Eating Disorders

Avoidant Restrictive Food Intake Disorder (ARFID)

Previously known as selective eating disorder, Avoidant Restrictive Food Intake Disorder (ARFID) is a relatively newly recognised eating disorder that can occur throughout one’s lifespan. Individuals with ARFID display rigid and selective eating habits that leads to a deficit in their nutritional intake.  

Increased sensitivity to sensory properties of food is one of the most prominent reasons for avoidance and restriction in ARFID. These sensory aversions includes a certain type of food’s taste, smell, texture and colour. Individuals may perceive vegetables to be bitter or chewy, hence avoid them. As a result, they tend to replace these foods which highly processed dense meals that could result in a deficiency in vitamins and minerals.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a diagnosis of ARFID is given when

Ψ Food restriction is characterised by persistent inability to meet caloric needs or developmental milestones

Ψ Eating problems are neither the result of food scarcity nor a cultural practice.

Ψ There is no indication of distorted perception of body weight or appearance.

Signs of ARFID include:

Ψ Fear of vomiting or choking

Ψ Limiting food intake as a result of particular food textures or fussy eating

Ψ Lack of interest in food

Ψ Complains about abdominal pain or feeling full around mealtimes

Ψ Significant weight loss/inability to gain weight

Ψ Avoidance of social situations due to a limited range of food preferences

How is Avoidant Restrictive Food Intake Disorder addressed?

Similar to Binge Eating Disorders, management of ARFID includes Cognitive Behavioural Therapy (CBT) and Dialectical Behavioural Therapy (DBT). Coupled with skills, an individual would be able to recognise food triggers and take steps to feel safer about consuming food in a typical manner.

 Exposure Therapy may also be an effective intervention as exposing an individual to certain food types in the absence of their feared outcome can serve to alter their belief systems based on experience.

Other therapeutic methods that involves the child and the family include: Family-Based Therapy (FBT). FBT acknowledges the importance of the family dynamic in a child or adolescents’ life and utilises this to both educate the individual and family while also encouraging behaviour change in both groups. 

How to manage AFRID in children:

Ψ Parents can try to gradually introduce new foods during mealtimes.

Ψ Use a gentle approach when encouraging children to explore new foods – try not to force them to finish their meals.

Ψ Routinely change the way meals are prepped – for example: exploring between mashed or baked potatoes or cutting up carrots in different shapes. This allows for food to look fun and engaging

Ψ Establish a mealtime & snack schedule – keep snacks out of reach to prevent limited appetite during mealtime