At Edinburgh Therapy Service, we are specialists in eating disorders, including ARFID (avoidant/restrictive food intake disorder). We offer specialised therapy utilizing evidence-based treatments, with a primary focus on cognitive-behavioural therapy (CBT). Our dedicated approach is designed to empower individuals facing ARFID challenges and guide them toward improved relationships with food and overall well-being.
Avoidant Restrictive Food Intake Disorder (ARFID) is a complex and relatively lesser-known eating disorder characterised by a severe and persistent avoidance or restriction of certain foods, textures, colours, or smells, leading to nutritional deficiencies and impairment in daily functioning. Unlike other eating disorders, ARFID’s focus is not on body image or weight, but rather on the avoidance of specific foods due to sensory sensitivities, fears of adverse reactions, or lack of interest in food.
People with ARFID exhibit a range of symptoms, including limited food preferences, avoidance of entire food groups, extreme sensitivity to food textures or smells, and difficulties in trying new foods. These behaviours often result in inadequate caloric intake, which can lead to weight loss, nutritional deficiencies, and compromised physical and psychological well-being. ARFID primarily affects children and adolescents, although it can persist into adulthood.
Genetic factors, sensory sensitivities, and early feeding experiences play a role in its development. Traumatic experiences like choking incidents or aversive food-related events can contribute to the development of strong aversions towards certain foods. Additionally, those with anxiety disorders or neurodevelopmental conditions like autism spectrum disorder are more susceptible to ARFID.
The prospect of recovery for people with ARFID varies depending on the severity of the disorder, the presence of underlying psychological conditions, and the willingness to engage in treatment. Early intervention is crucial, as ARFID can have significant physical and psychological consequences if left untreated. Treatment approaches may include nutritional counselling, exposure therapy to gradually increase food acceptance, cognitive-behavioural therapy to address fears and anxieties related to eating, and sensory-based interventions.
With proper support, individuals with ARFID can learn to expand their food preferences, manage their anxiety, and develop healthier eating habits. However, it’s important to recognize that the recovery journey may be gradual and can vary from person to person.
ARFID mainly presents in three main subtypes:
Sensory-based: Individuals in this subtype experience extreme sensitivities to certain textures, colours, smells, or tastes of foods. These sensitivities can trigger aversions that lead to restricted eating patterns.
Aversions due to trauma: Traumatic incidents involving food, such as choking episodes, can lead to strong aversions. Individuals in this subtype avoid foods that were present during the traumatic event.
Lack of interest/desire: Individuals in this subtype have little interest or desire to eat. They often don’t experience hunger cues and may skip meals or eat very small portions.
Seeking help for ARFID is essential to prevent the worsening of symptoms, nutritional deficiencies, and the potential negative impact on physical and mental health. If you or someone you know is exhibiting signs of ARFID, it’s important to consider seeking professional assistance in the following situations:
Persistent avoidance of foods: If someone constantly avoids certain foods, textures, or entire food groups due to sensory sensitivities, fears of adverse reactions, or aversions, it’s a potential sign of ARFID.
Weight loss or poor growth: Noticeable weight loss or poor growth, especially in children and adolescents, can be indicative of ARFID’s impact on nutritional intake.
Psychological distress: If avoiding certain foods or situations related to eating causes significant distress, anxiety, or impaired daily functioning.
Lack of improvement: If attempts to address ARFID on your own, or through general encouragement, have not led to improvements in eating behaviours.
Coexisting conditions: If there are coexisting conditions such as anxiety disorders, autism spectrum disorder, or sensory sensitivities, these can increase the complexity of ARFID and warrant professional attention.
Concerns about nutritional health: If there are concerns about meeting nutritional requirements, maintaining a healthy weight, or preventing nutrient deficiencies.
Family distress: If ARFID is causing stress and tension within the family.
While research on ARFID is still evolving, cognitive-behavioral therapy (CBT) has been used as a primary evidence-based approach to treat this disorder. CBT for ARFID typically involves gradual exposure to feared or avoided foods, along with addressing the underlying anxiety or sensory sensitivities related to food.
The goal is to gradually expand food acceptance, reduce anxiety related to eating, and improve overall nutritional and psychological well-being.
Our approach to ARFID therapy is centred on fostering gradual and sustainable recovery. Through a combination of evidence-based techniques, including CBT with exposure therapy, we guide clients in challenging their negative thoughts and fears related to food. Our therapeutic process emphasises gradual exposure to avoided foods and textures in a supportive and controlled manner, empowering individuals to reduce anxiety and expand their food choices.
