What is ARFID?

Diagnostic criteria for ARFID, according to 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.

New research studies report that ARFID is as common as other more well known eating disorders (Sanchez-Cerezo et al., 2023; Katzman et al., 2021). ARFID has received less attention from the research community and we therefore know less about exactly why, how and who develops ARFID. The research studies that have been done find that, just like all other eating disorders, ARFID does not discriminate and affects both sexes, gender identities, body sizes, ethnicities and age groups. However, some groups may be more at risk for developing ARFID, including people that experience:

1. Sensory sensitivities: Sensory issues related to taste, texture, smell, or appearance of foods are common in individuals with ARFID. These sensitivities can make it challenging to consume a wide range of foods and may lead to avoidance of certain textures or flavors.
2. Early childhood eating difficulties: Many individuals with ARFID have a history of early childhood eating difficulties, such as picky eating or difficulty transitioning to solid foods. These patterns can persist into adolescence and adulthood, contributing to the development of ARFID.
3. Psychological factors: Individuals with anxiety disorders, obsessive-compulsive tendencies, or other mental health conditions may be at a higher risk of developing ARFID. These conditions can make trying new foods or eating in unfamiliar social settings extremely challenging.
4. Autism Spectrum Disorder (ASD) or Developmental Disorders: ARFID is more prevalent among individuals with developmental disorders, including autism spectrum disorder. Sensory sensitivities, rigidity in routines, and difficulty with social eating experiences can be contributing factors.
5. Negative food experiences: Traumatic experiences related to food, such as choking incidents, food poisoning, or adverse reactions to specific foods, can lead to a heightened fear or aversion to certain foods, increasing the risk of ARFID.

It's essential to recognize that these risk factors often interact, and not all individuals with these risk factors will develop ARFID. Additionally, ARFID can manifest differently from person to person, and its severity can vary widely.

No matter who you are, the sooner you get help for ARFID, the better.

Though ARFID is different from more well known eating disorders, it is still an eating disorder that can cause serious health risks if left untreated. Common health risks associated with ARFID include (Bialek-Dratwa et al., 2022):

• Malnutrition
• Weight loss
• Developmental delays
• Co-occurring anxiety disorders
• Failure to gain weight (children)
• Gastrointestinal complications

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

Monte Nido & Affiliates provides specialized ARFID treatment across all of our programs and levels of care. In addition, we offer a specialty ARFID IOP treatment for individuals and families affected by ARFID. Walden’s ARFID treatment program 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.

• 87% of clients improved in the EDEQ.
• 74% of clients reported improvement in ED symptoms (EDI2).
• 88% of clients reported improvement in their quality of life (EDQOL).
• 91% of ARFID residents reported improvements in depression.
• 79% of clients reported improvement in state anxiety and 72% in trait anxiety.
• 84% of ARFID residents with PTSD at time of admission reported improvement in their trauma symptoms.