ARFID

Avoidant/Restrictive Food Intake Disorder

Avoidant/Restrictive Food Intake Disorder (ARFID), also known as “extreme picky eating,” is an eating disorder characterized by highly selective eating habits, disturbed feeding patterns or both. It often results in significant nutrition and energy deficiencies, and for children, failure to gain weight.

Common eating and feeding challenges for an individual with ARFID include difficulty digesting food; avoidance of specific types of food textures, colors and smells; eating at an abnormally slow pace, or having a general lack of appetite.

ARFID is most common in infants and children, with some cases persisting into adulthood. Preliminary study shows that it may affect up to 5% of children, with boys being at greater risk for developing ARFID, according to Neuropsychiatric Disease and Treatment. Overall, an estimated 3.2% of the general population suffers from ARFID, including 14% to 22.5% of children in pediatric treatment programs for any type of eating disorder (Neuropsychiatric Disease and Treatment).

Diagnostic criteria for ARFID, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), include:

• The individual demonstrates a disturbed eating experience that is associated with one or more of the following:
  • Nutritional deficiency as a result of inadequate intake of food
  • Weight loss (adults) or failure to gain weight (children)
  • Decline in psychosocial function
  • Dependence on supplements to maintain nutritional health
• The disturbed eating is not due to an explainable external factor, such as food being unavailable or in short supply.
• The person does not have a distorted body image.
• The feeding disturbance or food restriction is not a result of some other physical or mental illness. For example, a person who loses weight because of the flu or food poisoning does not have an eating disorder, so a diagnosis of ARFID would not be relevant.

Unlike cases of anorexia and bulimia, ARFID does not typically involve poor body image, a drive to be thin or a displeasure with external appearance. However, inadequate nutrition and caloric intake, especially among children, can seriously delay growth or prevent normal weight gain.

ARFID frequently occurs with other conditions, such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorders (OCD).

Symptoms of ARFID

• Extreme pickiness in choosing food
• Anxiety when presented with “fear” foods
• For adults, weight loss; for children, failure to gain weight
• Dependence on nutritional supplements, a feeding tube or both

ARFID Warning Signs

• Avoidance of particular foods, based on texture, color, taste, smell, food groups, etc.
• Frequent vomiting or gagging after exposure to certain foods
• Difficulty chewing food
• Lack of appetite
• Trouble digesting specific types of foods
• Consumption of extremely small portions
• Dependence on external feeding tubes or nutritional supplements
• Social isolation

Risk Factors for ARFID

• Malnutrition
• Weight Loss
• Developmental delays
• Co-occurring anxiety disorders

Health Risks of ARFID

• Malnutrition
• Failure to gain weight (children)
• Gastrointestinal complications

ARFID Treatment

Because of ARFID’s unique nature – and prevalence among young people – an intensive and specialized treatment approach is needed in most cases.

Walden Behavioral Care offers personalized treatment for individuals and families affected by ARFID. Treatment includes special pediatric and adolescent programming, both involving family-based therapy, which has been proven to minimize disordered behavior, lead to a more balanced diet and improve long-term recovery rates.

Our ARFID-specific treatment includes:

• Cognitive Behavioral Therapy (CBT)
• Dialectical Behavior Therapy (DBT)
• Meal Coaching
• Food Exposure Therapy
• Family-Based Education
• Individual and Group Counseling
• Nutritional Counseling

A Full System of Care

Walden offers a full system of care, with treatment and programming at all levels, for all genders. No matter what your background or individual needs may be, and regardless of the complexity of your disorder, Walden will provide the personalized care and support you require, as close to home as possible.

Our continuum of care includes treatment at all levels:

• Inpatient Hospitalization
• Residential
• Partial Hospitalization
• Intensive Outpatient
• Outpatient

ARFID Treatment Insurance

Walden is proud to be “in network” with most insurance providers and managed care companies. This children, adolescents and adults with ARFID can have the flexible and cost-efficient access to treatment they need. Click here for a list of organizations with which Walden has contractual relationships.

Regain Your Life. Walden Can Help.

If you are concerned that you – or a loved one – may have an eating disorder, we are here to help. Please call 888-791-0004 to speak with a Walden eating disorders intake specialist, or complete the form on the right, to start on the road to recovery.

Getting Started: Intake Assessment

Help for ARFID is always a quick and confidential phone call away.

We will conduct a brief (10 to 15 minute) intake assessment by telephone, during which we will review your concerns and gather basic information about your background, medical history and insurance coverage. Based on the assessment, we will determine whether a more detailed, in-person clinical evaluation is required at the Walden location closest to you.

The evaluation will be conducted by a member of Walden’s clinical staff and will include a psychiatric assessment, an in-depth review of clinical information and a recommendation for the proper level of care. Primary care referrals are not required and we will work with your insurance provider or providers for approval of ARFID treatment.

The entire assessment is confidential, and we will make it as easy and comfortable for you as possible.