How to Recognize & Treat ARFID Eating Disorder

Food and nutrition are two vitally important aspects of our overall health. Yet, despite the wealth of medical evidence available to support this statement, a considerable 46 percent of Americans have a poor quality diet.

There’s a range of reasons for this, including a pervasive fast food culture, a lack of access to healthy food options in low-income communities, and a school system that doesn’t prioritize nutritional education. 

And then there’s the spectrum of eating disorders that prevent people from maintaining a healthy relationship with food, exercise, and their own self-image. It’s estimated that 30 million Americans are living with an eating disorder—making it a major hurdle in the battle for better nutritional health in the United States.

Avoidant restrictive food intake disorder (ARFID) is one such condition, and it’s one many people aren’t familiar with. This is due (in large part) to the fact ARFID wasn’t recognized by the American Psychiatric Association until 2013, which makes it a new diagnosis compared to conditions like anorexia nervosa or bulimia nervosa.

Today, we’ll be detailing what it means to have an ARFID eating disorder, what signs and symptoms are associated with the condition, and the treatment options available to those who may be struggling. Let’s get started!

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What is ARFID Eating Disorder?

Avoidant restrictive food intake disorder (also referred to as restrictive food intake disorder) is a medically diagnosable mental illness that causes a person to intensely and fervently avoid specific foods, either due to environmental influence (witnessing a parent avoid specific foods), obsessive compulsive thought patterns (not being able to eat foods that are a specific color), anxiety (not eating dairy products out of fear of contamination) or a genetic predisposition.

Signs of Avoidant Restrictive Food Intake Disorder

1. Extreme Pickiness

The primary symptom of ARFID disorder is intensely selective eating habits. An individual who’s been diagnosed with the disorder might only eat a handful of food items and refuse to venture outside these approved staples. They may also be quite strict about how they eat. Having hot and cold foods touch one another, for instance, could send the person into a state of distress. This high level of meticulousness often makes it difficult for people with ARFID eating disorder to dine out at restaurants or maintain a consistent meal schedule.

2. Deficiencies in Nutrition

Due to the nature of food aversion disorders, many people living with them are unable to maintain a healthy, balanced diet, even if they know it’s in their best interests to do so. This puts them at a high risk for malnutrition. Signs of malnourishment include feeling weak, experiencing difficulty concentrating, hair loss, frequently getting sick, and increased sensitivity to cold temperatures.

If at all possible, it’s a good idea for individuals who have been diagnosed with ARFID to take a daily multivitamin as discussed with their healthcare provider.

3. Emotional Distress

Pushing someone with a restrictive eating disorder to eat foods they aren’t comfortable eating can cause them to feel anxious, irritated, distressed, or even angry. It’s important to understand their condition is beyond their control and requires medical treatment and intervention. Simply telling them to eat specific foods, or trying to force them to eat, won’t fix the issue. Try encouraging the person to speak to a healthcare provider, registered dietitian nutritionist, or mental health professional instead. 

4. Gastrointestinal Issues

Poor nutrition caused by an ARFID eating disorder often leads to stomach and intestinal health problems like constipation, bloating, nausea, abdominal or stomach pain, and indigestion. While many of these problems are treatable with over-the-counter medications, they can worsen over time and eventually require medical attention.

5. Stunted Weight Gain or Height Growth

Malnutrition often causes developmental delays, including stunted growth and cognitive impairments. In severe cases of ARFID, especially those that begin in childhood, it’s not uncommon for patients to fall short of standard growth curves, or to appear younger than their same-aged peers. These developmental delays can result in irreversible deficiencies or health problems, which is why seeking medical attention as soon as possible is always of utmost importance.

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ARFID Diagnosis and What to Expect

We’ve answered the question “What is ARFID?” and discussed the symptoms associated with the disorder, but what are the next steps? What should you do if you suspect you or someone you love may be living with an ARFID eating disorder?

The first step is getting an official diagnosis. Without one, you won’t be able to access the specialized treatments required to effectively manage your symptoms.

Here’s what to expect if you’re determining whether you or a loved one receive an ARFID diagnosis:

1. Find a Healthcare Professional You Trust

A physician is the only person capable of diagnosing an eating disorder. However, many general practitioners will refer patients to a specialist for these types of concerns. Registered dietitians, psychiatrists, psychologists, and pediatricians are a few examples of specialists who can assess and support eating disorder recovery.

