Avoidant/Restrictive Food Intake Disorder
Dominika Vašínová
When you encounter the term eating disorder, you will probably think of anorexia or bulimia, but those are the commonly known ones - there is much more. ARFID has been included in DSM-5 since 2013, so it is still quite a young and publicly unknown diagnosis. It is mainly characterised by fear of eating outside of a particular group of "safe foods". But it isn't just pickiness, because it's not done deliberately - a hungry ARFID person would rather starve than eat or swallow that meal. Compared to that, a picky eater would be able to eat it if they wanted to or they could also be bribed into eating it.
ARFID can be divided into four categories: aversive which is caused by sensory aversions such as sensitivity to certain textures, smells, colours or tastes, avoidant which is based on fearful experience, usually it is vomiting, choking or severe stomach-ache, which leads to the feeling that the food is the source of the pain or trauma and will hurt them again. For restrictive is typical low interest in eating, low appetite and distraction during mealtime. The last one, ARFID plus contains more types or features of anorexia.
ARFID people have a very narrow circle of the food they eat. The foods in the circle are called safe foods - they tend to be refined carbohydrates, high sugary and processed. There usually is low intake of protein and fresh fruits. Huge amount of food rules is also common. It could be described as a phobia - they are absolutely terrified of eating outside of "their" food.
Causes are genetic factors, environmental influence, food beliefs and psychological factors such as anxiety disorder or OCD. Individuals affected by this disorder are mainly young children, but it can occur at any age. It is estimated that 5 % of adolescents suffer from ARFID. It affects more men than women.
The symptoms and warning signs can include fears of choking and vomiting, lack of appetite, gastrointestinal issues, menstrual irregularities, anemia, being underweight, fine hair, restriction in food intake or eating only certain textures ARFID has similar signs and consequences as anorexia, but the major difference is that ARFID doesn't include distress about body shape or fear of being fat.
This ED affects the whole body. Due to the lack of meeting necessary nutritional value the consequences are nutritional and developmental deficiencies. Additional risks are cardiac concerns, kidney and liver failure, osteoporosis and low blood sugar. On top of that, it also has a major influence on relationships and work. Lunches with colleagues, dates, holidays - nearly every social interaction is somehow connected to eating.
Fortunately, it is possible to recover. The treatment has to be done specifically to the patient, because everyone experiences ARFID differently. The first step is identification of the type. Then there is education about the diagnosis, setting goals and values, involvement of the family - which is very important, anxiety management training, nutritional management, monitoring physical health and eg. cognitive behavioural therapy. The range of treatment (and also of the symptoms) is, of course, much wider and much more complex than listed here.
If you feel that any of these aforementioned symptoms are applying to you, I deeply encourage you to seek medical help (such as https://www.anabell.cz/ ). I would also like to emphasise that I am no doctor, nor an expert in this field, so, even though I tried to fact-check this article as much as possible, I might still be mistaken in some areas.
My resources were:
https://www.beateatingdisorders.org.uk/types/arfid
https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid
https://en.m.wikipedia.org/wiki/Avoidant/restrictive_food_intake_disorder
https://youtube.com/playlist?list=PLeJPSw0W2rRF7yMW591b2fvGA_Xd2lh1o
https://www.eatingrecoverycenter.com/conditions/arfid