What is ARFID? More Than Just "Picky Eating"

When people hear the phrase “Eating Disorder”, the more common disorders like anorexia and bulimia come to mind. However, there are actually a number of other types of eating disorders that are not as well known—but just as dangerous. One such type is ARFID, or Avoidant/Restrictive Food Intake Disorder. ARFID is more than just “picky eating”—it negatively impacts a person’s weight, harms his or her growth, or interferes with someone’s daily tasks. As a result of the severe eating problem, the person may not be able to get enough nutrition through his or her diet. Let’s learn more about ARFID, how it differs from picky eating, and how therapy can help those with ARFID.

What is ARFID?
More than just “picky eating,” people who suffer from ARFID often have intense, irrational fears about certain foods causing them to severely limit their diets. They do not struggle with intense fear of weight gain and negative body image, as is commonly seen in anorexia, bulimia, and other eating disorders. However, Avoidant/Restrictive Food Intake Disorder is just as harmful, as it frequently leads to significant weight loss and nutritional deficiencies. In growing children, ARFID can lead to “failure to thrive,” which means that a child is not hitting developmental or growth milestones appropriately.

What are signs and symptoms of ARFID?
Most commonly, people with ARFID have discomfort and extreme anxiety related to colors, smells, or textures of foods. A person might only have ten or so “safe” foods that he or she feels comfortable eating. It’s also common to have intense anxiety related to fears of choking or vomiting when eating a specific type of food. Someone with ARFID may have other irrational or distorted thoughts like, “This food will taste disgusting and I won’t be able to get the taste out of my mouth,” or “This food will make me sick and I will never feel better.” ARFID can also cause significant distress in older teens and young adults; they may avoid certain social situations based on intense anxiety about the foods that will be served there, or avoid going out to certain restaurants with friends or family members because the menu is too anxiety-provoking.  

How can therapy help someone with ARFID?
When an individual with ARFID comes to therapy, the therapist’s main focus is on reducing his/her anxiety, targeting his/her irrational thoughts, and incorporating more foods into his/her diet. Initially, a therapist may create a distress scale with the client, in which they discuss and rank fear foods from least fearful to most fearful. Distress tolerance, deep breathing, and other calming skills are then discussed in order to help the client regulate themselves during these exposures. Next, the client will participate in in-session “food exposures,” with the support of the therapist and his/her parents. Gradual desensitization to foods teaches a client and parents that his/her thoughts surrounding these foods, and potentially what may occur if he/she eats them, is not grounded in reality.

ARFID, or Avoidant/Restrictive Food Intake Disorder, may not be the most well-known eating disorder, but it can be just as detrimental as anorexia or bulimia. ARFID is more extreme than picky eating—it causes anxiety surrounding food and it interferes with a person’s health or daily routine. Luckily, there are ways to treat ARFID. A therapist can help people with ARFID address anxiety that comes with the disorder, learn coping skills to deal with distress related to ARFID, and gradually desensitize people to fearful foods. With time, patience, and support from other family members, many people have been able to greatly expand their diets and significantly reduce their distress!