If you already have a connection with one of these professionals, reaching out and expressing your concerns is the best first step. If you don’t, you can ask your family physician for a referral or visit a walk-in clinic and ask to be connected with one.

2. Ask for an Assessment

You’re going to need a DSM-5 Eating Disorder Assessment in order to receive a medical diagnosis. To receive one, let your specialist know the signs or symptoms you’ve been experiencing, and inquire about receiving an assessment. 

It’s important to note that you may have to pay out of pocket for an assessment if you do not have health insurance. 

3. Request Blood Testing

Blood tests are another necessary step for diagnosing eating disorders. For ARFID in particular, blood tests can detect signs of malnutrition, which will let your healthcare professional know how severe the condition is and help them determine the level of treatment required.

A few tests we recommend when seeking an ARFID eating disorder diagnosis include:

• Thyroid stimulating hormone (TSH)
• Glucose 
• Creatinine
• Potassium
• Magnesium
• Iron
• Zinc
• Folate
• Total cholesterol
• Vitamin B12

4. Get Results in Writing

Always ask for a copy of all test or screening results when seeking an eating disorder diagnosis. This allows you to seek a second opinion if you have any concerns and also ensures you have a complete record of your medical history should you need it in the future.

Remember, you have a right to access any and all documents related to your health. 

5. Put Together an Action Plan

Once you receive an official diagnosis, the real work begins. You’ll need to work collaboratively with a team of medical professionals to achieve your greater health and wellness goals. 

This team will likely consist of a family physician, registered nutritionist, psychologist, and more. Don’t forget—the more specialized experts you have assessing your progress and contributing to your treatment plan, the more likely it is you’ll succeed in maintaining long-term health.

ARFID Eating Disorder Treatments

There are several different treatment options available to those who’ve been diagnosed with a food aversion disorder. A few of the most common include:

1. Nutritional Rehabilitation

Nutritional rehabilitation, or the practice of restoring a person’s nutritional health via a personalized treatment plan for improving eating behaviors, is an essential component of treating eating disorders. A registered dietitian nutritionist works with the patient to normalize their food consumption and ensure a healthy and safe recovery process.

2. Cognitive-Behavioral Therapy

This evidence-based form of talk therapy centered around the belief that our thoughts shape our experiences, circumstances, and environment. When treating an eating disorder, cognitive-behavioral therapy (CBT) is used to help the patient shift how they think about food and address the mental thought patterns that contribute to (and exacerbate) their unhealthy food-related behaviors.

3. Prescribed Medications

There are a number of medications that can be used to treat a restrictive eating disorder. If your disordered eating is related to obsessive compulsive thoughts, for instance, your healthcare provider may prescribe a selective serotonin reuptake inhibitor (SSRI) medication. There are also low-dose antipsychotic medications that have been proven to alleviate many of the symptoms associated with ARFID.

Treatment plans vary from person to person. Your team of medical professionals will assess your unique symptoms and health history before compiling a personalized treatment plan, which may include some or all of the treatments listed above.

While discussing your treatment plan, be sure to ask questions about your options and express your personal wellness goals with your team. You should never feel excluded when it comes to your health. Eating disorders are serious medical conditions and they require vulnerability on the patient’s end to be treated effectively. The right provider will respect that at all times.

Being well-versed in the ARFID meaning and symptoms can help you identify early signs and begin the treatment process.

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Access Nutrition Care With Nourish

At Nourish, we believe in a holistic approach to health. We are the first national telehealth network of nutritionists who accept insurance, and we want to connect you with an experienced registered dietitian who can support you through eating disorder nutrition therapy.

There are many nutrition experts who specialize in eating disorder treatment within our growing network. They have the hands-on training, advanced therapy techniques, and foundational knowledge required to guide you through your recovery journey.

And the best part? All of our registered dietitians accept insurance. That’s why 94% of Nourish patients pay $0 out of pocket!

If you’re covered by Medicare, Blue Cross Blue Shield, United Healthcare, Aetna, or Humana, we can work directly with your insurance provider, allowing you to focus on what matters most — your health.

Find a dietitian near you through Nourish to get started.