A photo of a baby in a Disney T-shirt sitting in a highchair eating pasta and cucumber with the article title - ARFID: A New Eating Disorder You Need To Be Aware Of - in the top right corner

ARFID: A New Eating Disorder You Need To Be Aware Of

One of my favourite TV shows on UK TV is Food Unwrapped on Channel 4, and in 2020 they brought out a sister show, Food Unwrapped Investigates with Kate Quilton. While watching this sister series I came across an episode about ARFID, a relativity new and not a well-known eating disorder.

 

 

What Is ARFID?

 

Let’s start with what ARFID stands for, which is: Avoidant/Restrictive Food Intake Disorder. However, that on its own doesn’t give you the full story on what ARFID is. So next let’s flesh it out with some details.

 

What makes ARFID an eating disorder?

Well, according to Coglan and Otasowie (2019), an ARFID sufferer will pathologically avoid or restrict their food consumption that ISN’T a result of cultural or religious practices, due to food scarcity, or as result of a mental or other medical condition. An example of the latter might be someone who struggles to eat due to cancer or cancer treatment.

 

One of the notable characteristics of ARFID is how some sufferers will avoid certain foods or food groups, or they might restrict eating certain food and items from certain food groups (ARFID Awareness UK). So someone may avoid eating fruit or fish.

 

People with ARFID may show a lack of interest in food or eating, avoid food based on their sensory characteristics, or are worried about repeating food mishaps where they had an aversive consequence when eating a food item before (i.e. food poisoning or chocking; Coglan and Otasowie, 2019).

 

Expanding on the sensory characteristics of food as a reason certain foods might be avoided, this could be taste, smell, and even textures of food. When I was force-fed food when I was a primary school kid, I developed a pathological hatred of baked beans. The smell, texture, sight, and even tough of them on my hand when I was washing up would all trigger the same horrid response.

 

The picture is split in two with the top image being of a baby being spoon fed food and the bottom image being of a baby putting fruit into its mouth. The two images are separated by the article title - ARFID: A New Eating Disorder You Need To Be Aware Of

 

What makes ARFID different from other eating disorders?

​ARFID normally originates in early childhood and can result in a persistent failure to meet nutritional or energy needs Dovey (2018). However, ARFID isn’t driven by an individual’s belief about their size, weight, or shape of their body (ARFID Awareness UK). Thus, any weight, size, or shape changes aren’t the reason for this disorder and if these do change, it’s a consequence of having ARFID and not the reason for having it.

 

Because of this fact, the condition is underdiagnosed and under-recognised, because weight at presentation can range from underweight, to normal, to overweight (Coglan and Otasowie, 2019). It’s hard for people to recognise ARFID as an eating disorder when the food intake issues aren’t related to losing weight or their body image because it doesn’t feature any of the classic signs and behaviours associated with eating disorders like anorexia and bulimia (ARFID Awareness UK).

 

As a result of this underdiagnosis, the UK’s eating disorder services aren’t commissioned to support those with ARFID (Coglan and Otasowie, 2019).

 

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Examples Of ARFID

 

You might have seen news stories or read in newspaper and magazines about people who only eat a certain food item for years. One of the ones I can remember was the story of a teen who only ate chicken nuggets for 15 years, resulting in them being hospitalised.

 

Another story was where a teen went blind from only eating crips and chips due to severe vitamin deficiencies and malnutrition damage. Unlike other eating disorders where you might starve yourself, eat and then make yourself sick, and/or binge eating, with ARFID you could eat at “normal” regular eating times (breakfast, lunch, and dinner) with the issues being the choice of what you eat because body image and weight simply aren’t a factor with ARFID sufferers.

 

A photo of a hand holding a chicken nugget to represent the story of the person with ARFID who almost exclusively ate chicken nuggets to show the dangers of this less known eating disorder

 

As a result of these kinds of misunderstandings, according to Dovey (2018), doctors can find themselves giving incorrect advice to parents. Because of this, eating disorders can become more entrenched and undermine early interventions, meaning conditions like ARFID might never become diagnosed.

 

Causes

 

So far, there are known exact causes of ARFID genetically speaking, but things that can cause it to develop are sensory sensitivity, lack of interest in food and eating, and a fear of negative consequences (ARFID Awareness UK). I know from my personal experience that I don’t eat seafood due to chocking on bones and due to being so poor I had fish fingers every single day as a child for a decade (I really free to hate the taste because of that).

 

Choking on food can be a very unpleasant experience, much like getting food poisoning, so it’s not hard to imagine how people, especially children, can develop an avoidance to such foods if they’ve had experiences like that. I know I did.

 

Another example of how ARFID can develop is as a result of an anxiety condition known as emetophobia, a fear of vomiting (Coglan and Otasowie, 2019). A person with emetophobia could be so scared of vomiting that they might restrict how much they eat or avoid certain food they think might make them more likely to vomit.

