Avoidant restrictive food intake disorder (ARFID) is a type of eating disorder characterised by avoiding certain foods or food groups. Those with ARFID may also be very picky about the amount of food they consume. ARFID is similar to anorexia in that they both involve the restriction of types and/or amounts of food consumed, but a significant difference is that ARFID doesn’t involve any distress about body shape, size, or fatness. The DSM-5, a guide for clinicians to diagnose mental health conditions, recently acknowledged ARFID as a recognised disorder.
To be diagnosed with ARFID based on the DSM-5, the following criteria must be met:
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 a 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.
However, even if one does not meet all of the DSM-5 criteria, they may still have a serious mental disorder. Furthermore, it may be difficult to spot symptoms in others as they may hide them. So here are some warning signs that one might have ARFID:
Noticeable fluctuations in weight
Limited range of food choices that gets narrower over time
Constipation, abdominal pain, and/or cold intolerance
Only eating foods with certain colors or textures
In ARFID, the body is denied essential nutrients so the body may be forced to slow down its functions. This can lead to serious physical and psychological consequences. It can take time, but one can fully recover from ARFID. The process would be different for every patient, so it is important to get the help of health professionals for treatment. Also, it is crucial to understand that eating disorders can look different from patient to patient, so treatment must be modified for each person. Understanding the underlying reasons for restricting behavior also plays a key role in treatment.
If you think that you or someone you know may have ARFID, don’t be afraid to ask for help. The day you take action is the day your recovery journey starts.
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