Avoidant restrictive food intake disorder (ARFID) is classified as an eating disorder, yet not many people know or have heard about this condition. ARFID, previously known as selective eating disorder, is described in the DSM-5 as an eating or feeding disorder characterised by a persistent and disturbed pattern of feeding or eating that leads to a failure to meet nutritional/ energy needs. This condition is typically associated with children who are described as ‘picky eaters’, however is actually known to also affect adults, which includes people of different genders, shapes and sizes.
As opposed to other eating disorders such as anorexia nervosa and bulimia nervosa, individuals experiencing ARFID are not typically weight conscious and do not restrict their food intake with the intention of weight loss, or because they fear gaining weight. Typically, an individual with this condition might be avoiding or restricting certain foods or food groups due to a host of other reasons, which may include:
- A sensitivity to the taste, texture, smell, or appearance of certain types of food, or are only able to eat foods at a certain temperature (e.g. avoiding fruit and vegetables, or crunchy foods)
- A traumatic experience associated with food (e.g. choking or vomiting), and may therefore have developed a fear or anxiety around particular foods, resulting in them avoiding foods of certain textures
- Not particularly enjoying the experience of eating, or having a very poor appetite, thereby resulting in an insufficient food intake
Signs and symptoms of ARFID
A person experiencing ARFID may display a range of physical and behavioural/ psychological symptoms that one could look out for. Some behavioural symptoms include: a limited range of preferred foods that worsens progressively over time; reporting constipation, abdominal pain, feeling cold, lethargy, and/ or having excess energy; and avoiding events where food will be served or becoming distressed when preferred foods aren’t available. Physical symptoms of ARFID can affect several parts of the body, hair and skin due to nutritional deficiencies. These may include: dry skin, hair loss, headaches, poor circulation, gastrointestinal issues, dehydration and irregular/ absent periods, amongst others.
Impact of ARFID on health
ARFID can have a negative impact on a person’s physical and psychological health and wellbeing. Due to their restricted diet, a person with ARFID may not be able to get the essential nutrients that are required for them to be able to develop and function on a daily basis. In children, this may look like a difficulty in gaining weight, which may affect their growth process. In more severe cases of ARFID, serious weight loss or nutritional deficiencies requiring treatment may occur. Some people may need to be prescribed supplements or a period of tube feeding if there are high risks associated with their physical health. In terms of psychological wellbeing, a person with ARFID may encounter difficulties when it comes to eating around other people, and may require extended meal times. This can result in difficulties in several contexts, including family mealtime conflict, peer social isolation, and difficulties with school, relationships and work.
If you think that you can benefit from professional support on this issue you can reach out here.
Pamela Borg is a counsellor who enjoys working therapeutically with adults experiencing various issues. These include general mental health and wellbeing, gender, sexuality, relationship issues.
Eating Disorders Victoria (n.d.). Avoidant/ Restrictive Food Intake Disorder (ARFID). Retrieved from: https://www.eatingdisorders.org.au/eating-disorders-a-z/arfid/
National Eating Disorders (2021). Avoidant/ Restrictive Food Intake Disorder (ARFID). Retrieved from: https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid
Bryant-Waugh, R. (2019). What is Avoidant/Restrictive Food Intake Disorder? Beat Eating Disorders. Retrieved from https://www.beateatingdisorders.org.uk/get-information-and-support/about-eating-disorders/types/arfid/