What is the best ARFID Treatment? Avoidant Restrictive Food Intake Disorder

Key Points

• ARFID, or Avoidant Restrictive Food Intake Disorder, is an eating disorder where a person restricts the types of foods they eat.
• The eating disorder is driven by intense fear, aversion, or a lack of interest in certain foods and the act of eating.
• Anyone of any age, sex, or background can have ARFID, including infants.
• Effective ARFID treatment involves a team of specialists, including a Registered Dietitian (RD).

Avoidant Restrictive Food Intake Disorder, or ARFID, may look like picky eating, but it's much more. It's an eating disorder where someone severely limits their food choices. This condition often stems from intense fear, sensory sensitivities, or a complete lack of interest in eating. It leads to severe food restrictions and health challenges.

Living with ARFID can make it hard to envision a life free from the fear of eating. However, it is possible to recover from this life-limiting eating disorder. Learning more and reaching out for help is the first step to breaking free from ARFID.

What is ARFID (Avoidant Restrictive Food Intake Disorder)?

Like many eating disorders, ARFID is primarily a mental disorder. ARFID is defined by extreme food restriction that stems from an intense fear of choking, vomiting, or digestive issues like diarrhea or constipation. Unlike other restrictive eating disorders, the disordered eating is not related to wanting to be thin or having a negative body image.

Sensory preferences are another reason behind food restriction. The look, taste, smell, or texture of certain foods can make eating them impossible. Some also report no interest in food at all and feel overwhelmed by the entire process of eating.

Registered Dietitian Rita Faycurry RD says, "ARFID is still not well understood, as it was only formally recognized in 2013. Research shows a connection between ARFID and neurodivergent conditions like autism spectrum disorder and attention deficit hyperactivity disorder (ADHD). Common co-occurring conditions also include anxiety, depression, obsessive-compulsive disorder (OCD), and various mood disorders."

Who is most at risk of having ARFID?

ARFID can occur in childhood, adolescence, and adulthood in people of any age, gender, cultural background, or sexual orientation. Recent research shows that genetics may significantly influence who develops ARFID and who does not. One study also suggests that ARFID may be more common in males than in females. But there's still a lot we don't know.

Understanding this connection could be a step toward better treatments.

How is ARFID diagnosed?

ARFID is diagnosed based on specific criteria outlined in the DSM-5, the standard manual for mental disorders.

ARFID symptoms include significant weight loss, failure to meet growth or weight expectations, or nutritional deficiencies caused by severely restricted eating. Some individuals may rely on supplements or feeding tubes to meet their nutritional needs. Eating habits that interfere with daily life, like avoiding social situations involving food or experiencing extreme distress during meals, are also key indicators.

Faycurry, RD, notes, "If mental health professionals don’t focus on the fear tied to eating, ARFID can be overlooked or mistaken for other eating disorders like anorexia."

A proper diagnosis starts with ruling out other causes, like medical conditions, cultural factors, or alternative eating disorders. A healthcare provider or licensed mental health professional will assess medical history, eating patterns, and emotional health to determine if ARFID is the right diagnosis.

How does it feel to live with ARFID?

A common misconception is that people with ARFID are just being fussy or attention-seeking. Nothing could be further from the truth.

Having ARFID means fighting a mental battle with the voice of the eating disorder all day. This internal dictator warns, threatens, and manipulates to control food intake. It constantly seeks ways to avoid most foods and creates elaborate schemes to overcome barriers such as the social pressure to eat during meals.

The reality is that people with ARFID want to eat and be healthy. They long for a life free from constant thoughts about food, where meals aren’t a source of stress, and they can enjoy a sense of normalcy.

ARFID treatment isn’t perfect, but it offers real hope for better health and improved quality of life.

What does ARFID treatment look like?

If you or someone you care about is dealing with ARFID, it’s important to know that treatment is available and tailored to meet individual needs.

Overview

ARFID treatment takes a multidisciplinary approach that combines:

• Medical care
• Nutrition support from dietitians
• Psychotherapy
• Medications to address medical complications from ARFID, stimulate appetite, or lower anxiety.

Note: there are no medications to treat ARFID directly.

Goals of ARFID treatment

Specialists like doctors, dietitians, and therapists work together to help with both the physical and emotional challenges of ARFID.

The overall goal is to make eating feel less overwhelming.

This means treating nutritional deficiencies, restoring weight, and addressing fears or discomfort around food. Therapies like CBT-AR (Cognitive Behavioral Therapy for ARFID) and Family-Based Therapy (FBT) are key parts of the process. They help reintroduce foods, ease anxiety, and give families tools to support recovery.

In severe cases, hospitalization may be needed to stabilize health and provide extra support. This team approach helps many people regain their health and enjoy a higher quality of life.

Tests and examinations

ARFID affects each person differently, so there’s no one-size-fits-all approach to treatment.

The process begins with a thorough evaluation. A medical professional will ask about feelings toward food, eating history, and any traumatic events that may have triggered the disorder, such as choking, vomiting, or public embarrassment from diarrhea. Past medical procedures could also play a role.

A psychiatrist will assess for co-existing conditions like anxiety, autism spectrum disorder, ADHD, OCD, or others. They’ll also check for signs of laxative misuse or a focus on body image. Sharing information about menstrual history and any family history of eating disorders is equally important.

A physical exam, including heart rate, blood pressure, height, weight, and temperature, helps detect signs of malnutrition, like lanugo (fine body hair). Lab tests, such as a complete blood count, metabolic panel, and urinalysis, provide further insights to guide a personalized treatment plan.

A Registered Dietitian (RD) plays an integral role during ARFID treatment. They collaborate with the treatment team to help someone with ARFID reduce their anxiety around eating. They evaluate nutritional deficiencies and create personalized nutrition plans to correct and prevent them.

According to Faycurry, RD, "Dietitians experienced in eating disorders can help gradually expand the list of 'safe' foods. In the long term, an ARFID nutritionist or dietitian can be a great accountability partner to stay on track with recovery and maintain a healthy weight."

Why is ARFID treatment challenging?

There are a few reasons why it can be hard to treat ARFID, including:

• ARFID is a more recent addition to the official list of eating disorders. So, a lot remains unknown.
• ARFID often co-exists with other physical and mental health conditions, which complicates diagnosis and treatment.
• A person's genes contribute 80% of the risk of developing ARFID. This makes it extremely difficult to create standardized treatment plans.
• Not much is known about how to treat ARFID in adults.
• If ARFID begins in infancy or early childhood, it can be hard to learn about environmental factors that contribute to the eating disorder because of the child's communication and cognitive skills.

Can you recover from ARFID?

ARFID is progressive; the condition will continue to worsen without treatment. It's important to get help as soon as you can. Despite the difficulties in treating ARFID, long-term recovery is possible.

Get help for ARFID now. Find ARFID treatment near you.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.