What is ARFID? Eating disorder explained, meaning, signs of condition, treatment, NHS and charity advice

An eating disorder is a mental health condition where sufferers use the control of food to cope with their feelings about other situations.

Anyone can get an eating disorder, but teenagers between 13 and 17 are mostly affected, according to the NHS.

The good news is that, with treatment, most people can recover from an eating disorder.

The most common types of eating disorder are anorexia nervosa, bulimia and binge eating disorder (BED), but there’s also a less common type called ARFID.

So, what exactly is ARFID, what are the signs to look out for, how is it treated and what should you do if you think you or someone you know has it?

Here’s everything you need to know.

What is ARFID meaning?

ARFID stands for Avoidant Restrictive Food Intake Disorder.

What is ARFID eating disorder?

ARFID is a condition characterised by the person avoiding certain foods or types of food, having restricted intake in terms of overall amount eaten, or both.

Why do people have ARFID?

People can develop AFRID for a number of reasons, but three reasons are the most common, according to eating disorder charity Beat and the NHS.

They are:

• They might be very sensitive to the taste, texture, smell, or appearance of certain types of food, or only able to eat foods at a certain temperature. This can lead to sensory-based decisions about food intake.
• They may have had a distressing experience with food, such as choking or vomiting, or experiencing significant abdominal pain. This can cause the person to develop feelings of fear and anxiety around food or eating. 
• In some cases, the person may not recognise that they are hungry in the way that others would, or they may generally have a poor appetite. For them, eating might seem a chore and that could result in them struggling to eat enough.

One or more of these reasons may contribute to a person developing AFRID, so the condition can present differently person to person.

All sufferers share the same outcome though; the avoidance or restriction of food intake in terms of overall amount, range of foods eaten, or both.

In a difference to other eating disorders, beliefs about weight or body shape are not reasons why people develop ARFID.

What are the signs of ARFID?

Due to ARFID being an umbrella term that includes a range of different types of difficulty attached to food intake, there is a wide range of possible signs and symptoms.

Possible signs of ARFID, according to Beat, include:

• Eating a reasonable range of foods but overall having much less food than is needed to stay healthy. 
• Finding it difficult to recognise when hungry. 
• Feeling full after only a few mouthfuls and struggling to eat more.
• Taking a long time over mealtimes and finding eating a chore.
• Missing meals completely, especially when busy with something else.
• Sensitivity to aspects of some foods, such as the texture, smell, or temperature. 
• Appearing to be a picky eater.
• Always having the same meals.
• Always eating something different to everyone else.
• Only eating food of a similar colour.
• Attempting to avoid social events where food would be present.
• Being very anxious at mealtimes, chewing food very carefully and taking small sips and bites.
• Weight loss (or, in children, not gaining weight as expected).
• Developing nutritional deficiencies, such as anaemia through not having enough of certain nutrients in the diet.
• Needing to take supplements to make sure nutritional and energy needs are met.

Not all of these symptoms would necessarily occur in one person, and neither are they necessarily an indication that someone has ARFID.

What are the possible impacts of ARFID on a person?

ARFID can have a detrimental effect on a person’s overall physical health, as well as on their psychological wellbeing.

When a person does not take in enough energy through the food they consume, they are likely to lose weight.

If children and young people fail to gain weight as expected then their growth may be affected.

A narrow or restricted diet may also lead to a person not getting all the essential nutrients needed for their health, development and the general ability to function on a day-to-day basis.

Their limited diet also often causes people to experience significant difficulties at home, at school or college, at work and when with friends, as their mood and day-to-day functioning can be negatively affected.

Many people with ARFID find it difficult to go out and socialise, or to go on holiday, as they have a negative relationship with food.

They may find it difficult to make new friends or establish close relationships as social eating occasions are often central to this.

How is ARFID treated?

Treatment for ARFID is usually best tailored to the needs of the individual, based on the specific nature of the difficulties the person is experiencing and the impact it is having on them.

Some ARFID sufferers also have various nutritional deficiencies, and in some people that can mean that treatment is needed.

Nutritional supplements may be prescribed for people whose food intake is very limited.

In some more extreme cases a period of tube feeding may be recommended for a person if their food intake is extremely limited, their weight and nutrition levels are low and physical risk is deemed to be high by medical professionals.

The course of treatment recommended by medical professionals may depend on the age of the person who has ARFID.

Young people may be treated by their local community eating disorders service for children and young people, generic Child and Adolescent Mental Health Services (CAMHS), community paediatric services, or by a range of private practitioners, including dietitians, and psychologists.

Adults may be treated by specialist eating disorders services and general mental health services or by private practitioners.

What should I do if I think I, or someone I know, may have ARFID?

If you think you might have ARFID, you should make an appointment to discuss this with your GP.

If you are concerned that a loved one has ARFID, you should talk with them to encourage them to seek the right help and support. You could suggest that they visit their GP and offer to go with them for support.

You can also talk in confidence to an adviser from Beat by calling the Beat helpline on 0808 801 0677 or visit beateatingdisorders.org.uk

The free, confidential helplines is open 365 days a year from 9am to 8pm Monday to Friday and 4pm to 8pm on Saturday, Sunday and bank holidays.

You can also join one of the charity’s online support groups, which are anonymous, and provide the opportunity to speak to people going through similar experiences.