Do you know what the deadliest behavioral health disorders are? While opioid addiction maintains the top spot, eating disorders come in at number two. Over 28 million Americans will struggle with an eating disorder during their life.
One rarely discussed eating disorder is Avoidant Restrictive Food Intake Disorder (ARFID). Learn how to spot the warning signs for ARFID and explore its causes and treatments.
ARFID is a new addition to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). It was added in 2013 to replace a category of childhood eating disorders. Researchers now understand that ARFID can occur throughout the entire lifespan.
Most eating disorders, like anorexia and bulimia, revolve around:
ARFID doesn’t usually fall into these same patterns. People who suffer from ARFID might create restrictive eating conditions because of:
If someone experiences choking on a specific food, they might begin to avoid it in the future. This event becomes a traumatic experience that fuels their restrictive eating. And this behavior may cause increased risk for devastating health consequences.
People who struggle with ARFID often fail to meet their nutritional needs. They might lack energy and develop psychosocial impairments, like avoiding food at parties. Severe ARFID patients might need a feeding tube or dietary supplements to meet their daily caloric needs.
There are four major subtypes of ARFID. They describe how the patient deals with their food issues. These four types often overlap, and an individual can have more than one subtype.
Individuals with the avoidant subtype choose not to eat certain foods. The reason is often a sensory issue, such as overstimulation or sensitivity. They might have trouble processing the taste, smell, or texture of a specific food.
Not enjoying certain textures, smells, or tastes is normal – some people despise mushy food, while others hate green vegetables. But ARFID is an extreme case where the avoidance impacts physical and behavioral health.
The aversive subtype often stems from past trauma. The individual might have choked on a specific food or experienced food poisoning. This painful health event creates a fear associated with the food.
Individuals might stop eating that food entirely. Over time, the category of acceptable foods might decrease as new fears pop up.
Most eating disorders follow restrictive patterns of consumption, but ARFID doesn’t stem from self-image issues or a fear of gaining weight. People with restrictive ARFID might lack interest in food or forget to eat regularly.
Individuals with ARFID may also be very picky eaters. Their dislike of certain foods might lead to diet restriction to the point of malnutrition. A low appetite and becoming distracted while eating are other ways this subtype can manifest.
ARFID Plus is a co-occurring disorder where individuals begin to exhibit symptoms of other eating disorders. For example, their behavior around food might be so severe that they start to show signs of anorexia. They might also develop body image issues and a fear of weight gain.
Eating disorders are defined by specific behavioral, psychological, and physical symptoms. But it’s not uncommon that people with the same diagnosis will exhibit different symptoms. Psychological and behavioral warning signs of ARFID include:
These signs will often worsen with time. The list of avoidance foods might expand, further limiting their intake. Symptoms will occur without any body image issues associated with the food intake.
When someone doesn’t meet daily nutritional standards, their body begins to react. Physical symptoms that occur as a result of problematic eating patterns include:
An individual will often have abnormal blood test results if they see their doctor. They might have anemia, thyroid problems, or low blood cell counts.
ARFID’s 2013 entry into the DSM-V makes it a relatively new disorder with limited research. Experts believe that its orgin is similar to other eating disorders. The causes of ARFID are likely a combination of biological and environmental factors.
Biological causes include inherited anxiety, sensory issues, and appetite type. Environmental factors might be the family diet and availability of a variety of food. Healthy eating behavior modeled by the parents is also a key factor.
Certain risk factors can increase the chances of developing ARFID. These, combined with biological and environmental factors, include:
ARFID is more commonly diagnosed in young children and adolescents. Older teens and adults are less likely to receive the diagnosis or exhibit symptoms. Most studies also show that ARFID patients tend to be younger than people with other eating disorders.
Unlike eating disorders like anorexia which is more common in females, ARFID is more often diagnosed in males. One study showed that 29% of ARFID patients were young males. Almost double that of male anorexia patients (15%) and bulimia (6%).
