Avoidant/Restrictive Food Intake Disorder (AFRID): What is it, Signs, Symptoms, & Treatment

Avoidant Restrictive Food Intake Disorder, also known as ARFID, in one of less commonly known eating disorders. While it has a lower prevalence in the general population as Anorexia Nervosa or Bulimia Nervosa, it has a greater prevalence within specific communities and children. ARFID is more than just picky eating (though the beginnings of ARFID can be classified in this way), it’s categorized by diagnostic criteria in the DSM5 and can pose serious health risks to those who experience ARFID symptomatology.  

How is ARFID Diagnosed? 

The Diagnostic & Statistical Manual of Mental Disorders (DSM) was created by 160 mental healthcare professionals around the world. Many people around the world struggle with eating disorders, the DSM categorizes food intake disorder with the following criteria.

ARFID Diagnosis Standards

• An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:
  • Significant weight loss (or failure to achieve expected weight gain or faltering growth in children). 
  • Significant nutritional deficiency. 
  • Dependence on enteral feeding or oral nutritional supplements. 
  • Marked interference with psychosocial functioning. 
• The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice. The eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced. 
• The eating disturbance is not attributable to a concurrent medical condition or not better explained by another mental disorder. When the eating disturbance occurs in the context of another condition or disorder, the severity of the eating disturbance exceeds that routinely associated with the condition or disorder and warrants additional clinical attention. 

As stated through DSM criteria, what makes ARFID markedly different from other eating disorders is that it does not involve worry or distress over body image, weight, or weight gain. This distinguishing factor guides treatment efforts in a different way, but unfortunately does not diminish the health concerns that are prevalent in both. 

Signs & Symptoms of ARFID  

Signs of ARFID

Behavioral signs that may be associated with ARFID include sudden weight loss, restriction around the types of food eaten, issues and concerns with food textures, fears of choking and/or vomiting, or an overall lack of interest in food.  

Symptoms of ARFID

Physical symptoms of ARFID mirror physical symptoms of anorexia, as both disorders restrict adequate nutrition. These include muscle weakness, dizziness, feeling cold, poor immune functions, struggles with concentration, fainting, stomach cramps, and more.  

Risk Factors 

There are several co-occurring and comorbid factors that work to inform the prevalence of ARFID. The risk factors that play into this disorder are unique for each person and involve multiple layers of identity, such as psychological and sociocultural influences.

Some risk factors include

• Autism Spectrum Disorder (ASD) 
• Attention Deficit Hyperactivity Disorder 
• Intellectual Disabilities 
• Children who don’t outgrow picky eating 
• Anxiety Disorders 

It’s also important to note that a primary health concern is that ARFID denies the body essential nutrients needed to function successfully. This is why there is such a high medical concern for those who suffer. Pay attention to health conditions that may present in children, adolescents and adults as a result of malnutrition; this may be a warning sign of ARFID.  

How to Seek Treatment  

As with all eating disorders, ARFID is not without the hope of recovery. There are specialists in the field who can both assess and diagnose ARFID, and guide you towards a tailored treatment plan to start to address underlying causes and conditions of this disorder.  

An interdisciplinary team in the best approach to treating ARFID which would include a psychotherapist, a medical doctor and a dietician who specialize in eating disorders. There may be medications introduced to increase appetite or address anxiety. The goal of treatment is to restore physical health by achieving a healthy weight and a new, structured approach to eating, while also exposing and increasing the number of foods consumed.  

The level of care necessary for ARFID recovery will be determined by your treatment team. Depending on the level of medical need, it can range from treating the disorder at home to attending a hospital-based program.  

Overcoming this condition is not without its challenges, but the road to healing is worth it. Many children and adults who are able to explore ARFID patterns with a treatment team and therapist will learn new, healthy ways of coping even beyond their relationship with food. Worry will decrease, fear will dissipate, and a new story can be built around how food can exist in our lives in a new, fulfilling way.

If you’re struggling with an eating disorder, take that first step toward getting help today. Our team at Victory Bay will provide you with the care you need to heal. With our compassionate approach, evidence-based treatments, and experienced staff, we are committed to providing the best experience possible for you to recover from your eating disorder. Call 855.738.6530 to begin today.

Published on 6/8/2023 | Written by Victory Bay