Let's make it clear what ARFID is, what causes it, and what to do about it.

I've only recently discovered myself that i suffer from ARFID due to my OCD, due to my extreme weight loss people may often confuse my weight loss with Anorexia, but i have no desire to control my weight or shape, it's purely Magical Thinking and that's where ARFID comes in

ARFID is a name given to a cluster of eating difficulties.  It means Avoidant Restrictive Eating Disorder. It exists in children who were called ‘fussy eaters’ and it exists in adults in various forms. I (Deanne Jade) am an eating disorder specialist and I am a Selective Eater, there are many foods I just don’t eat because of texture or taste. But I eat well. You could call me an ARFID case, but I am healthy fit and very well fed.

The form of ARFID that would best describe me is

OTHER CAUSES OF ARFID Restrictive eating can exist in people with other mental health difficulties like schizophrenia where for example, people have delusions about food in general or certain types of food. Delusions of being poisoned can lead some mentally fragile people to avoid eating, but what about other forms of ARFID?

Is ARFID an eating disorder?

An eating disorder is SPECIFICALLY eating disturbances which are motivated by the need to control weight and shape. Not all behaviours thus satisfy the definition of being a classical eating disorder like anorexia or bulimia. ARFID is an artificial name given to different kinds of what used to be called “fussy eating”. The name was invented to give Americans access to funding for private treatment.  So it is not a specific illness, mental health problem or disease, but eating restraint can make young people unhealthy.  In severe cases, restrictive eating can be devastating and can affect family and social life. Let us look at different reasons why children, adolescents and some adults avoid eating a healthy diet.

ANOREXIA NERVOSA in a child. Children as young as 5 can develop anorexia. The diagnosis is only valid if the eating motivations are fear of weight gain. Children with anorexia don’t usually complain of feeling fat; they are more likely to complain of tummy aches. It takes a specialist to tease out the weight control issues that are affecting their desire to eat.

SELECTIVE EATING – where a child will only eat bread and jam or crackers. Selective eating is normal in children due to something we call neophobia (fear of eating what is unfamiliar). It can be very dangerous or mild and often changes as a child ages. The REASONS are very diverse. Some children might have early traumatic experiences with choking, swallowing difficulties if given food lumps too soon fear of being sick which they associate with certain foods, or they just haven’t been well trained in eating a wide variety of foods. It is easier for a child to eat a wide variety of foods if their mother has eaten widely and well during pregnancy and breast feeding. Selective eating can emerge due to unhelpful parenting, family poverty where parents only give children food they will eat. They cannot afford to buy vegetables and have them discarded.  Parents who want their child to eat often don’t know how to persuade their child to try something they dislike and give up too easily or use the wrong skills such as shouting or bribery which often doesn’t work.

SELECTIVE EATING OR ANOREXIA – AUTISM Avoidant Restrictive Eating Disorder behaviours are common in people with autism of all ages; people with autism typically have a narrow range of foods they feel able to eat. They may avoid certain colours, only eating yellow food, and commonly experience panic if they are asked to eat anything unfamiliar. The primary problem in autism is what psychologists call “central coherence”- this means problems with how the brain is wired. Wiring is not an illness but it can help make people ill; they find it hard to shift out of persistent unhelpful behaviour.

ORTHOREXIA could be viewed as a form of Avoidant Restrictive Eating Disorder. Orthorexia is where people restrict the types of food that they are willing to eat because they think it is bad for them.  They may for various reasons start to cut out meat, dairy food, wheat, all carbohydrate because they have developed fixations that such eating is wrong, or they are allergic. Orthorexia is associated with anxiety and in some people orthorexia is linked to weight control,  being just another way of being on a diet. Orthorexia in those cases is a classical eating disorder not unlike anorexia. It is a problem when it interferes with life and general happiness. Orthorexia is explained more fully elsewhere on our website.

CHILDHOOD FOOD AVOIDANCE EMOTIONAL DISORDER is not anorexia; it is a stress response, sometimes to drama or adverse experiences during childhood. It is more common in sensitive children. We cannot make assumptions about whether the problem is in the family or in the personality of a child or their environment. A careful assessment must be made.

PERVASIVE REFUSAL to eat is present when a child is unable to take care of themselves in any way and is often the effect of trauma and abuse.