Why ARFID is about more than just ‘picky eating’
What is ARFID?
Avoidant/Restrictive Food Intake Disorder (ARFID) is a serious eating disorder where people restrict what they are eating or avoid certain food groups completely.
Isn’t ARFID just about picky eating?
In simple words, no. People with the disorder often only eat a very limited range of foods and may have significant phobias that have a detrimental effect on their health.
ARFID was only formalised as a diagnosis in 2013, with the publication of the Diagnostic and Statistical Manual, 5th Edition (DSM-5) in 2013. Until then, it had existed under an umbrella term to describe ‘other infant and early childhood’ feeding disorders.
A lack of ARFID awareness
Anecdotally, many parents report that among professionals, awareness of ARFID is low – leading to a lack of help and support for families.
Mandy Bartlett, a mum of an autistic teenager who also has the eating disorder, told us:
“We had to really fight for a diagnosis of ARFID. Even then, lots of the professionals involved in my daughter’s care didn’t even know what the condition was.
“It’s worrying. We need to do more to raise awareness of what this eating disorder is, and how it can have such a massive impact on life.”
What are the main types of ARFID?
Avoidant ARFID – certain foods are excluded from a person’s diet due to sensory difficulties, such as taste, texture and smell.
Aversive ARFID – some foods are avoided potentially because of a traumatic historical event, such as choking or illness associated with that food.
Restrictive or low-interest ARFID – people with this type often have lower levels of hunger and can find eating a chore.
Is it about losing weight?
While losing weight isn’t usually a goal of someone with the condition, it can occasionally lead to other eating disorders like orthorexia and anorexia later on.
Is ARFID the same for everyone?
The term ‘ARFID’ includes a range of difficulties that present differently. Nevertheless, all people who develop the condition avoid or restrict food intake, in terms of amount, range of foods eaten, or both.
It’s an eating disorder, not ‘childish behaviour’
Because of the lack of understanding of ARFID, many parents report their children to have difficulties at home and school.
Lucy Jelpin, whose son Rex has ARFID, told us:
“It’s not just about being fussy with food. It has a severe effect on Rex’s emotional and physical wellbeing, both at school and at home. It affects his weight, his mood and his day-to-day functioning.
“If professional understanding of ARFID is so low, it’s no surprise that understanding of the disorder in the general community is too.
“Teachers don’t always understand it’s not ‘childish behaviour’. It’s a psychological disorder just like anorexia and bulimia that needs to be taken seriously.
“Even social occasions, eating out and not having the right snacks can cause Rex extreme distress. He lashes out at everyone, has severe physical symptoms like tummy ache, and is moments away from having a feeding tube.”
What are the symptoms of ARFID?
- Refusing to eat certain foods because of a fear of choking or vomiting
- Not wanting to eat foods of a certain texture or taste
- No appetite for no known reason
- Very slow eating, or being unable to eat a whole meal
- Difficulties with eating during social occasions, such as eating with family and friends
- Not gaining weight as expected
- Losing weight, particularly among the teenage population, who have already stopped growing
- No growth or delayed growth
- Stomach cramps and constipation
- Abnormal blood test results
- Weakened immune system
- Dizziness and fainting spells
- Fine hairs all over the body, known as lanugo
- Menstrual irregularities.
How to tell if someone is fussy or really does have an eating disorder like ARFID
While there are many differences between an ARFID diagnosis and picky eating, the line can often be blurred. You can read more about the differences between ARFID and picky eating here.
How ARFID is treated
According to ARFID Awareness UK, ARFID has a number of therapies, interventions and treatments, but there’s no one-size-fits-all approach.
As ARFID is a fairly new diagnosis, there isn’t much known about the most effective treatments. But cognitive and behavioural interventions used to treat anorexia have been successfully adapted. There’s even an ARFID-specific form of CBT, CBT-AR.
Trust your parental instinct
As a parent, you’ll know your child better than anyone else, so trust your gut instinct. If something doesn’t feel right, reach out to your GP or pediatrician as soon as you can.
Eating disorder support
If you or your child needs eating disorder support, Arfid Awareness UK , Beat and Eating Disorders NI can be great places to start. And don’t forget to download the Friendili app to exchange support with other parents.