 

People with ARFID can also be a result of having food neophobia, which is an overwhelming fear of new or unfamiliar foods (Newbridge). Food neophobia and ARFID can also be mistaken for picky eating. However, ARFID is way more than that as it goes beyond just being a fussy eater (I’m a picky eater) because it’ll affect their daily life.

 

One often overlooked cause is psychosocial influences from family and peers. According to Newbridge, if parents have food neophobia then they’re likely to pass that on to their children, which makes sense. We often develop habits and behaviours based on what we observed are parents doing.

 

According to Beat, it’s very important to know that someone could have more than one reason behind their ARFID. As a result, ARFID will present differently for each person due to these individual differences. Thus, it’s not always useful to compare one ARFID sufferer to another. The main similarity between ARFID sufferers is just that they avoid or restrict food for reasons not related to weight loss, shape change, or other body image issues.

 

The link between developing ARFID in childhood is strong because children might not outgrow the normal developmental stage of picking eating, thus putting them at risk of developing the eating disorder. (The National Eating Disorders Association, NEDA; and ARFID Awareness UK).

 

In the context of the show, Food Unwrapped Investigates, which was looking mainly at children, picky eating doesn’t last and it’s only really an issue between the ages of 2-6, the food neophobia stage (Alimentarium). However, although this condition is most likely to start and end in childhood, ARFID doesn’t discriminate and can affect anyone of any age (ARFID Awareness UK), gender, race, etc.

 

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Risk Factors

Slightly different to causes, this section will look at what increases the risk of developing ARFID without some sort of eating-related bad experience. But as with other eating disorders, there are risk factors for ARFID which range from biological, psychological, to sociocultural. 

 

According to ARFID Awareness UK, many children with ARFID are comorbid with an anxiety disorder, with the potential to also develop other mental health conditions.

 

People with autistic spectrum disorder (ASD) are more likely to develop ARFID, as are other people with intellectual disabilities, and people with ADHD (NEDA and ARFID Awareness UK).

 

Autism

There is an accepted association between ASD and food neophobia. Those with ASD commonly rely on routine, with deviations often resulting in a lot of difficulties, as I imagine a lot of parents of ASD children can testify to. Due to this lack of flexibility and their resistance to change, getting ASD people to eat different or new foods can be hard.

 

According to Newbridge, the research suggests that people with ASD can have rigid food preferences based not just on taste, but on textures and colours as well. This rigid preference adds to their food neophobia and ARFID condition.

 

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ARFID Tips

 

  • Avoid putting pressure on children to try new food.
  • Offer any new food options numerous times, but don’t force or threaten them to eat.
  • When offering food to picky eaters, especially new food, try providing options helps. For example, if they don’t like eating vegetables, try offering them a selection of three to choose from.
  • Repeated exposure to the new food items without pressure to try it will allow them to become accustomed to it being there, which should then make them comfortable to try it.
  • Allow them to have control, removing that control from them will only make things worse.

 

For more tips on helping a child with ASD with ARFID and picky eating, click here to be taken to an article by Autism Parenting Magazine for more specialised advice to support a child on the autistic spectrum.

 

Although these tips might be useful for trying to tackle ARFID, they shouldn’t be a replacement for professional support. Therefore, if you believe you or someone you know has ARFID, then seek professional support to avoid the physical costs of the disorder.

 

If you’re interested in watching episode four (‘How Dangerous Is Fussy Eating?’) of Food Unwrapped Investigates with Kate Quilton, which inspired me to write this article, then you can do so by clicking here.

 

As always, leave your feedback in the comments section below. Also, feel free to share your experiences ARFID, picky eating, ASD and eating, and other eating disorders in the comments section below as well. If you want to stay up-to-date with my blog, then sign up for my newsletter below. Alternatively, get push notifications of new articles by clicking the red bell icon in the bottom right corner.

 

Lastly, if you’d like to support my blog, then you can make a donation of any size below as well. Until next time, Unwanted Life readers.

 

 

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References

 

Coglan, L & Otasowie, J. (2019). Avoidant/restrictive food intake
disorder: what do we know so far? BJPsych Advances, 25, 90–98. Retrieved from https://www.cambridge.org/core/services/aop-cambridge-core/content/view/6FD093EE6A5665822066A87F2CEDB7D8/S2056467818000488a.pdf/avoidantrestrictive-food-intake-disorder-what-do-we-know-so-far.pdf.

Dovey, M. T. (2018). Avoidant/restrictive food intake disorder: An eating disorder on a spectrum with food neophobia. In S. Reilly (Ed.), Food Neophobia: Behavioral and Biological Influences (pp. 329-349). Cambridge: Woodhead Publishing. Retrieved from https://doi.org/10.1016/B978-0-08-101931-3.00016-1 and https://bura.brunel.ac.uk/handle/2438/15762.

