ARFID - An Eating Disorder that is life altering.
ARFID is more than just picky eating. It is a serious, legitimate eating disorder and can become life threatening if not treated and supported in a helpful way.
What is ARFID?
ARFID is the short form for Avoident Restrictive Food Intake Disorder. It is a new diagnosis in the DSM 5 and categorizes an eating disorder that may not result in weight loss, but sees the number of foods an individual can eat severely restricted. This may be accompanied by a fear of choking or a belief that there is something gross in the food (maggots or bugs). This anxiety is consistent and not explained away. This disorder is characterized by a lack of distorted body image or desire to be thinner. Put another way, the person isn’t restricting to lose weight, or look different, they’re afraid of the food itself.
What can I do to help my loved one with ARFID?
Be truthful about what they are eating, don’t try to sneak or hide foods when disclosing concerns to an anti-diet dietitian, or a physician. Nutrient deficiency, or malnourishment can be a negative impact of ARFID and there are many ways that nutritional needs can be met with the support of healthcare professionals. If we hide information it can alter the treatment that is received.
Be patient. Your person doesn’t want it to be like this either. By putting pressure on your loved one to eat different, eat more, or forcing them to eat food can convey you are angry with them, lead them to become even more anxious about eating, restrict more foods, and reduce their safe foods that sustain their bodies ability to stay alive. It’s important to seek your own support, educate yourself with helpful materials, and focus on supporting your loved one is a supportive, non pressuring manner especially when food is involved.
Remember that a safe food (foods that can be eaten all the time) today, may not be a safe food tomorrow. Safe foods evolve for sometimes known or understood reasons, and other times we may never be able to identify a reason too.
Don’t be offended, it’s really nothing to do with your food or your cooking. ARFID actually is currently thought to have a genetic marker that contributes to the extreme selective eating preferences. Foods can taste extremely different to someone with ARFID, or they can have a severe adverse reaction of anxiety that prevents them from being able to eat something. It’s not your fault, and it’s not there fault either.
ARFID can leave you feeling judged.
Support is available.
Seek professional help. Serious eating challenges are not a do it yourself fixit. You need supports, and so does your person. Ensure that you feel confident that the healthcare professional is the RIGHT SUPPORT. You can always seek out someone who is neurodivergent affirming in their approaches, as well as finding someone who understands ARFID and can share their approaches beyond just CBT for ARFID or Food Therapy/Exposure Therapy.
Who Diagnoses ARFID?
A doctor or a mental health professional (such as a psychologist or psychiatrist) can diagnose ARFID here in Canada. Every country and jurisdiction can be different so consult with your primary healthcare provider nearby you to determine what access you have to assess and diagnose if you think ARFID is present. Although, when choosing a practitioner to make this diagnosis, it is important to ask if they know what ARFID is. ARFID is a new diagnosis and not all psychologists or psychiatrists are familiar with the diagnostic criteria.
Is ARFID serious?
Some people come to believe that ARFID might not be serious as it may not be accompanied by weight loss (although some people do lose weight), but people who have ARFID can develop vitamin deficiencies, see slow or stagnant growth (in growing children) and develop other issues. In some clients, the list of acceptable foods (these are foods that are safe some of the time) and safe foods (foods that are generally okay to eat) can shrink. Leaving the person with a very limited diet. ARFID may always be present, however it’s always a good idea to ensure you are medically stable and not experiencing consequences that impact your health due to untreated ARFID.
Are there treatment programs for ARFID?
There are treatment programs for ARFID, and counselling may help. Starting with an online search, and speaking with your healthcare providers can be a place to start with accessing support.
Counselling is also an important support for families working with a person who has developed ARFID. You can also access peer support as someone living with ARFID (for adults typically), or as a caregiver providing support too with online support groups available.
ARFID Supports Matter. It’s never too late or too early to seek support.
With appropriate supports, people with ARFID can reduce anxiety about eating, work on their individualized goals, if it’s a goal they can work towards expanding their range of edible foods again, and working towards meeting their individualized nutritional needs. There are also other aspects outside of “food therapy” to focus on when supporting ARFID. This may look like talking about the relationship with their body, exploring interoceptive sensory awareness (hunger and fullness cues for example), working on reducing anxiety and self-criticism about the ARFID experiences, or even processing trauma associated with the ARFID experiences are all common areas that can be explored in counselling with your provider.
Meet Amanda, guest author for the above blog post.
Amanda Broderick, an autistic, disabled, white bodied female who is currently pursuing her Bachelor of Social Worker degree from Dalhousie University. She is completing a practicum placement with a clinical social work focus in Shelley Restall’s Counselling practice. Amanda is passionate about supporting late diagnosed autistic females (including self-diagnosed, exploring neurodivergence), to build a life that is based on self-knowledge, self-acceptance, creating systems of neurodivergent affirming support for daily life, and de-constructing internalized ableism that is self-limiting.