“Mrs. Maya is worried about her toddler. She doesn’t eat anything unless she’s extremely hungry, and even then, it is a serious struggle to get her to eat. The only things she willingly consumes are nutritional supplements and pap; everything else she will spit out! She was a chubby baby, but now she’s a slim toddler and hasn’t grown as tall as her agemates.”
Avoidant Restrictive Food Intake Disorder (ARFID), previously known as Selective Eating Disorder, is an eating disorder that is characterized by extreme picky eating and limited interest in food, but does not involve fears about weight gain or issues with one’s body shape or size.
ARFID usually begins in early childhood, and research has shown that it is more common in boys than girls. When a person has ARFID, they do not eat enough food to obtain the necessary nutrients and energy for maintaining body functions or growing appropriately in weight and height.
ARFID shares similar signs with other eating disorders, but it differs in specific ways. Here are some important signs and symptoms to look out for in children and adults.
In both adults and children, individuals with ARFID often display a lack of appetite or disinterest in food, having a restricted range of preferred foods that reduces over time. They also have picky eating based on specific sensory properties of food such as tastes, texture, or smell.
In kids, symptoms to watch out for are intense negative responses to tastes, textures, colors, and odor of food, neophobia (an intense fear of new foods), and fears associated with eating, such as choking or vomiting. There are also appetite issues that manifest as a lack of interest in food and eating, never reporting being hungry, and a very low appetite. Children with ARFID may also have difficulty adding weight or meeting the growth milestones for their age.
Signs and symptoms of ARFID to watch out for in adolescents and adults are:
Physiological symptoms, such as abdominal pain, fatigue, hyperactivity, constipation, weight loss, sensitivity to cold, irregular or absence of menstrual periods, sleep difficulties, dry skin, dizziness, brittle nails, thinning and drying of hair, reduced heart rate, low blood count, anemia, muscle weakness, slowed healing rate, and reduced immunity.
Behavioral: dressing in layers to stay warm or hide weight loss.
Psychological: non-specific abdominal problems that occur around mealtimes, fear of vomiting or choking during eating, and difficulty concentrating.
What causes ARFID?
Doctors and researchers are yet to identify a definite cause for ARFID. However, there are several possible risk factors that may increase a person’s chances of developing ARFID. They include:
- Developing an aversion to food because of a bad food experience such as vomiting, choking, or illness
- Living with an autism spectrum disorder, anxiety disorder, or ADHD (attention deficit hyperactivity disorder)
- Presence of disease conditions such as gastroesophageal reflux disease (GERD), the cause of heartburn
ARFID can lead to both physical health problems and social issues.
Most people with ARFID experience malnutrition, which can cause low blood pressure that may lead to fainting, dehydration, delayed puberty, osteoporosis, weakened muscles, and amenorrhea (loss of menstrual periods). The disorder can also result in difficulties at work, school, or other social situations as the individual may find it difficult to eat with others, resulting in social isolation.
Your doctor may hesitate to diagnose ARFID if:
- The condition is caused by a lack of food, or by religious or cultural practices.
- The condition occurs alongside another disorder such as anorexia nervosa, bulimia, body dysmorphia, or a pre-existing medical condition.
Avoidant Restrictive Food Intake Disorder (ARFID) is an eating disorder that usually begins in early childhood but may persist into adulthood. People with ARFID avoid food based on sensory properties such as taste, color, or texture. ARFID is not the same as being a picky eater; it is more extreme. This disorder often results in malnutrition and stunted growth in children. If you suspect that your child or loved one has ARFID, please see a doctor for a proper diagnosis.