Have your friends and family pointed out that you’re a picky eater?
Do you sometimes feel that certain aromas, textures, and ingredients appear highly unpleasant that they suddenly make you lose your appetite?
Or maybe some food items make you go from ravenously hungry to extremely nauseous within seconds?
If you answered ‘yes’ to any of these questions, then you may have a condition known as ARFID or ‘Avoidant/Restrictive Food Intake Disorder’.
ARFID is an eating disorder that is most prevalent among the pediatric population, and some people carry this condition into their adult years as well.
What is ARFID?
People with ARFID develop a highly peculiar or sensitive attitude towards the foods that they eat. That is, they not only become extremely picky eaters, but they also develop certain aggressive or anxious attitudes when their ‘disliked’ food items are brought in front of them. [1]
In the long term, these habits lead to a highly disrupted eating schedule and loss of normal appetite, making them vulnerable to the long-term consequences of unbalanced eating habits.
How Do I Know if I Have ARFID?
When it comes to eating, we all have our choices. There are some foods we are more than happy to gobble down within seconds, whereas certain foods are so unappetizing to us to the extent we can’t eat them at all! These ‘disliked’ foods are those that render you willing to drop extra cash to take away or order a pizza from your favorite restaurant!
However, ARFID is more serious than that. ARFID displays certain characteristic symptoms that allow doctors to diagnose it without requiring extensive examination. If you spot someone or yourself showing these symptoms, they are likely attributed to ARFID rather than picky eating.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the following set of symptoms must be present in an individual for them to be diagnosed with ARFID. These are considered warning signs that warrant treatment as soon as possible for the patient. [2]
- Significant weight loss or a body weight that is not abnormal for that particular age group.
- Resultant significant nutritional deficiency that manifests in the form of different symptoms.
- Having a dependency on nutritional supplements through enteral or oral routes.
- Significant interference in the psychosocial functioning of an individual, that is, how they interact with their surroundings.
Previously, it was thought that only children develop this condition. However, studies have shown that while children are predisposed to a greater risk of developing this condition, they can carry it into adulthood, which is why some adults experience ARFID as a persisting chronic condition.
It’s always best to have any unhealthy eating habits checked and treated if necessary to prevent detrimental health consequences in the future.
What Are Some Common Symptoms of ARFID?
Doctors may be able to diagnose ARFID based on the diagnostic criteria, but you may find yourself a little confused differentiating between picky eating and ARFID.
Here is a list of the most common symptoms that people with ARFID experience that typically lead to the diagnosis of ARFID: [3]
- Sensory Sensitivity – That is, a person starts feeling weird or ticklish when eating particular fruits or vegetables, such as crunchy foods, that seem to trigger them.
- General Lack of Interest – This means that you might not feel hungry, even at meal items, or even forget to take your meals on time, just because you don’t feel like eating anything at all.
- Fear – Strangely enough, a person might develop the fear of eating some particular types of foods. They develop this fear of choking or purging whatever they eat, and so, it is better if they avoid eating it at all.
- Very Slow Eating – People with ARFID are amongst those who have the LEAST interest in eating anything! Therefore, they could be easily pointed out as the ones who finish the last off their plates in the very end!
Is ARFID the Same As Anorexia or Bulimia?
Anorexia nervosa and Bulimia nervosa are two common eating disorders classified as mental health disorders nowadays.
In anorexia, the affected person develops a strong fear of ruining their body image by putting on excess weight, and so they try to prevent weight gain by starving themselves.
It is more of a type of obsessive-compulsive disorder accompanied by symptoms of depression in the person.
Bulimia nervosa or binge-eating disorder, on the other hand, is an eating disturbance disorder where a person experiences uncontrollable sessions of binge eating, followed by periods of compensatory behaviors such as purging and self-induced vomiting to reduce the impact and guilt of the overeating episode. [4]
However, the medical condition ARFID is nowhere similar to anorexia and bulimia. Indeed, there are a few similarities between ARFID and anorexia because a person ‘restricts’ what they eat. However, the ‘mental perception’ present in anorexia that forces a person to starve themselves so that they do not gain weight is missing from the equation.
The same is the case with anorexia and ARFID. There is no fear of weight gain as a consequence of overeating because, in ARFID, overeating is not present at all.
Therefore, all of this makes it safe to assume that both eating patterns as seen in anorexia and bulimia are different from ARFID.
Is ARFID Linked to Autism?
ARFID and autism both involve strong ‘thought’ backgrounds and interestingly enough, research has also found links connecting both of them.
Sensory sensitivity is the root cause or one of the most important risk factors connecting both ARFID and Autism Spectrum Disorder. In both these conditions, the predisposed population, that is, the pediatric population is seen to have developed an aversion to certain sensory experiences.
This involves food items too, which then makes children with autism scared to try out any new food items just because they perceive them to be harmful to them. Ultimately, these children are left with limited food options, which leads to them developing ARFID in the long run, thus associating both these disorders together in a single loop. [5]
Is There Any Solution To Make ARFID Go Away?
Being aware of your condition and wanting to stop the cycle is a positive attribute in itself that would kickstart your treatment journey. ARFID is highly treatable through a series of non-pharmacological interventions.
Firstly, you might be worried about having ARFID, which is understandable. If you have any pressing concerns, it’s always best to seek the advice of a healthcare professional who can diagnose and recommend treatment options for that condition.
If you are diagnosed, you can then talk it out with a psychiatrist or counselor. Being able to talk about your concerns and perceptions towards this condition and eating in general is part of the recovery process and would work massively in your favor.
In the majority of cases, cognitive behavioral therapy alone with a psychiatrist is effective in helping people handle, overcome, and recover from this condition. Many learn how to tackle this condition effectively and are eventually able to practice healthy eating habits that meet their nutritional needs.
Bottomline: ARFID Symptoms and Diagnosis
So, if you are concerned that you may ARFID, seek the advice of a healthcare professional. It’s completely normal to feel overwhelmed or have concerns at times, and seeking treatment may take a huge leap of courage.
However, you don’t have to embark on this journey alone. Working together with your trusted healthcare providers and garnering support from close friends and family can make your journey a less choppy one.
Disclaimer: This article is only a guide. It does not substitute the advice given by your own healthcare professional. Before making any health-related decision, consult your healthcare professional.
Editorial References And Fact-Checking
- Zimmerman, J., & Fisher, M. (2017). Avoidant/Restrictive Food Intake Disorder (ARFID). Current problems in pediatric and adolescent health care, 47(4), 95–103. https://doi.org/10.1016/j.cppeds.2017.02.005
- Substance Abuse and Mental Health Services Administration. (2016). DSM-5 Changes: Implications for Child Serious Emotional Disturbance. Substance Abuse and Mental Health Services Administration (US).
- Zickgraf, H. F., Franklin, M. E., & Rozin, P. (2016). Adult picky eaters with symptoms of avoidant/restrictive food intake disorder: comparable distress and comorbidity but different eating behaviors compared to those with disordered eating symptoms. Journal of eating disorders, 4, 26. https://doi.org/10.1186/s40337-016-0110-6
- Giannini, A. J., Newman, M., & Gold, M. (1990). Anorexia and bulimia. American family physician, 41(4), 1169–1176.
- Lucarelli, J., Pappas, D., Welchons, L., & Augustyn, M. (2017). Autism Spectrum Disorder and Avoidant/Restrictive Food Intake Disorder. Journal of developmental and behavioral pediatrics : JDBP, 38(1), 79–80. https://doi.org/10.1097/DBP.0000000000000362