Avoidant Restrictive Food Intake Disorder (ARFID) Cookbook, Introduction

What is ARFID, and what is the experience of someone who has or is suffering from ARFID?

Future articles will discuss interventions, and then a series of recipes intended to help those with ARFID expand their eating and consequently health and social functioning.

ARFID stands for Avoidant Restrictive Food Intake Disorder. This is often lumped in with Eating Disorders like Anorexia Nervosa or Bulimia Nervosa, but it is categorically distinct and considered a Feeding Disorder. Fundamentally, there is not a fear of body-fat, gaining weight or body image issues as in Eating Disorders, but a fear of consequences of eating such as choking or becoming sick.

People with ARFID may appear to just be "very picky eaters." Their friends and family may refer to them that way, and frequently they think of themselves this way too. There might be shame and self-consciousness about eating, and difficulty to move on from foods they and others may judge as "childlike," such as chicken tenders or noodles with butter. There can be mild to severe health problems due to lack of moderation and diversity in food choices, and frequently people recovering or in remission from ARFID report significant improvements in physical and mental health, even if they didn't realize these problems were present before changing eating habits.

The three common factors that underlie and maintain ARFID include:

• Fear of consequences, such as someone who has personally or witnessed choking, allergic reactions or vomiting related to eating. Avoiding eating or eating certain foods is to avoid these consequences.

• Lack of hunger cues or rarely feeling hungry, so eating becomes a chore or something that must be scheduled into the day. These individuals may become full quickly. This can in-part be learning about hunger sensations as well as physical in origin such as a small stomach due to a history of low-intake.

• Super-sensors or otherwise heightened sensitivity to or awareness of sensory aspects of food. This could be tastes, smells or textures.

People with ARFID frequently want to change their eating behaviors and are proud of progress they make in therapy. ARFID tends to be quite treatable, and the skills for treatment are usually easily attainable to people suffering from AFRID. Individuals in treatment can pace themselves. See the next article for treatment information.