Does your child not like to eat certain foods? Or do you yourself not like to even look at certain foods, and have no interest in eating? Today, we will discuss in detail whether this is just a 'food intolerance' or something more serious. Understanding this condition properly will help you and your loved ones.
What is ARFID? Simply put...
ARFID, or Avoidant/Restrictive Food Intake Disorder, is a condition in which a person restricts or refuses the amount and types of food they eat. It is not , like other eating disorders, a condition in which a person is obsessed with their body image and tries to lose weight.
ARFID can cause you to:
- I lose interest in eating.
- Fear of what will happen after eating. For example, constant worry about choking or vomiting.
- Some foods are rejected because they are unpleasant in color, taste, smell, or texture.
Sometimes your doctor may call this a "selective eating disorder." This means that you may only like to eat a few types of food. You may also develop habits, patterns, or rituals about how you eat. For example, some people eat food in a specific order, one after the other.
This condition, called ARFID, can affect your overall health by preventing your body from getting the nutrients it needs. It's also important to remember that if not treated properly, it can be life-threatening .
Is this just picky eating?
No, ARFID is not just picky eating. There are young children who do not like the color, taste, smell, or texture of certain foods and will not eat them. This is what we call 'food pickiness'. But this is usually limited to only a few foods. It does not have a significant impact on the child's appetite or growth. This 'pickiness' often disappears as the child gets older.
But ARFID is a more serious condition . In this case, the lack of adequate nutrition can seriously affect a child's appetite, growth, and overall health. This condition does not improve without treatment.
How common is ARFID?
In fact, ARFID is a relatively new condition that was included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a classification of mental disorders that doctors use to diagnose patients. As such, there is still limited data from large population studies on its prevalence.
What are the symptoms of ARFID? How do we recognize it?
ARFID can cause physical and behavioral changes such as:
Physically visible features:
- Significant weight loss.
- Frequent constipation .
- Stomach aches, stomach discomfort, and bloating.
- Body temperature lower than normal.
- Constant feeling of tiredness and lethargy .
- Irregular menstrual cycles in women and young girls.
- Feeling dizzy or faint.
- Growth of fine hair (lanugo) on the body, especially on the back and arms.
- Muscle weakness.
Changes in behavior:
- Feeling "full" before eating, or losing your appetite altogether .
- It's hard to stay focused.
- Consciously limiting the amount of food eaten.
- Only eats foods with a specific texture (e.g., only very soft foods, or only crunchy foods).
- I'm always afraid of things like vomiting after eating or getting food stuck in my throat.
- The previously 'food-crazy' mentality is becoming more and more prevalent, and the number of foods that can be eaten is becoming more limited.
The important thing is that ARFID is not caused by a negative attitude towards one's body image or by the desire to lose weight.
What are the causes of ARFID?
The exact cause of ARFID is not yet known , but medical research suggests that several factors may play a role:
- Severe anxiety .
- Fear of various things, especially food.
- Some genetic changes .
- Some of the influences in our environment, society, and culture.
- Previous traumatic experiences , especially those related to food.
Who is at higher risk of developing ARFID?
ARFID can affect people of any age, including adults and children. However, it is most common in childhood . You may be at risk for developing this condition for the following reasons:
- If you have experienced any traumatic experiences related to food. For example, experiencing food deprivation, being force-fed, or being starved of food.
- If you have a mental health condition (e.g., anxiety, depression, attention deficit hyperactivity disorder (ADHD)) or another condition that affects neurodevelopment.
- If you have a strong dislike for the texture of certain foods.
- If you are constantly afraid that eating food will harm your body.
- If your close family members (biological family) have had eating disorders.
What complications can occur due to ARFID?
If ARFID is not treated properly, a variety of complications can occur, some of which are very dangerous.
- Malnutrition : Not getting the nutrients the body needs.
- Dehydration : Decreased amount of water in the body.
- Electrolyte imbalance : An imbalance of salts such as sodium and potassium.
- Anemia : Blood deficiency.
- Low blood pressure.
- Thinning of bones (Osteoporosis) .
- Sudden cardiac arrest can even occur.
- Delayed puberty in children.
- Changes and impairments in physical development.
These effects can sometimes be life-threatening . Surprisingly, sometimes the body of a person with ARFID can become somewhat accustomed to this stress and not show any outward symptoms. Therefore, even with tests, the condition may not be clearly identified, but the condition may be worsening internally.
ARFID can also have a big impact on your social life. For example, you may not want to eat with family, go to friends' parties, or participate in any events involving food. This can damage your relationships with family and friends, and distract you from schoolwork and work.
How is ARFID diagnosed?
A doctor will determine whether you have ARFID by considering a few specific criteria. These criteria are:
- The restriction of food must have resulted in significant weight loss (in children, failure to achieve expected growth), malnutrition , reliance on tube feeding or vitamin/nutritional supplements for nutrition, and/or social interactions with others must have been affected by the restriction of food.
- This food restriction should not be due to food insecurity, fasting for religious reasons, or an underlying medical condition or treatment for it.
- Also, this food restriction should not be done out of a negative attitude about one's body appearance or with the aim of losing weight or changing one's body shape.
