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Dr Charlie Baily

Author: Dr Charlie BailyClinical Psychologist

Avoidant / restrictive food intake disorder (more commonly known as ARFID) used to be known as ‘Selective Eating Disorder’ until a few years ago – it can have serious long term health impacts so treatment is always advised. We can help.

What is ARFID?

ARFID is an eating disorder in which those who have the illness restrict what they are eating or avoid certain food groups completely.

It is different to anorexia as weight loss is not the primary reason for restricting food intake, however, some people will go on to develop another eating disorder like anorexia or orthorexia if it is untreated.

There are three main types of ARFID:

  1. Avoidant ARFID - certain foods are exclude because of sensory issues such as smell, taste or texture
  2. Aversive ARFID - eating all or certain foods is very distressing, normally because of a traumatic event such as choking or serious illness associated with that food)
  3. Restrictive ARFID – the person doesn’t feel hungry in the same way or the person is easily distracted from the task of eating

Any of the three types of ARFID can develop from or into another eating disorder like anorexia, where the symptoms described above are accompanied by a wish to lose weight and low body image.

5%
of children are thought to meet the criteria for ARFID


Causes of ARFID

The diagnosis of ARFID is relatively new, so there is limited research on what causes it to occur, however it is likely to be a complex interplay between several factors – such as a genetic predisposition triggered by some sort of biological, social or environmental set of circumstances.

We know ARFID affects younger children more than those who are in adolescence or adulthood and we know that boys are more likely to be affected than girls1. We know there are strong links to neurodevelopmental disorders such as Autism or ADHD, to learning disabilities and to anxiety disorders including OCD.

We also know there are some circumstances that might trigger ARFID to develop. Choking and swallowing issues are very common (as much as a quarter of those with ARFID ).

Anxiety disorders such as Generalised anxiety disorder (GAD) or OCD are also much more common in ARFID than for other eating disorders – around 75% of ARFID sufferers will have an anxiety disorder compared to 37% of anorexics2.

1 Nicely, T., et al (2014)
2 Fisher, M., et al (2014)

Everyone was so kind to us, we weren’t really sure what help our son needed but the triage team were able to give us some great advice and arranged our appointment with the psychologist without any hassle. Couldn’t have wished for more.

Eloise, Norfolk


Symptoms of ARFID

It’s very normal for children to develop some degree of pickiness as to what they do and don’t like to eat around the age of 6 or 7 (for instance - it’s thought carbohydrate rich foods are preferred to help growth spurts).

For most, by the time a child reaches puberty, their repertoire of food will have increased and they will no longer be as picky about what they eat. It’s understandable therefore, that ARFID can be confused with picky eating however, ARFID is a diagnosable mental health condition that often is visible in very young children, and which they won’t grow out of naturally.

There are both physical and behavioural signs that someone might be suffering with ARFID.

Behavioural symptoms

  • Fear of eating – anxiety around meal times
  • Refusal to eat some or all food
  • Difficulty eating in front of others
  • No or very reduced appetite
  • Forgetting to eat
  • Limited amount of ‘ok’ foods

Physical symptoms

  • Delayed growth against expectations
  • Stomach complaints
  • Vomiting, choking or gagging when eating

20%
of those with ARFID have sensory issues

ARFID is more common in younger children (though adults may also have the disorder) and research suggests boys are more likely to develop the disorder than girls. It is commonly misunderstood as being something a child will grow out or just picky eating. These are dangerous misconceptions as ARFID can be a very serious condition.
Dr Charlie Baily
PhD, CPsychol

Clinical Psychologist
London

Dr Charlie Baily is a Clinical Psychologist currently working in the private sector. He has a PhD in Clinical Psychology and is a member of The British Psychological Society and Health and Care Professions Council.

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