What is ARFID?
Have you ever heard of ARFID? It might sound complicated or confusing, but it is a newly defined eating disorder that has actually always existed. It has just only been recently defined.
ARFID is an important condition to understand, especially for professionals working in paediatrics and mental health. ARFID stands for Avoidant/Restrictive Food Intake Disorder. Traditionally ARFID was seen as ‘extreme fussy eating’ but in fact it is an eating disorder because of the mental barrier to eating that is driven by significant Anxiety. This disorder can have a significant impact on one’s mental health, self-care, and overall wellbeing. It is also commonly associated with Autism and Neuro-divergence.
ARFID Diagnostic Criteria
In healthcare we use what’s called the DSM (Diagnostic and Statistical Manual of Mental Disorders) to diagnose eating disorders. The latest version the DSM-5 came out in 2013 and that is when ARFID was first named. ARFID can affect anyone, children, adults and all genders alike.
In the DSM-5 ARFID is defined as:
In the absence of another discrete mental disorder or medical condition, An eating or feeding disturbance which can include:
- Lack of interest in food
- Refusal or inability to eat foods based on smell, taste, texture, or appearance.
- Concern about aversive consequences of eating, this can often come as a result of a choking experience, allergic reaction or Emetophobia (fear of vomiting)
Plus one or more of the following:
- Failure to meet nutritional needs resulting in significant weight loss or faltering growth in children.
- Significant micro-nutrient deficiencies.
- Requirement for oral nutrition supplements (liquid diet) or tube feeding.
- Marked interference with psychosocial functioning- e.g.- stress around the family dinner table, or avoidance of social activities involving food.
ARFID cannot be due to lack of food or a culturally sanctioned practice. (e.g., religious fasting or religious/ cultural dietary regulations). ARFID is also exclusive from anorexia nervosa or bulimia nervosa, in that there is no distorted body image. (This can be a tricky one as I have seen young people with ARFID who feel a level of dissatisfaction with their bodies. The important defining factor is that this is not the driving factor in the dietary restriction).
Identifying ARFID involves recognising specific patterns of behaviour related to food and eating. If you find yourself avoiding certain foods or food groups due to sensory issues, concerns about negative consequences, or a lack of interest in eating, you might be experiencing ARFID. Other signs could include difficulty with certain textures, limited variety in your diet, and anxiety around mealtimes. Remember, you’re not alone in this, and seeking help is a positive step towards healing.
What to do if you think you have ARFID
Realizing you might have ARFID can be a turning point on your journey to healing. First and foremost, be kind to yourself and acknowledge that seeking help is a sign of strength. At the time of writing, the NHS is very limited in what it can offer to people with ARFID. Only those who are most physically unwell because of this condition can access help, and even then, it may include travelling very far or seeing professionals who are not well equipped or qualified.
ARFID Awareness UK is the main UK charity that offers educational resources and peer support groups. This is a good place to go to find out more information and connect with people who are also affected.
Consulting a registered dietitian who specialises in eating disorder recovery can provide you with essential guidance to improve your diet and health. They can help you understand your relationship with food, address your concerns, and provide tailored nutrition advice that supports both your physical and mental health.
How I support my clients with ARFID
As a registered dietitian with a focus on eating disorder recovery and mental health, I’ve had the privilege of assisting numerous clients on their path to recovery from ARFID. Navigating this journey requires a holistic approach that goes beyond just the food on your plate. Together, we explore the emotional aspects tied to eating, body image, and self-care.
When working with my clients, I emphasize the importance of nourishment—both physical and emotional. Healing from ARFID involves gently challenging the avoidance behaviours and gradually expanding food choices. It’s not about rushing the process but rather creating a safe and supportive environment for exploration. We work on building a positive relationship with food, understanding hunger and fullness cues, and incorporating self-care practices that foster mental wellbeing.
In Conclusion
- ARFID is a newly recognised eating disorder.
- It can impact anyone, from young children to the elderly and people of all genders.
- It is most common in young people who are neurodivergent.
- ARFID can be managed and seeking help from a specialist dietitian or a therapist is an important step towards embracing a healthier relationship with food.
- You’re not alone, and there is hope for a brighter and more peaceful future.
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Blog written by Sophie
Sophie is a Specialist Eating Disorder Dietitian passionate about delivering great quality care and advocating for her clients. She is naturally curious and driven for continued learning both within the profession and outside of it. Sophie founded Mental Health Dietitians in 2024 to be able to work in a way that is value-aligned and makes a difference to the individuals in her care. She currently supports ARFID clients 1-1 in her online clinic.
