Selective Eating Disorder, also known as Avoidant-Restrictive Food Intake Disorder (ARFID), is characterised by the avoidance of particular foods or food groups, resulting in insufficient calorie intake to maintain basic bodily functions. This failure to meet dietry requirements often results in weight loss. Individuals avoid certain foods for various reasons, in some instances because they are very sensitive to taste or texture, or because they had a distressing experience with that particular food. They might have a poor appetite and are often referred to as ‘picky eaters.’ It is important to note while people who have AFFID limit their intake of food, also a defining characteristic of Anorexia Nervosa, there is usually no accompanying preoccupation and fixation around weight loss and body image. Nevertheless, all people who develop ARFID share the central feature of avoidance or restriction of food intake.
It has been suggested that this disorder is not characterized by an obsession with body shape or weight, but is simply due to a disinterest and avoidance of foods. Selective eating disorder can often result in excessive, unhealthy weight loss and malnutrition. The concerns surrounding this condition is that it can lead to nutritional impairment and deficits, and in extreme cases the need for feeding tubes. As is often the case with a lack of good nutrition, psychosocial impairments stemming from ARFID can also develop.
What are the signs, symptoms and diagnosis of Selective Eating Disorder and ARFID?
ARFID includes a wide range of symptoms ranging in severity, each of which contribute to or involve the avoidance or restriction of food intake. The DSM-V recognizes both Selective Eating Disorder and Avoidant-Restrictive Food Intake Disorder as eating disorders, but which are clinically distinct from Anorexia Nervosa and Bulimia Nervosa. Although ARFID is most commonly found in children, it has since been recognised that all age groups can be affected to varying degrees.
There are four diagnostic criteria that must be met in order for an individual to be diagnosed with AFRID:
- The individual fails to meet appropriate weight gain or nutritional requirements and displays significant weight loss. There is a lack of interest in eating, accompanied by a refusal to eat certain foods. This refusal to eat particular foods is based on colour, texture and smell, or fears of choking or vomiting. This disturbance must present to the extent that enteral feeding (where supplemental nutrition is administered through a feeding tube) is required and nutritional supplements are required. The individual also displays a significant decrease, and interference with, psychosocial functioning.
- This disturbance does not originate from cultural or societal values.
- There is no intentional disturbance in body weight or shape and this disorder is not due exclusively to Anorexia or Bulimia Nervosa.
- This disorder is not due to a medical condition or another mental health disorder.
Consequences of ARFID
There are a number of serious health risks associated with ARFID. Individuals diagnosed with ARFID often experience weight loss, nutritional deficiencies and growth failure (mostly in adolescents) or an increased risk to not thrive. For low weight patients, complications associated with ARFID may closely resemble the health risks of Anorexia Nervosa namely:
- Cardiac complications
- Heart problems
- Kidney and liver failure
- Bone density loss
- Electrolyte imbalances
- Low blood sugar
- Bloating and other gastrointestinal issues
About ARFID treatment
At Rise Treatment Centre we offer a residential clinical programme for treatment of ARFID. Our programme is evidence-based and covers the overall health and well-being of our clients who suffer from any form of an eating disorder. We help them understand the root causes of their ARFID and combine psycho-education, mindfulness, group sessions, individual therapy and family support to guide them towards a sustainable recovery.