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Learn more about the results we get at Within

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ARFID in adults

Avoidant/restrictive food intake disorder (ARFID) is an eating disorder (previously known as selective eating disorder) wherein people avoid or restrict their food intake due to psychological or sensory factors. People with ARFID experience a significant struggle to regularly meet their nutritional and energy needs.1

Keep reading to learn more about ARFID, the unique experience for adults, and the best treatment options for adults with ARFID.

Last updated on 
January 31, 2024
Person in distress from ARFID
In this article

Can adults have ARFID? 

Yes, adults can have ARFID. When examining ARFID in adults it’s important to remember that, like other forms of disordered eating, ARFID can affect anyone of any age from any background.2 Many children that experience the challenges of ARFID grow to be adults with ARFID, and some adults experience ARFID symptoms for the first time in adulthood. 

Since ARFID is a newer mental health diagnosis, there is not a great deal of information gathered regarding the scope of the condition. The best evidence suggests that about 0.3% of people 15 years old and older have ARFID.3

ARFID rate graphic
Rates of ARFID in adults could be much higher in people with gastrointestinal (GI) issues. A study of adults who presented for a GI evaluation found:4
  • 23.6% of people had some symptoms of ARFID
  • 17.3% of the group most likely had ARFID, with more assessment needed
  • 6.3% of the adults met the full criteria for ARFID

Of the adults in this study, only one had a current diagnosis of AFRID from their GI doctor.4 Based on these findings, adults can and do have ARFID, but the disorder is not widely recognized or understood by professionals. 

AFID and GI issues graphic

Why do people question ARFID in adults?

Since the diagnosis is not yet well-understood, some doubt and hesitation surround the idea of ARFID in adults. Prior to 2013, the ARFID did not exist as an official mental health condition. In its place was “feeding disorder of infancy or early childhood.”5

Feeding disorders of infancy or early childhood only applied to small children, with no room for adults to have the condition. To receive this diagnosis, children had to show symptoms before they were six years old.5

The American Psychiatric Association performs continual research to track ARFID and other eating disorders. These experts determined that ARFID was a suitable replacement eating disorder for feeding disorders of infancy or early childhood, which acknowledges adults with this form of eating disturbance.

Person feeling distressed because of ARFID

Understanding ARFID in adults

The presentation of ARFID in adults will overlap greatly with ARFID in children, with a few differences. Like children, adults with ARFID will display restriction, avoidance, and aversion to food that results in an inability to meet their nutritional and energy needs.2

The reasons for avoiding and restricting intake in adults with ARFID seem to vary from children with the condition. In children, the reasons to avoid foods center around low appetite and the sensory aspects of food. If the food has an unfamiliar or unwanted taste, texture, smell, or appearance, the child is not likely to eat that food—this may just be a symptom of picky eating.2

ARFID symptoms in adults

In the adults studied, none were concerned with sensory issues with their food. Instead, those studied reported a lack of interest in eating and fear of negative consequences as their motivation to avoid foods. The feared consequences included:4

  • Nausea
  • Bloating
  • Stomach pain
  • Vomiting

Just like children, adults can be picky eaters, but several qualities will separate a picky eater from someone with ARFID. Adults with ARFID are more likely to:6

  • Experience eating inflexibility. They may choose to eat only certain foods prepared certain ways and at specific times of the day
  • Display food neophobia, which is an intense and irrational fear of new or unknown foods
  • Have a limited food range. Their entire diet may be restricted to 20 or fewer foods.

People can display a variety of signs and symptoms of ARFID in adults like:2

  • Significant weight loss
  • Poor appetite
  • Changes to hair, skin, or nails due to poor nutrition
  • Being tired
  • High stress or anxiety during meals
  • Trouble concentrating
  • Slow eating

Can ARFID develop later in life?

Eating disorders can present at any stage in life. It is possible for an adult to develop ARFID, even if no symptoms of the condition were present during childhood.3

Some issues that could contribute to ARFID developing later in life include:3

  • Genetic factors: Heredity and a family history of eating problems could lead to ARFID symptoms later in adulthood.
  • Health issues: Having food allergies or sensitivities that present later in life can result in people reducing and eliminating foods from their diet.
  • Traumatic events: If someone chokes on food, has food poisoning, or has a socially awkward situation, like having diarrhea in public, food aversions and restrictions could begin as a reaction to these food fears.

Many people will work to cope positively with these situations, while others will struggle with the unwanted impact. ARFID can affect someone at any time.

Developing ARFID graphic

What happens if ARFID is left untreated?

When ARFID is left untreated, the person lacks the levels of nutrition and energy needed to feel and perform well. Physically, socially, mentally, and emotionally, the entire person suffers when ARFID is present.1

Two of the most dangerous risks linked to untreated ARFID are electrolyte imbalance and cardiac arrest because either effect can prove deadly.1 Other risks of ARFID include:2

  • Osteoporosis
  • Anemia
  • Low vitamin levels
  • Kidney and liver failure
  • Digestive problems
  • Anxiety
  • Depression
  • Low self-esteem
  • Social anxiety and isolation

Since these issues are too serious to ignore, an adult with ARFID should seek professional help immediately.

Treatment for ARFID at home

If you or anyone you love is struggling with ARFID, consider reaching out to the treatment professionals at Within Health. Great treatment can lead to great results.

Call us today | (866) 293-0041

How do professionals treat ARFID in adults?

A full evaluation is the best start to the treatment process for ARFID. Once the diagnosis is established, a treatment plan coordinated between mental and medical professionals can begin.

Cognitive behavioral therapy (CBT) and responsive feeding therapy (RFT) are two treatments that show promise.2 CBT can help by exposing adults to feared foods, teaching relaxation skills, and promoting eating changes. RFT works by establishing meal times as a low-stress, distraction-free time to listen and respond to hunger signals.2

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

Resources

  1. Avoidant restrictive food intake disorder (ARFID). (2018, February 22). National Eating Disorders Association. Retrieved April 25, 2023.
  2. Avoidant/Restrictive Food Intake disorder (ARFID). (2023, February 9). NEDC. Retrieved April 25, 2023.
  3. American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.)
  4. ARFID Very Common with Neurogastroenterology Symptoms. (n.d.). Mass General Advances in Motion. Retrieved April 25, 2023.
  5. DSM-5 Changes: Implications for Child Serious Emotional Disturbance. (n.d.). Retrieved April 25, 2023.
  6. Zickgraf, H. F., Franklin, M. E., & Rozin, P. (2016). Adult picky eaters with symptoms of avoidant/restrictive food intake disorder: comparable distress and comorbidity but different eating behaviors compared to those with disordered eating symptoms. Journal of Dating Disorders, 4, 26.

FAQs

Further reading

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