Avoidant Restrictive Food Intake Disorder (ARFID) is gaining more and more recognition. In simple terms, ARFID is “extreme picky eating.” However, the diagnosis goes deeper than that. This blog will take a deep dive into various ARFID symptoms. As well as ARFID treatment protocols. We will discuss why you should work with a dietitian. Additionally, steps you can take at home as a support person.
People who experience ARFID can have very different symptoms. ARFID symptoms include struggles with textures, tastes and different temperatures of food. Individuals with ARFID have strong aversions to foods. Some are extremely “brand loyal.” For example, a client with ARFID may only choose to eat Skippy peanut butter. And do not eat Jiffy. Even if Jiffy is the only brand available, they will not eat it. Therefore, many clients experience malnutrition. This is because it’s difficult to fuel enough throughout the day with limited intake.
According to the DSM-5, diagnostic criteria for ARFID includes:
- An eating or feeding disturbance. For instance, having a lack of interest in eating or food. Or avoiding food becuase of what it it looks like or smells like. This leads to consistent 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.
- Impaired sychosocial 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. 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 caused by another 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 increased and warrants additional clinical attention.
How can you recognize ARFID symptoms in loved ones?
- Your loved one consumes a limited food variety.
- Your loved one sometimes gags when eating certain foods.
- Mealtime is stressful because of foods that are presented at the table.
- Eating out at a restaurant can be overwhelming.
- Your loved one may go long periods of time without eating. Especially if they don’t have food they deem acceptable to eat.
- Your loved one might find it difficult to recognize when they are hungry.
- Certain tastes, textures, smells, or temperatures are reasons why your loved one doesn’t eat certain food.
- Your loved one may only eat a particular brand of a food. But not other brands. For example, they might eat Kraft Mac & Cheese. But not Amy’s.
- Food is not a priority for your loved one.
What are treatment options for ARFID? What is “ARFID nutrition?”
Although ARFID is becoming more widely recognized, it can still be difficult to find ARFID treatment options. Courage to Nourish is a nutrition practice located in Maryland, Virginia, DC, Pennsylvania and Colorado. We offer ARFID individual nutrition treatment.
Below are some ways you or a loved one can improve their relationship with food. And heal from ARFID.
Creating a list of “preferred,” “sometimes” and “non preferred” foods.
Part of ARFID treatment is working with a registered dietitian. During sessions, you will discuss preferred foods, sometimes foods, and non-preferred foods. Preferred foods are foods that you or a loved one can eat relatively freely without much concern. Sometimes foods are foods that you sometimes eat depending on the circumstance. Non-preferred foods are foods that you or your loved one does not eat and does not enjoy. From this list, you might discuss ways to slowly incorporate new foods into the diet.
A dietitian can support you in navigating ARFID nutrition. Please contact us for more information.
Food exposures in session.
Food exposures in session with an ARFID dietitian can be extremely helpful. A registered dietitian can create a supportive and safe environment to try new foods. When introducing non-preferred food or sometimes foods, anxiety and stress can happen. The dietitian can help walk you through these emotions. From here, a deeper discussion about the food can occur. During these sessions, the goal isn’t to eat all of the food. Instead, the goal is to simply be exposed to having a different food on the plate. Sometimes that means just touching the food. Or smelling the food. Or perhaps putting it on your tongue.
Doing food exposures at home.
In addition to session food exposures, some clients may find it helpful to do food exposures at home. They may do these exposures with a trusted loved one. Although the dietetian is not present, the goal is the same. We simply want to have the new food presented to the client. Without any pressure to complete or try the food.
Touching and smelling new foods.
As previously mentioned, sometimes the goal is just touching and smelling new foods. Clients who have ARFID can be extremely activated and triggered when there is an overwhelming sensation from the food. Therefore, it’s important to take it slow. We acknowledge progress with just touching, smelling and experimenting with the food.
Loved ones respecting boundaries.
If your loved one has ARFID, it’s extremely important to respect boundaries of what they are telling you to do. Excessive praise or discipline related to trying foods can actually cause more harm than good. We want to allow space and time for your loved one to experiment with a new food. At their own pace. Praise comes from a place of love and support, so it is completely understandable why you would want to give it. However, this can actually upset a person with ARFID. Ask your ARFID dietitian how you can support your loved one on this journey.
Part of ARFID treatment is assuring that an individual is eating appropriately. Lack of food can cause an increase in anxiety and thoughts about food. Along with other emotions. Such as frustration or anger. Therefore, when trying to challenge the new foods, adequate food and take is extremely important. A dietitian who specializes in ARFID can help with this.
How can a dietitian support ARFID treatment?
A dietitian has a crucial role in supporting an individual in healing from ARFID. The registered dietitian can support you or a loved one in various ways. Assuring adequate nutrient intake. Creating a plan for food exposures. Providing support for family members. Sampling foods from restaurants together are just a few. Courage to Nourish is a practice that specializes in ARFID nutrition treatment. Our dietitians would love to work with you or a loved one today. Please visit our ARFID nutrition page. Read more about our services. We can help! We would love to set up a 15 minute discovery call and answer any questions you may have about working with us. Visit our contact us page to send us an email. Also, sign up for our client or clinician newsletter!
Helping my clients cultivate meaningful connections and interests outside of their eating disorder is a true passion of mine. I like to think my clients and I are on a team to navigate recovery. I love working with high school and college students as well as athletes seeking to have a better relationship with exercise. I am a proud anti-diet dietitian and work with my clients through a Health At Every Size © and intuitive eating framework.