A recent study has shown that there is an alarming increase in eating disorders among individuals under the age of 17. Health visits related to eating disorders have nearly doubled from 50,000 in 2018 to 100,000 in 2022. However, a major issue is the delayed diagnosis of these disorders. For example, picky eating in childhood is often dismissed by parents as a phase that the child will grow out of. But if this behavior persists and causes intense stress and anxiety in response to specific food textures, tastes, smells, or appearances, it could be an indication of Avoidant Restrictive Food Intake Disorder (ARFID). Unfortunately, ARFID is often not distinguished from picky eating, which puts many children and adults at risk of developing weight loss and malnutrition.

What is ARFID?
ARFID, also known as avoidant/restrictive food intake disorder, is characterized by restricted food intake. Unlike other eating disorders that are driven by negative self-image or the desire to change body weight, ARFID is primarily triggered by fear and anxiety surrounding food or the potential consequences of eating, such as choking incidents.

This fear and anxiety make it challenging for individuals with ARFID to consume a varied and balanced diet. They may also experience severe weight loss, lack of appetite, abnormal menstrual periods, stomach cramps/pain, constipation, lack of focus, low iron levels, or dizziness.

Causes of ARFID
The exact causes of ARFID are not well understood, but it is believed to be influenced by a combination of genetic, psychological, sensory, and environmental factors. Some individuals may have a genetic predisposition to sensory processing issues, which makes them more susceptible to aversions related to food textures and tastes. Traumatic experiences, such as choking incidents during childhood, can also trigger ARFID.

Children who are exposed to limited food options during early development or those who have restricted access to diverse foods in their environment may be at a higher risk of developing ARFID. Psychological factors like anxiety, obsessive-compulsive traits, and neurodevelopmental disorders could also contribute to the development of the disorder.

Impact on physical and mental health
ARFID can have serious consequences on physical health due to the limited range of foods consumed. Nutritional deficiencies, including insufficient intake of vitamins, minerals, and macronutrients, can lead to malnutrition, delayed growth and development (in children), weakened immune system, and gastrointestinal problems.

On a mental health level, individuals with ARFID may experience increased stress and anxiety when it comes to mealtime and social gatherings involving food. Avoiding these situations can result in social isolation, depression, and low self-esteem.

Addressing ARFID and minimizing its impact
Recognizing and understanding the effects of ARFID is crucial as it affects an individual’s lifestyle and nutritional levels. Multidisciplinary approaches, such as addressing sensory sensitivities, negative experiences, and emotional challenges, are necessary to address the dietary habits of individuals with ARFID. Therapies such as exposure therapy, trauma-focused therapy, cognitive-behavioral therapy, or dialectical behavioral therapy can help individuals cope with the factors affecting their nutritional levels and immune system.

To ensure individuals with ARFID meet their dietary requirements and expand their food choices, it is important to incorporate nutritional counseling into their treatment plan. Gradually introducing new foods and using techniques such as food chaining, which involve making small and incremental changes to food choices, can help expand their palate. Seeking guidance from a team of healthcare professionals, including mental health specialists and nutritionists, is advisable to provide the best support for individuals on their path to recovery, according to Laxman.

The takeaway
The key takeaway from this is that to minimize the stress and trauma associated with ARFID, it is essential to address both the challenges related to limited dietary options and the psychological aspects of food aversion. By gradually building a healthy relationship with food and raising awareness about the disorder, we can expedite the recovery process.