WHAT IS ARFID? A Guide to Avoidant/Restrictive Food Intake Disorder

As Avoidant/Restrictive Food Intake Disorder (ARFID) is still an emerging area to study within the eating disorder community, the individuals who live with ARFID have been, and will continue to, experience the impact of their voices being negated. Historically, ARFID has been treated by forcing exposures, and as some individuals may benefit or prefer this, it is harmful to others. More research is needed to better understand the varying types of ARFID, as they all need to be treated according to the person and not historical beliefs. 

Types of ARFID:

1. Avoidant individuals refuse food based on negative or fear-based experiences such as choking, nausea, vomiting, pain, or swallowing.
2. Aversive individuals accept only limited foods based on sensory features. They may have a sensory processing disorder.
3. Restrictive individuals are those who do not eat enough and show little interest in eating. They may be picky, distractible and forgetful, and wish they would eat more.
4. Mixed type includes features of more than one of avoidant, aversive, and restrictive types. The individual usually presents with features of one category first but then acquires additional features from another type.
5. ARFID “Plus” individuals present with one of the ARFID types initially, but then start to develop characteristics of anorexia nervosa such as weight and shape concern, negative body image, or avoidance of more calorically dense foods.

While more research needs to be done, we also need to better understand the underlying aspects associated with ARFID in order to hear the voices of those impacted. 

At Empower Your Mind Therapy, our therapists are trained to ask the following questions:

1. Do you experience hunger/fullness cues? (interoception)
2. What is your experience of clothing when you eat? (sensory profile)
3. Where do you feel safe eating? (environment)
4. What are your safe foods and no no foods? (food hierarchy/sensory profile)
5. What happens after you eat? (interoception)
6. Bladder and bowel habits (gastroparesis, challenges swallowing, GI issues)
7. Experience of body/aversion to weight gain (interoception and proprioception)

Overall, there is a significant gap in understanding ARFID as it is extremely individually-focused and can sometimes be treated with more general eating disorder treatment – which can be severely traumatizing. The overlap of neurodivergence with ARFID also adds a layer of trauma for individuals with ARFID due to the treatment of clients in ED recovery settings (which tends to be more rigid). As clinicians, we aim to work with each specific client to hear their needs and work together to problem solve how to build a life worth living. If you or a loved one is experiencing symptoms of ARFID, you can find more information about treatments for eating disorders on the Empower Your Mind Therapy website here.