ARFID, which stands for avoidant/restrictive food intake disorder, is an eating disorder that involves eating less food than what is needed to nourish the body to function properly. Sometimes called extreme picky eating, ARFID is typically seen in children but can persist into adulthood if not treated. (1,2)
People with ARFID tend to avoid eating certain foods, because they don’t like the smell, texture, or taste of something or are afraid of choking, nausea, or vomiting. They may not like tomatoes, because they feel slimy in their mouths, or peaches because they feel prickly on their tongues. They may gag at the smell of fish. They may not eat meat, because they find it too hard to chew and swallow and think they’ll choke. They often have little interest in food and get full quickly..
While they may only eat a limited number or amount of foods, people who have ARFID do not have negative body image or fear of weight gain issues. (1,2)
Most parents grow accustomed to their child being a picky eater or having neophobia, which is when the child refuses to try new foods. In fact, up to 46% of children struggle with picky eating, with one in ten having extreme picky eating. (2) But children with autism and other developmental disorders are five times more likely to have an eating concern than non-autistic developing peers. (2) Children with autism have sensory processing issues and often have aversions to certain textures,tastes, and smells.
Autistic children are sometimes unable to properly interpret internal body states of hunger or fullness. This is called interoception. They may struggle with heightened anxiety surrounding food, but cannot properly express their feelings. This adds to their social-communication anxiety, which can make meal times even more stressful. (5)
There may be a genetic component, as well. A recent study published in Frontiers in Psychiatry revealed a strong genetic link between autism and ARFID. Their estimates revealed that up to 17% of parents with affected children also had ARFID, illustrating the lifelong risk of developing disordered eating. (2)
The most common presentations of ARFID in those who have autism include: (2,5)
As a result of all these factors, children with ARFID and autism most often present with vitamin deficiencies from eating a micronutrient poor diet. Some of the most common deficiencies include: (4)
If a child with autism has ARFID, it’s important to have regular blood work performed to ensure they do not develop a serious vitamin deficiency. Symptoms can be difficult to detect until they reach a critically low level.
If you or someone you care about is looking for help in overcoming an eating disorder, we are here to help. The clinical care team at Within Health have created a clinically-superior eating disorder treatment program that happens virtually, through our app. Call our admissions team today to get started.