What is ARFID?
By Emma Williams
We all have foods we dislike, but for someone living with Avoidant/Restrictive Food Intake Disorder (ARFID), it goes far beyond ordinary food preferences and can have a significant impact on nutrition, growth, physical health and everyday life.
ARFID is an eating disorder characterised by persistent avoidance and aversion to food and eating. A meal might be avoided because the texture feels unbearable, because there is a fear of choking or vomiting, or simply because there is very little interest in food at all.
ARFID can affect children, adolescents and adults. Unlike eating disorders such as Anorexia Nervosa or Bulimia Nervosa, food restriction in ARFID is not typically driven by concerns about body weight, shape or appearance.
ARFID is more than “fussy eating”
While picky or fussy eating is a commonly observed behaviour, particularly in children, these behaviours can be part of normal development, as children learn about their food preferences and begin to develop a greater sense of independence and control. However, ARFID goes beyond having a few disliked foods.
For example, a child with ARFID may only tolerate foods of a particular colour or texture, become extremely distressed when a “safe food” changes brand or packaging, or avoid birthday parties because they are worried there will be nothing they can eat. For others, eating may feel frightening following an experience such as choking, vomiting or becoming unwell.
Picky eating doesn’t impact a child’s health as significantly as ARFID. It can be easy to dismiss restrictive eating as a phase in children, however, ARFID symptoms tend to persist without appropriate support and can result in serious health and medical complications.
Why might someone with ARFID avoid food?
There is no single presentation of ARFID. Food avoidance or restriction is commonly linked to one or more of the following:
· Sensory sensitivity: Tastes, smells, textures, temperatures or even the appearance of certain foods may feel overwhelming or unpleasant.
· Fear of something bad happening: Eating may become associated with fears of choking, vomiting, allergic reactions or becoming sick.
· Low interest in food: Some people rarely experience hunger, have little interest in eating or find eating feels like a chore.
These experiences can overlap, and every person with ARFID will present differently.
What does ARFID look like?
ARFID can look different from person to person. Some common signs can include:
· Eating a very limited range of foods
· Strong distress when presented with unfamiliar foods
· Avoiding entire food groups or foods with particular textures or smells
· Fear of choking, vomiting or becoming sick after eating
· Low appetite or limited awareness of hunger cues
· Difficulty eating enough to meet nutritional needs
· Relying on nutritional supplements
· Avoiding social situations involving food, such as parties, restaurants or school camps
· Weight loss, difficulty gaining weight or concerns regarding growth and nutrition
ARFID can also occur alongside other difficulties, including anxiety, Autism and ADHD.
How can ARFID affect everyday life?
The impact of ARFID often extends to other parts of life. Family meals can become stressful, parents may find themselves preparing several different meals, and children or adolescents may avoid social events because of uncertainty about what food will be available.
For the person experiencing ARFID, repeated pressure to “just try it” can also increase anxiety and make eating feel even harder.
Understanding why someone is avoiding food is therefore an important part of treatment.
How is ARFID treated?
Treatment for ARFID should be individualised and consider the reasons a person is finding food or eating difficult. Depending on their needs, treatment may involve a multidisciplinary team including a psychologist, GP or paediatrician, dietitian, occupational therapist and/or speech pathologist.
Psychological treatment may focus on reducing anxiety around eating, gradually increasing the range and amount of foods that feel manageable, developing strategies for sensory sensitivities, and supporting the individual and their family to reduce stress around mealtimes.
Approaches such as Cognitive Behavioural Therapy for ARFID (CBT-AR) and adaptations of Family-Based Treatment for ARFID are emerging treatment options, although research into ARFID treatment continues to develop.
When should I seek support?
If eating difficulties are affecting you or your child's nutrition, growth, physical health, emotional wellbeing or ability to participate in everyday activities, it may be helpful to seek professional support. A GP is often a useful first point of contact and can assess physical health, nutritional concerns and whether referrals to other health professionals may be appropriate.
Early identification and support can help individuals and families better understand what is driving food avoidance and work towards making eating feel safer and more manageable.
At Blueprint Psychology, we understand that difficulties with food and eating can be complex. Our psychologists can work collaboratively with individuals, families and other treating professionals to support the psychological factors associated with ARFID.
Contact our friendly team for further information.
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