Family involvement is crucial, as we work collaboratively to improve communication, create structured meal plans, and cultivate a positive mealtime environment. By equipping clients with mindfulness strategies, behavioural techniques, and ongoing support, we aim to instil a sense of autonomy and confidence in making healthier eating decisions.
The symptoms of ARFID encompass a range of behaviours and emotional responses related to eating:
Limited food variety: Individuals have a narrow range of preferred foods, often avoiding entire food groups or textures.
Avoidance of certain foods: Aversion to specific colours, smells, textures, or tastes of foods leads to refusal or avoidance.
Weight loss or poor growth: Restricted food intake can result in inadequate caloric intake, leading to weight loss, growth impairment (especially in children), and nutritional deficiencies.
Mealtime anxiety: Intense anxiety or distress is experienced in anticipation of eating, making mealtimes stressful.
Slow eating: Individuals might eat very slowly, taking small bites or chewing excessively.
Food rituals: Engaging in rituals like cutting food into tiny pieces or arranging food in specific patterns before eating.
Dependence on certain foods: Relying heavily on a few select safe foods while avoiding all others.
Physical symptoms: Gastrointestinal discomfort, nausea, or other physical reactions when faced with non-preferred foods.
Lack of interest in eating: Displaying minimal interest or desire to eat, even when hungry.
Social impairment: Difficulties participating in social events or gatherings that involve food, leading to isolation.
Nutritional deficiencies: Deficits in essential nutrients due to a limited diet, causing health issues like anaemia, fatigue, or weakened immunity.
Negative impact on well-being: ARFID can result in emotional distress, reduced quality of life, and impaired functioning in daily activities.
We don’t know the exact causes of ARFID, but multiple risk factors can increase the likelihood of developing the disorder. Some of these include:
Sensory sensitivities: People with heightened sensory sensitivities may find certain textures, tastes, smells, or appearances of food aversive, leading to avoidance.
Early feeding experiences: Negative interactions during infancy and early childhood, such as force-feeding, pressure to eat, or mealtime conflicts, can contribute to aversions and selective eating patterns.
Traumatic incidents: Choking episodes or other traumatic events involving food can trigger strong aversions and anxieties around eating.
Neurodevelopmental factors: Conditions like autism spectrum disorder and ADHD can involve sensory sensitivities and rigidity in routines, which may influence food preferences.
Anxiety and mood disorders: Anxiety disorders, particularly social anxiety or generalised anxiety, can contribute to the avoidance of situations that trigger anxiety, including mealtimes.
Genetics: Genetic predisposition may play a role in the development of ARFID, as some people may have an inherent sensitivity to certain sensory experiences.
Medical conditions: Gastrointestinal issues, reflux, or medical treatments affecting taste and appetite can influence eating behaviours.
Food allergies or sensitivities: Negative reactions to specific foods due to allergies or intolerances can lead to avoidance of those foods.
Cultural and environmental factors: Cultural norms, family food preferences, and social influences can impact food choices and aversions.
Personality traits: Perfectionism, rigidity, and a tendency towards sensory overload might contribute to the development of ARFID.
Psychological factors: Stressful life events, low self-esteem, and emotional challenges can intersect with ARFID development.
The Edinburgh Therapy Service offers both in-person ARFID counselling in Edinburgh (United Kingdom), and convenient online therapy accessible worldwide You can find our exact location here. We specialise in therapy for ARFID disorders, offering a range of evidence-based approaches including CBT with ERP, and customized combinations tailored to your specific needs.
Hello, I’m Cristina, a therapist at Edinburgh Therapy Service, specialising in eating disorders. I’m deeply passionate about delivering evidence-based treatments. While ARFID is a relatively newly discovered disorder, and treatments are still under investigation, cognitive-behavioural therapy (CBT) has shown promise in addressing ARFID. I’m dedicated to working with those who are facing challenges with food issues. My goal is to provide a non-judgmental, safe space where you can explore and make changes at your own pace.
The Edinburgh Therapy Service is a psychotherapy and counseling practice based in Edinburgh, Scotland (United Kingdom). We offer therapy both in-person in Edinburgh and online, available in English and Spanish.
Contact us for more information or to book your first appointment: [email protected]