Selective Eating Disorder / ARFID
It’s very common, it’s very misunderstood by health care professionals and treatment options are very poor at present. I am seeking to develop better treatment protocols.
As an eating disorder that is somewhat overlooked in our modern society, a selective eating disorder is largely characterized by an aversion or repulsion to a certain food for a number of different reasons.
Many people will consider selective eating disorder to be less of an eating disorder, and will instead consider someone struggling with the condition to simply be a fussy eater—which can be highly damaging for someone who is struggling with the condition.
A selective eating disorder is sometimes referred to as ARFID. It commonly goes undiagnosed for people struggling with the condition, which can make symptoms worse over time.
The causes for selective eating itself are poorly understood, although it can be caused by factors as simple as a dislike of a particular food, that develops into a disorder over time. Some therapsts report that the problem may developed very early in childhood from a near choking experience which develops into a complex phobia.
Incidence of Selective Eating Disorders
Selective eating disorders are hard to estimate in terms of numbers, due to the fact that the condition is commonly overlooked. Indeed, many people wrongly assume that someone who has a selective eating disorder is merely a “fussy eater”—but this is far from the truth and can be highly damaging.
People struggling with selective eating disorders are on the rise in terms of diagnosis of the condition. It is most commonly diagnosed in young children—hence why it is often mistaken for fussiness—and is linked to a number of obsessive habits.
As many as five percent of young children may actually be suffering from this condition, though many do not go diagnosed due to the aforementioned factors surrounding a lack of understanding. It is believed that young boys are at the highest risk of developing a selective eating disorder; however, young girls and older people as well are also at a relatively high risk of developing a form of this condition.
Concerningly, it has been estimated that somewhere in the region of 63 percent of pediatricians and pediatric subspecialists were not familiar with selective eating disorders; this further reduces the number of children who are diagnosed with ARFID.
Symptoms of Selective Eating Disorders
Selective eating disorders are overlooked but can be incredibly serious for someone who is unable to eat certain foods. Indeed, some people may find that they are unable to even let some of these “offending” foods near to their face, due to the repulsion that they cause for the individual.
People who are struggling with a selective eating disorder will often find themselves trying to cope with a number of other conditions that may be affecting their mental health.
These conditions may include anxiety, depression, or social awkwardness and Asperger’s to name a few. People and young children who have a selective eating disorder will commonly avoid an entire food group at a time; this might be fruits, vegetables, pulses, etc.
Unlike with other types of eating conditions, a selective eating disorder is not often characterized by weight loss. The condition does often lead to other mental health conditions developing, though. Often, these are triggered by stress on the part of the individual.
Diagnostic Statistical Manual 5 Criteria for Avoidant Restrictive Food Intake Disorder (ARFID)
An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:
- Significant weight loss (or failure to achieve expected weight gain or faltering growth in children).
- Significant nutritional deficiency.
- Dependence on enteral feeding or oral nutritional supplements.
- Marked interference with psychosocial functioning.
- The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice.
- The eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced.
- The eating disturbance is not attributable to a concurrent medical condition or not better explained by another mental disorder. When the eating disturbance occurs in the context of another condition or disorder, the severity of the eating disturbance exceeds that routinely associated with the condition or disorder and warrants additional clinical attention.
As with all eating disorders, the risk factors for ARFID involve a range of biological, psychological, and sociocultural issues.
- People with autism spectrum conditions are much more likely to develop ARFID, as are those with ADHD and intellectual disabilities.
- Children who don’t outgrow normal picky eating, or in whom picky eating is severe, appear to be more likely to develop ARFID.
- Many children with ARFID also have a co-occurring anxiety disorder, and they are also at high risk for other psychiatric disorders.
Warning Signs and Symptoms
- Dramatic weight loss (though from talking with ARFID sufferers and aprents, this dosnt seem to be very common)
- Dresses in layers to hide weight loss or stay warm (older children and adults)
- Reports constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy
- Reports consistent, vague gastrointestinal issues (“upset stomach”, feels full, etc.) around mealtimes that have no known cause
- Dramatic restriction in types or amount of food eaten
- Will only eat certain textures of food
- Fears of choking or vomiting
- Lack of appetite or interest in food
- Limited range of preferred foods that becomes narrower over time (i.e., picky eating that progressively worsens).
- No body image disturbance or fear of weight gain