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81 thoughts on “ARFID: A New Eating Disorder You Need To Be Aware Of

  1. Wow. What an interesting read and very educational for a Wednesday morning 🙂 I have genuinely never, ever heard of this condition before so thank you for bringing this to people’s attention. I think people do assume eating disorders are just either not eating or eating too much, this looks like something that’s a lot harder to acknowledge straight off the bat but something good to look out for. Thank you.

  2. This was a really interesting read. My son is what could be described as a picky eater. Although he loves all fruits and vegetables, he struggles with other meal elements. It is hard to track a pattern because each issue with a food item seems to contradict another. I was beginning to think it might be a control thing, he is 13 and has spent a year at home and is struggling, I think food is the only thing he can control. But this is certainly something to consider as so much of what you said fits.

    Thank you for sharing x

    • I’ve always been described as a picky eater myself, but now I’m starting to realise I most likely have a form of ARFID given the reasons why I’m a picky eater

  3. Oh wow, this was such a fascianting read! I had no idea that these issues were related to an eating disorder. It’s great that we’re living in a world now where such things are brought to light and people can seek help for issues that were dismissed before. A great read, thank you for sharing xxx

  4. I think you have given some great tips on how to feed your baby. We never enforced food to ours, and now they can eat anything well-cooked. Your post is informative and helpful.

  5. This was very interesting, I never heard of ARFID and didn’t know that what could pass as fussiness had a deeper root!When I was younger i wouldn’t eat any fish except for some of them which had a ‘plain’ taste, I am still highly put off by the smell, but eat more of it now. I never thought there might be more behind it than simple dislike. I will watch Food Unwrapped, it seems very interesting! Thanks for sharing 🙂

  6. I have never heard of this condition before but I sure have seen examples on it on the media, really informed post and I know more on it for sure. I totally agree, let children rather than make them eat something they don’t like.

  7. I had never heard of this ED before! When I was younger, I got sick on pizza a couple times so for years I wouldn’t eat pizza. I’m so glad I outgrew that because I love pizza again now! 🍕Thank you for bringing this topic to light.

  8. Wow, this is actually quite scary! My niece was (and still it) a very picky eater. She would not eat meat, vegetables, fruit, pasta, or rice. It was mainly bread, cheese, and crappy carbs! She’s since added a few other foods to her diet, but at 25, she definitely doesn’t eat well. This disorder kinda fits with her eating habits. Thank you so much for sharing and bringing attention to these disorders.

    • That really doesn’t sound like a good diet, excessive carbs can also lead to the development of reactive hypoglycaemia (which I developed due to binge eating carbs as part of my bulimia) or worse, type 2 diabetes. Has anyone tried to talk to her about seeing someone about this eating issue she has?

  9. I have not heard or was aware of ARFID. I am so glad that you are being awareness to this. I really liked how you explain what is AFRID is and how to help others. I glad now I am aware of this and hope others will learn and stress awareness of this.

  10. What an interesting post. I kind of suspect ARFID is just newly discovered rather than actually new…I know some people who are in their 30s and 40s who probably have it. Including one woman who refuses to eat anything other than meat, potatoes, and corn, and someone else who mostly lives off of Campbell’s chicken noodle soup. It’s concerning to see.

  11. Wow! I always enjoy reading your posts! You’re a very talented writer and I love how you always raise awareness. Thank you so much for teaching me about this today!

  12. A fascinating article. I restrict food due to a fear of vomiting. I have difficulty swallowing due to a spinal injury and it has definitely affected my earring habits.

  13. This is very important information! Unfortunately, some parents still force their children to try new foods. I order to expose them to new foods for at least a dozen times before they might try it….

  14. Interesting and educational article! Never heard of this as an eating disorder but somehow I think we all have a particular food that we don’t want to it depending on the reason, but I didn’t think it would reach to those effects and risk factors. Now that I think more of it, I think I have a friend who has this disorder or at least I think I do. Learned a lot! Thank you so much xx

    http://www.lifebeginsattwenty.com

  15. This is such an interesting read! I definitely see segregation of certain food among people my age and it’s scary to think that it could go further into an ED!
    Rosie

  16. Such a thoroughly research argument. I love how much time you’ve clearly put into shining a light on ARFID. It’s so important to raise awareness. Another one people don’t know of is OSFED, otherwise specified feeding and eating disorder, which accounts for the highest percentage of eating disorders but so many people don’t know about it!

