What is Avoidant /Restrictive Food Intake Disorder ARFID?
Some individuals notice that their eating preferences and experiences are different to others. They may find foods they can eat are limited based on their appearance, smell, taste, temperature, texture, brand, presentation, or having had a past negative experience (eg choking, vomiting, significant abdominal pain) with particular food. This can cause individuals to avoid certain foods / textures due to feelings of fear and anxiety around the consequences of eating, perhaps only eating ‘safe foods’. For some individuals they may not recognise sensations of hunger or they may generally have a poor appetite and may restrict their intake because of a low interest in eating. ARFID was previously known as selective eating disorder (SED), it is a type of eating disorder, which can have an adverse affect on health, but the good news is that people respond well to treatment.
We offer diagnosis and treatment options
Our professionals have specialist training and clinical supervision to support them with working
with ARIFD. The team are experienced in working with ARFID in NHS and private settings. They have
as delivered national teaching, and supported the developing services in this area.
It is important if you think you might have this ARFID, that you seek expert help and advice.
Possible Symptoms / signs of ARFID
- Eating a reasonable range of foods but overall having much less food than is needed to stay healthy.
- Finding it difficult to recognise when hungry.
- Feeling full after only a few mouthfuls and struggling to eat more.
- Taking a long time over mealtimes/finding eating a ‘chore’.
- Missing meals completely, especially when busy with something else.
- Sensitivity to aspects of some foods, such as the texture, smell, or temperature.
- Appearing to be a “picky eater”.
- Always having the same meals.
- Always eating something different to everyone else.
- Only eating food of a similar colour (e.g. beige).
- Attempting to avoid social events where food would be present.
- Being very anxious at mealtimes, chewing food very carefully, taking small sips and bites, etc.
- Weight loss (or in children, not gaining weight as expected).
- Developing nutritional deficiencies, such as anaemia through not having enough iron in the diet.
- Needing to take supplements to make sure nutritional and energy needs are met. (Source BEAT 2019)
What causes ARFID?
ARFID is different from other eating disorders as beliefs about weight and shape do not contribute to the avoidance or restriction of food intake.There is no single cause for ARFID and the latest research indicates that it develops as a result of genetic, psychological and sociocultural factors.
What is the Treatment?
At insighteating we tailor the treatment of ARFID to the needs of the individual, based on the specific difficulties that the individual is experiencing and is maintaining these. It is likely to involve evidence-based treatments such as family-based treatment (for young people), cognitive behavioural therapy, behavioural interventions We might also want to monitor your physical health with the help of your GP.
A diagnostic assessment
- This is carried out by a specialist clinical psychologist and an advanced practice dietitian. The
cost includes a written with a report and recommendations for treatment. The assessment is
carried out over two sessions via online. (Parents can attend without a child if appropriate.)
We will then share our findings with you and check you are happy with the report. We can
consult with private/NHS psychiatry and occupational therapy as needed.
- Some families find it helpful to have the formal diagnosis that they can share with other
professionals and schools to support reasonable adjustments.
Dietetic and psychology treatments
- psychological treatment for feeding difficulties
- dietetic treatment for feeding difficulties
- support with reasonable adjustment plans
Treatment is highly individualised but often include elements of the following:
- Education and a shared understanding of the difficulties and targets for treatment.
- Dietary analysis and targeted interventions to ensure diet is safe and growth or weight are
not adversely affected.
- Behavioural analysis
- Anxiety management
- Cognitive strategies
- CBT -AR
- Food chaining and exposure work as appropriate
- Sensory strategies
- Habit acquisition training
- Trauma work/EMDR