship between anxiety and restrictive eating behaviors.

individual looking down

What are the Signs and Symptoms of ARFID?

Being familiar with the signs and symptoms of ARFID can help you champion early intervention and recovery through ARFID treatment near you. Watch for dysregulated emotions around mealtimes, significant weight loss, and a failure to meet nutritional needs and growth trajectories. Associated disorders, or “comorbidities,” include anxiety disorders, autism spectrum disorders, and cognitive disorders.

  • Weight loss and nutritional deficiencies
  • Failure to meet growth trajectories
  • Emotional dysregulation and high anxiety around mealtimes
  • Chronic abdominal pain lacking an apparent cause
  • Fears or phobias around illness, choking, or vomiting
  • Neutral or positive body image

What are the Long-Term Risks of ARFID?

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

  • Cognitive impairment
  • Delayed puberty or dysregulation of reproductive hormones
  • Impaired brain functioning and signaling
  • Weakened food-related reward pathways
  • Chronic abdominal pain, fatigue, and headaches
mother and child hugging

Is ARFID Treatment Near You an Option?

If you or a loved one are struggling with ARFID, don’t wait to reach out for help. The earlier ARFID is treated, the better the outcomes tend to be. ARFID treatment must be holistic and well-informed by the symptoms that accompany the disorder in each case that it arises, and Veritas Collaborative understands the importance of treating you as the unique person you are.

At Veritas Collaborative, we work with you to create an individualized care plan so you or your child get the right treatment at the right time. We offer a full continuum of care, which includes inpatient, residential, partial hospitalization (PHP), intensive outpatient (IOP), outpatient, and virtual programs for children, adolescents, and adults. This allows us to provide best-in-class care and support throughout your recovery journey, even as your needs change. Our treatment programs focus on real-life skills, including hands-on nutrition and culinary experiences that you can take with you for lasting recovery. We encourage family involvement and offer family-based therapy and educational support for children and adolescents.

Ask for help. You are not alone. Begin healing today.

Key Takeaways about Avoidant/Restrictive Food Intake Disorder (ARFID)

What is ARFID?

ARFID is defined by an ongoing inability to fulfill proper nutritional and caloric requirements. This stems from issues related to eating or feeding, such as disinterest in food, aversion to certain textures or flavors, or worries about the negative effects of consuming food.

Unlike other types of eating disorders, ARFID doesn’t involve a skewed body image or dissatisfaction with one’s body. However, it can result in notable weight reduction, developmental delays, and social or psychological issues.

Causes of ARFID

The development of ARFID is a gradual process influenced by a mix of genetic, biological, and situational factors. There’s no singular cause, and it’s important to note that family and community support systems are not at fault.

The average age for diagnosis is around 11 years, although symptoms can appear earlier. Contributing factors may include changes induced by malnutrition, exposure to traumatic events, and societal norms.

Signs and Symptoms of ARFID

Emotional instability and heightened anxiety during meal times are typical.

Other warning signs encompass substantial weight loss, failure to achieve expected growth milestones, and unexplained chronic abdominal discomfort.

Risks and Consequences

Untreated ARFID can result in cognitive deficits, delayed onset of puberty, compromised brain activity, and other physiological complications.

Treatment and Support

Early intervention and treatment are crucial for better outcomes.

Veritas Collaborative offers a range of eating disorder treatment programs focusing on real-life skills and encourages family involvement for comprehensive care.