    • I stumbled across OSFED while researching ARFID, it crossed my mind to try and write something about it at some point. One of the reasons I was reluctant to think I had an eating disorder for so long was because I didn’t fit neatly into any of them, if I’d of known about OSFED I would have realised a lot sooner I was an atypical bulimic. I might have avoided developing reactive hypoglycaemia if I had

  17. Very interesting! I am a lifelong picky eater, and I suspect I am an Aspie, though I have never been diagnosed. I don’t think I am this far along the continuum, but it is a good reminder to think about what I might be missing because of how habitually I eat.

  18. So interesting and so thorough! Very informative and I haven’t heard of it before!! Definitely opened my eyes up so thanks for sharing!

  19. This was really interesting (if that’s the right word), and I suppose it made me realise I wasn’t aware of the existence of many eating orders besides the most commonly-known. I can understand how arfid would be difficult to diagnose too, and could be mistaken for someone being picky. It’s great to give them additional exposure, to increase awareness and reduce stigmas

  20. Thanks so much for this post. My friend has a little boy who is autistic who has also been diagnosed with AFRID. I will share your post with him and hopefully they will learn more from it.

  21. Oo boy, disorders like this that are only beginning to come to light are scary! The main reason being support lines do not recognize them or know how to respond so, while I like that the show mentioned the disorder, I love that you expand on the disorder with all the knowledge available.
    I connect with this kind of disorder not because I have it but because I can see how something like this can develop and impact lives.
    Thank you so much for sharing!

  22. I have never heard of this condition before and it was nice seeing it here. At least I know there’s an eating disorder called ARFID and I would be able to use your tips to help if I come across someone with ARFID.

  23. This was a very interesting read. My kids used to be very picky eaters when they were little but luckily they grew out of it. I always tried to offer variety and to make eating a social event where everyone is invited to join in. Also it’s an idea to make whatever food the kid eats a more nutritious variant. For example swap white pasta to whole wheat pasta. Also cutting veg differently can help. My 6yo son still says that cucumber sticks taste better than slices. But of course!

    • That’s interesting that the presentation of food makes such a big difference. I guess we are very visual creatures. I’d be interested to see how many people have similar experiences

  24. I read this and immediately thought of an individual I used to know who literally lived off of mostly chicken and candy. He occasionally ate pizza, but as an adult in his late 20s, predominately ate mostly less than 10 food items on a regular basis. As usual, the amount of research in your articles as well as the attention to issues that are largely ignored is evident in this post. Great article!

    • Thank you. It’s surprising how dangerous this kind of eating disorder can be, because you can eat regularly, even over eat, and still suffer serious health complications due to a lack of nutrition.

      I remember hearing a story on a documentary about how there were trappers who lived solely off of rabbit. They are rabbit frequently but died, but if they’d had eaten a bit of vegetables every now and then, they wouldn’t have lived. Makes you wonder how carnivores survive

  25. Very interesting read! I have a niece and nephew (brother and sister) who will only eat certain foods and I’ve always wondered if there wasn’t more to it. On the flip side, I also have an autistic niece who cautiously tries more new foods than her cousins. Fascinating perspective. Thank you for sharing!

  26. I can’t imagine only eating just one food – that can’t be healthy at all – I don’t eat sugary foods because I had a gastric bypass, and it is a risk 🙂

  27. I’ve never heard of this before. When I was 8, I got a norovirus that left me with emetophobia. It was so bad that I would be afraid to eat dinner or go to bed with a full stomach. Thankfully, my parents were smart enough to not make it a big deal, and I grew out of the worst of it when I was a teenager and my metabolism kicked in. However, as an adult, that fear of eating (and nausea) had me down to 90 pounds at one point and 104 a few years later. I’m going to have to mention AFRID to my therapist. Thank you!

  28. Wow this was so informative & such an interesting read. I never knew about this. Thank you for widening my understanding of eating disorders. As a nutrition coach, I am always trying to learn more.

  29. I have never heard of this eating disorder but, as you say, I can see how common it must be, particularly if it stems from unpleasant childhood experiences. A very helpful post, thank you for researching and sharing this.

  30. Such a good read! ARFID, I’m not familiar with until reading it here. It’s not even talk about over here in the US. While I was reading this it made me think about my godchildren because they avoided certain foods (nutrient based foods) that it impacted their weight.

    This disorder as you mentioned can be easily mistaken for others things if we don’t look at other factors. One can quickly include that they are picky eaters but it can be much more than that if it’s not looked into.

    This post is excellent! Thanks so much for sharing.

  31. I had honestly never heard of this eating disorder so thank you for such an insightful post! There are huge misconceptions around eating disorders; you either don’t eat or eat far too much. People don’t realise that it isn’t always the case! Fab post!

  32. I haven’t heard of ARFID so thank you for sharing this post. I can see how ARFID is underdiagnosed because weight and body image aren’t a factor & it was also interesting reading about the different causes. The articles you linked about the teen who only ate chicken nuggets & another teen who went blind from only eating chips are eye-opening to how serious ARFID can be

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