30 million Americans suffer from some form of an eating disorder (Eating Disorder Coalition). While typically what comes to mind when thinking of an eating disorder is either Anorexia or Bulimia nervosa, numerous other eating disorders take hostage the people they consume. For instance, other eating disorders include Binge Eating Disorder (rapidly consuming large amounts of food with little to no control; the most common ED), Pica (involves craving and consuming non-food items), and Rumination Syndrome (regurgitating and then re-chewing and either swallowing or spitting out the regurgitated food). However, there is an even more obscure eating disorder that deals with the sensory aspect of food and/or the physical reaction that certain or all foods might illicit.
ARFID, or Avoidant Restrictive Food Intake Disorder, was just recently added to the DSM-5. It was also previously referred to as Selective Eating Disorder (NEDA.org). While it is similar to Anorexia nervosa in the sense that both involve restrictions or limitations to what or how much food is consumed, ARFID differs in the sense that there is no fear or anguish regarding body shape, size, or anxiety towards being “fat.” However, like Anorexia nervosa, ARFID also allots to becoming malnourished and nutrient deficient due to lack of proper nutrition…ARFID has more to do with a fear of color, smell, texture, taste, and the physical aftermath having once consumed the food, rather than a fear of becoming a certain size or to maintain or attain a certain appearance or shape.
According to the DSM-5, ARFID can be diagnosed when the following is exhibited:
- An eating or feeding distress- this can be a lack of desire to eat or an interest in food in general
- Avoidance of food due to sensory aspects: color, smell, texture, along with the taste
- Fear or concern about the adverse reactions to eating: Throwing up, gagging, allergic reactions, illness, etc.
- Significant weight loss, great nutritional deficiency, dependency on other feeding means such as feeding tubes or nutritional supplements/ replacements
- Food disturbance is not correlated to either anorexia or bulimia nervosa and is not related to a fear of body shape, weight, or the other physical attributes
- The eating issue is not related to another medical condition and there is not a more suitable diagnosis
Those who have been diagnosed with OCD, ADHD, and Autism Spectrum Disorder are more likely to develop ARFID, as are those who have other intellectual or developmental disorders. Likewise, those who suffer from ARFID are also more likely to have other coexisting anxiety disorders and are at a greater risk of developing other psychiatric disorders later on. Additionally, those who greatly suffer from severe picky eating, or do not outgrow normal picky eating, are also at a greater risk for developing ARFID. It is also important to remember that ARFID can impact all genders equally and at all ages. So, the four-year-old next to you may have ARFID, and likewise the 85 year old across your street may also have it. Equally important, it should be noted that those who suffer from eating disorders may present themselves in a variety of ways. It might not be apparent that someone may be suffering from an eating disorder as there is no set way for someone with an ED to look or to present themselves. Those with eating disorders can be shorter, taller, smaller, larger, average-sized, and of any race, ethnicity, cultural background, socioeconomic status, and gender or sexual identity.
Furthermore, ARFID goes far beyond that of just picky eating. ARFID is a deep phobia of food. Perhaps it is due strictly to a sensory issue of color, taste, smell, or texture. Or perhaps it has to do with a worriment of possible adverse physical reactions such as gagging, vomiting, allergic reactions, sickness, etc., or a combination of all or some of these. We need to actively remember that those with ARFID have an eating disorder rather than specific, fussy, and diva-like tendencies. These are real people who are not trying to be difficult but are trying to prevent their worst fears from occurring. It is merely a form of self-preservation. ARFID is a psychological disorder and needs to be treated as such. This is a disorder rather than a quirky character trait that might be mildly irritating. This is something that disrupts and can cause epic derailing if not treated and adequately addressed. We need to treat those with ARFID, and all eating disorders, as people first and meet those overcoming eating disorders with patience, acceptance, and the space to exist exactly as they are as they begin to grow and prevail. You are not alone.
~Ashley Anderson