A lot of avoidance and aversion symptoms come from fear. Thus it’s no surprise that many ARFID patients also have several co-occurring disorders. One study found that as many as 72% of patients had anxiety!
Obsessive-compulsive disorder, autism, and ADHD are also often co-morbid. These three disorders can emphasize sensory issues creating conditions for ARFID to flourish.
Any untreated eating disorder can lead to dangerous medical complications. An electrolyte imbalance can cause death without any warning. Similarly, severe nutritional deficiencies can lead to an unexpected heart attack.
But because ARFID often begins at a young age, it can also have serious developmental impacts. Children might suffer from:
ARFID can also lead to severe psychological stress. An individual might struggle with social events, making friends, and sense of self. Increased isolation can then lead to depression and other mood disorders.
Eating disorder treatment often focuses on addressing mental and physical health simultaneously. A proper nutrition plan must be established to promote weight gain if needed. At the same time, therapy can help individuals deal with their food aversions.
ARFID treatments might include:
Sometimes, individuals will need to stay at a hospital to address extreme weight loss or medical needs. They might need round-the-clock care or a feeding tube. But patients can also deal with their disorder through a treatment center.
Outpatient treatment is a good option for those who don’t need 24-hour monitoring. It often involves group and individual therapy at the center. Individuals can also participate in workshops and holistic treatment while working with a medical team.
Individuals with more severe cases should seek residential treatment. A stay in a residential center provides constant care, intensive therapy, and dedicated staff. These factors are especially important if the patient has co-occurring disorders or addiction.
Eating disorders and addiction have a strong link. Dual-diagnosis treatment aims to tackle both issues at the same time. Individuals receiving this treatment will often take part in therapy to minimize their food aversions.
At the same time, they will receive addiction counseling and learn healthy coping mechanisms. They may undergo a detox phase at the treatment center as well. Dual-diagnosis treatment is essential for those who struggle with ARFID and addiction.
There are no medications specific to ARFID, but a doctor can prescribe certain medications to reduce anxiety. Some anti-depressants can also stimulate appetite and lessen fears centered around food.
Therapy is crucial when undergoing treatment for ARFID. Cognitive-behavioral therapy (CBT) connects thoughts, emotions, and actions. It helps individuals alter their thought patterns to change their behavior.
CBT studies with ARFID patients found it to be effective in some cases. Individuals were able to increase their food intake and decrease food-related stress. Relaxation training, self-monitoring, and exposure techniques are common tools.
Family-based treatment is the go-to option for younger patients with eating disorders. The parents become responsible for ensuring their child consumes a nutritious diet. Greater exposure to new food is strongly emphasized in family-based treatment for ARFID.
Avoidant Restrictive Food Intake Disorder can wreak havoc on a person’s life. Not only does it interfere with their physical health, but it can also damage their behavioral health. When addiction or co-occurring disorders are also present, the entire well-being of a person declines.
ARFID doesn’t have to control your life! Whether you need help with an eating disorder, addiction, or behavioral health, we can help. New Method Wellness provides outpatient and residential dual-diagnosis treatment in beautiful California.
Contact us for more information! Our team is ready to help you reclaim your life.
Deanna Crosby is a Licensed Marriage and Family Therapist (LMFT) with over 20 years of experience working with clients in recovery. Her expertise has catapulted her into the spotlight. Featured on several episodes of the Dr. Phil Show as a behavioral health expert, DeAnna is a routine contributor for NBC News, The Huffington Post, Elle Magazine, MSN, Fox News, Yahoo, Glamour, Today, and several other prominent media outlets.
After receiving her bachelor’s degree from the University of California in Irvine, Crosby did postgraduate work at Centaur University where she graduated at the top of her class with a CAADAC certification in Centaur’s chemical dependency program. Following her time at Centaur, Crosby received her Master of Counseling Psychology degree from Pacifica Graduate Institute, where she also attained a Doctoral Degree in Depth Psychology.
From all of us at New Method Wellness co-occurring treatment center, we wish you peace and serenity in knowing that you or your loved one will get the necessary help.