- Even if the restriction of food is due to a medical condition or treatment, it must be at a level that exceeds the level of side effects that can normally be expected and causes major complications for overall health.
To confirm these things, your doctor will do a physical exam, and may also order blood or urine tests to check your general health, nutritional levels, and monitor the functioning of your internal organs. These tests are important because the side effects of this condition can be life-threatening and can affect many parts of the body.
How is ARFID treated?
There are several main goals in treating ARFID:
- Helping you achieve and maintain a healthy weight .
- Preventing complications that affect your overall health.
- Helping you manage your emotional issues, sensory aversions, and fears about food.
The main treatment for this is Cognitive Behavioral Therapy (CBT) . This therapy can help you with things like:
- Identify problematic thoughts and behaviors that are affecting your health.
- Reduce fear or anxiety about food.
- Be more relaxed and at ease with sensory challenges.
Sometimes, your doctor may prescribe medications to help your mind and body recover and prevent life-threatening complications. These may include antipsychotic medications, antidepressants, or medications that stimulate appetite. It is important to talk to your doctor about the possible side effects of any medication before you start taking it.
In some severe cases, the doctor may decide to temporarily administer enteral nutrition. This is a flexible, thin tube that is inserted through the nose or directly into the stomach or small intestine. This tube allows the body to receive nutrients without having to eat by mouth.
Who treats ARFID? Do you need a team of specialists?
Yes, because ARFID is a complex condition, you may need the help of a team of doctors and therapists to treat you. This team may include:
- Your family doctor (Primary care physician) .
- A mental health counselor or cognitive behavioral therapist .
- A doctor who specializes in the digestive system (Gastroenterologist) .
- Speech-language pathologist (if there are problems such as swallowing).
- Specialist doctors who treat other complications caused by ARFID.
How soon will I feel better after treatment?
Treatment for ARFID takes time. Since everyone is different, it is difficult to give an exact time when you will start feeling better. It varies from person to person. However, as your body begins to receive the nutrients it needs, you will gradually begin to feel relief from your symptoms. The most important thing is to monitor your progress and be on the lookout for new complications that may arise in the future, as you may need the support of your medical team and regular follow-up throughout your life .
Is there a way to prevent ARFID?
Unfortunately, there is currently no known way to prevent ARFID from occurring.
What is the experience like for someone with ARFID? What should you expect?
ARFID is a mental health condition that directly affects your body. While it may seem like a simple 'food intolerance' at first, the consequences of restricting food can be very serious and even life-threatening if not treated properly. Although children usually outgrow their food intolerances as they grow older, ARFID definitely requires medical attention. It can be a lifelong condition that needs to be managed. People with ARFID are often hospitalized.
Because this condition is a relatively new diagnosis in medical science, there is no single treatment that works for everyone. Often, the best results are achieved by using a combination of treatments, such as medication and cognitive behavioral therapy (CBT).
When should you see a doctor?
If you or someone you know has any of these symptoms, it is very important to see a doctor as soon as possible:
- If you can't even eat or drink a little water.
- If you feel intense fear or anxiety while eating.
- If you have no interest or desire to eat.
- If you suddenly lose a lot of weight for no reason.
- If you are experiencing other symptoms related to ARFID mentioned in this article.
Remember, it's not always easy for someone with a mental health condition to realize that they need help and ask for it. Therefore, the support, understanding, and encouragement of your loved ones is very important in getting them referred to someone who can provide the necessary medical care.
What questions should I ask the doctor?
When you go to see the doctor, don't hesitate to ask questions like these:
- "Doctor, what exactly is my diagnosis?"
- "Do I need to see a mental health therapist?"
- "What side effects might the medications you are prescribing for me have?"
- "If I can't eat properly, what do I do to get the nutrition my body needs?"
- "Will I need a feeding tube?"
What is the difference between ARFID and Anorexia?
ARFID and Anorexia Nervosa are both mental health conditions that restrict eating. But there is a key difference . Anorexia occurs when a person has a negative self-image about their body and restricts their eating in an attempt to change that image, especially to lose weight. In ARFID, the restriction is not about their body image.
Is ARFID part of Autism Spectrum Disorder?
No. Although some of the symptoms of ARFID may be similar to those of autism spectrum disorder (ASD), they are two different conditions . For example, both conditions can involve a strong aversion to the texture of certain foods. However, in people with ARFID, this sensory aversion can lead to serious complications, such as severe malnutrition.
The most important things we need to remember (Take-Home Message)
Okay, so I hope this gives you a better understanding of ARFID. Finally, keep these points in mind:
- ARFID is a complex mental health condition that does not improve without treatment, so it should not be taken lightly.
- Although this may seem like just a 'food intolerance' at first glance, if the body does not receive the necessary nutrition, it can lead to very dangerous, life-threatening complications .
- There are treatments available , but it takes time and patience. The support of your medical team and your loved ones will go a long way in helping you get back to good health.
If you think you or someone you know may have this problem, please seek medical advice. Early diagnosis and treatment are very important!
` ARFID, Avoidant/Restrictive Food Intake Disorder, food aversion, food refusal, nutritional deficiency, mental health, child health, eating disorders, picky eating
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