What is ARFID? (July 2014)
In March 2014 I had the opportunity to attend ICED which is the International Conference on Eating Disorders. Out of the many sessions I was planning on attending this session was the one that I was most excited about. This session was presented by Rachel Bryant-Waugh who is one of the key individuals to come up with this new diagnosis.
ARFID is Avoidant-Restrictive Food Intake Disorder and this new term is currently in the most recent edition of the DSM-5. This eating disorder has replaced the term Feeding Disorder of Infancy or Early Childhood and it is not limited to children. ARFID is a diagnosis that can affect kids, adolescents and adults.
The way an individual is diagnosed would be by the following criteria: The client fails repeatedly with weight gain (usually a child is not moving forward on the growth grid), low weight or a significant weight loss over one month. Also the child may have a lack of interest in eating or is bothered by some sensory characteristics of food such as smell, taste, texture and appearance. The second way a person would be diagnosed is that the lack of intake of food interferes with some psychosocial development. The third way is the individual would have a nutritional deficiency such as being deficient in Zinc, Iron, and Vitamin B-12 just to name a few vitamins and minerals let alone protein. The final way an individual would be diagnosed is that the client would require an alternate feeding such as supplementing his/her diet with an enteral feeding (tube feeding) or oral nutritional supplement (Ensure/Orgain).
This diagnosis is not to be confused with anorexia nervosa as the individual does not have a body image issue or is scared about weight gain. The client does not have any weight or shape concerns. The problem is often due to some type of trauma such as the fear of choking or vomiting since this may have happened before. It is also seen that the client may have rumination disorder (regurgitate food).ARFID could certainly turn into anorexia nervosa but the two eating disorders are not the same. The best way to describe this eating disorder is it is associated by energy needs and nutritional needs.
Since this is an eating disorder it is recommended that this client be referred to a registered dietitian who can help address their nutritional needs, find foods that offer a safe texture, smell and consistency. Upon evaluation the client could possibly benefit from therapy during the process of restoring their nutritional status.
Finally it is important to point out that is does not matter what the client is eating, but that the client is eating to improve their nutritional status.
References:
1. ICED 2014 Rachel Bryant-Waugh
2. Bryant-Waugh, R., Markha, L. Kreipe, R. E., & Walsh B. T (2010). Feeding and Eating Disorders in Childhood. International Journal of Eating Disorders, 43: 98-111.
