ARFID in Adults

title of article and The Kitchen Patch logo on background of light green wall with flowering vines on the right side of the wall.

Disclaimer: this article is meant for educational purposes only. It is not a substitute for medical advice. If you suspect that you have ARFID, you should seek the advice of a medical professional. 

Trigger warning: eating disorders, trauma

Resources for the treatment of eating disorders:

What is ARFID?

ARFID is short for avoidant/restrictive food intake disorder. ARFID was added to the DSM-5 list of eating disorders in 2013 so research is still new and emerging. However, we know it has been around for much longer without an official definition. 

ARFID is most commonly diagnosed in childhood or adolescence but can be diagnosed at any age. The DSM-5 defines it as:

“An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:

  1. Significant weight loss (or failure to achieve expected weight gain or faltering growth in children)
  2. Significant nutritional deficiency.
  3. Dependence on enteral feeding or oral nutritional supplements.
  4. Marked interference with psychosocial functioning.”

ARFID is not related to a gastrointestinal issue or other medical condition and cannot be due to a mental disorder or lack of available food. 

There are 3 potential subtypes of ARFID. A person with ARFID may have one or more subtypes.

  1. Sensory (or avoidant): a person has sensory issues with trying new food. For example, slimy foods may not be acceptable or only crunch foods are eaten. 
  2. Aversive (fear of aversive consequences): a person may fear choking on food which limits their variety of foods to smooth textures and liquids. 
  3. Restrictive (lack of interest): more commonly seen in people with ADHD or autism, a person may forget to eat or have very little interest in eating. Hunger cues are often not strong or go unnoticed. 

ARFID in Adults

ARFID is often underdiagnosed in childhood or adolescence for many reasons, leading to a diagnosis in adulthood. For example, many children are labeled as picky eaters. ARFID may even develop in adulthood for various reasons such as trauma surrounding food. Those with a delayed diagnosis of autism or ADHD may also have underlying ARFID. 

Often, children or adolescents with ARFID have very little desire to work through treatment goals of ARFID. However, when they reach adulthood and become interested in participating more in food-related social settings, young adults can become more interested in increasing their variety of foods.

ARFID Treatment

Treatment for ARFID in adults will depend on the severity of weight loss or nutritional deficiencies. It can also depend on whether there are other eating disorders co-occurring with ARFID that also need to be addressed. 

ARFID in adults may need to be treated in an inpatient setting, an outpatient treatment center, or in an outpatient clinic. They should have a team including a medical physician, therapist, psychiatrist, and Registered Dietitian. 

If weight loss has occurred with ARFID and another eating disorder is not at play, then increasing the volume of food is the first line of treatment. For example, a dietitian may work with the client on eating larger portions of the person’s accepted foods or eating more frequently throughout the day. 

If a nutritional deficiency has occurred, the medical team will need to correct it before moving through increasing the variety of acceptable foods. 

After weight is restored and/or deficiencies have been corrected, then the dietitian will start to help the client increase the variety of foods that are accepted by the client. This process is often referred to as food exposures and is done at a quick pace. 

The client should also be working with a therapist frequently to help with coping with heightened anxiety, trauma responses, or other uncomfortable emotions/feelings surrounding this process. 

Many different types of food exposures can be done, depending on the client. For example, some may have an exposure at a grocery store. Some exposures may include picking up and smelling foods. Finally, exposures will include tasting the foods in different ways, e.g. as a part of a smoothie, cooked into another accepted food, and on its own. 

Gardening and ARFID

Gardening can be helpful for adults with ARFID as it provides another exposure to food. Being in the garden can help increase interest in, appreciation of, and familiarity with produce. Produce from the garden is usually peak quality and nutrition content so the taste may be more acceptable to the person with ARFID or provide a different/better taste than what they’ve possibly experienced in the past.

Recap: ARFID in Adults

ARFID is a complex eating disturbance and it can be treated. The goal for treatment of ARFID is to expand the affected person’s diet, or accepted foods, to allow for weight restoration and maintenance as well as variety in nutrients to prevent deficiencies. Research on ARFID is still new and developing. 

People of any age can be diagnosed with ARFID. There is a higher incidence of ARFID in those with OCD, ADHD, autism spectrum disorder, and generalized anxiety disorder. Other eating disorders may or may not co-occur with ARFID. Treatment is highly individualized as it depends on the individual’s experience with other mental or learning disorders, past experiences and trauma, and medical diagnoses. 

Seek the advice of a Registered Dietitian, mental health therapist, and physician with experience with treating eating disorders if you suspect that you have ARFID or another eating disorder. 

This information is for educational purposes only and is not meant to be a substitute for medical treatment or diagnosis. You should consult with your doctor before changing your diet or starting supplements for any health condition.

Leave a Comment

Your email address will not be published. Required fields are marked *

Scroll to Top