Avoidant/Restrictive Food Intake Disorder (ARFID) is one of many feeding and eating disorders categorized in the DSM. These disorders are characterized by persistent disturbances in the consumption/absorption of food, which negatively impact health and psychosocial function.
When most people think of eating disorders, they picture purging/binging or starvation by those who want to lose weight. But there are other disorders, like ARFID, that involve food avoidance, not tied to weight loss.
This condition can significantly impact adults, causing nutritional deficiencies, gastrointestinal problems, and psychosocial issues. Recognizing ARFID symptoms is imperative for early intervention. The sooner you can recognize the need for help, the sooner you can learn to manage your symptoms.
Core symptoms of ARFID in adults
With symptoms of ARFID in adults, the core symptoms of avoidant/restrictive food intake disorder are avoidance or restriction of food intake. This avoidance or restriction is associated with one or more of the following consequences:
- Significant weight loss,
- Significant nutritional deficiency (or related health impact),
- Dependence on enteral feeding or oral nutritional supplements or
- Marked interference with psychosocial functioning
Avoidance Based on Sensory Characteristics
For adults, AFRID signs and symptoms are often related to avoidance behaviors because of sensory characteristics. This means the sensory characteristics of the food. An adult with ARFID might be extremely sensitive to:
- The appearance of food
- The color of food
- The smell of food
- The texture of food
- The temperature of the food
- The taste of food
In some individuals, this avoidance extends beyond the food they are eating and applies to the food that others are eating around them. They might, for example, refuse to eat particular brands of food, or they might be intolerant of the smell of something a colleague or family member is eating.
Fear-Driven Food Avoidance
Other avoidant/restrictive food intake disorder symptoms center on fear-driven avoidance. Fear-driven food avoidance is tied directly to the fear of aversive experiences or anticipation of it. These ARFID symptoms in adults might include:
- Fear of choking on certain foods
- Fear of repeated vomiting because of certain foods
- Fear of a traumatic procedure being required, like an esophagoscopy, because of eating certain foods
Lack of Interest in Food or Eating
Some ARFID eating disorder symptoms are simply a complete lack of interest in eating or in food in general. These are not symptoms related to things like a desire to lose weight but rather a complete lack of interest.
ARFID symptoms analysis
These AFRID symptoms can manifest in many physical and psychosocial issues. Malnutrition can be life-threatening in severe cases.
Nutritional deficiencies and their signs
AFRID symptoms in adults can cause significant nutritional deficiencies.
Shared signs of nutritional deficiencies include the following:
- Weight loss
- Dizziness
- Fatigue
Ongoing nutrition deficiencies can lead to malnutrition. Symptoms can cause physical and mental issues. What are the symptoms of ARFID for those with nutritional issues? Some people might experience symptoms like:
- A failure to thrive
- Slow performance at work or school
- Weight loss
- Muscle weakness
- Loss of muscle
- Dizziness
- Dehydration
- Fatigue
Gastrointestinal symptoms
Other symptoms of ARFID cause gastrointestinal symptoms due to limited food variety. The most common issues are:
- Reflux
- Abdominal pain
- Nausea
- Constipation
These gastrointestinal symptoms can be particularly devastating because they can exacerbate the continued behaviors of food avoidance. If, for example, an adult experiences severe abdominal pain and constipation when eating as a result of their ARFID, they are likely to continue avoiding food because of those secondary symptoms.
Anxiety and stress
Adults who struggle with ARFID can also struggle with anxiety and stress related to eating or food.
In fact, anxiety disorders are the most common comorbidity with ARFID. This means symptoms of ARFID in adults are most likely to cause a secondary anxiety disorder.
The more an individual withdraws socially, engages in specific behaviors like food rituals, and reinforces the avoidant behaviors because of things like gastrointestinal issues, the more likely that same person is to experience high stress and subsequent anxiety surrounding food.
Social withdrawal
Social withdrawal becomes a significant secondary issue with ARFID symptoms in adults, too. For example, those who avoid food may not feel comfortable being involved in social activities that involve food or eating.
Moreover, this can have a negative impact on relationships if someone has issues tolerating the smell or other aspects of other people eating food. Such intolerance is likely to place a strain on close relationships.
Specific behaviors indicating ARFID
Specific behaviors in adults might indicate ARFID, such as excessive food rituals or eating only a very limited range of foods.
Difficulties facing social eating situations
As mentioned, social withdrawal and anxiety can be serious issues related to ARFID signs and symptoms in adults. However, it also leads to difficulties facing social situations where food is involved.
This can lead to social isolation. It can cause people to avoid inviting that same individual to activities, which can not only impact family and intimate relationships but also cause issues at work or school.
Key differences between ARFID and disorders like anorexia and bulimia
ARFID differs from other eating disorders in many ways, but the biggest difference is that weight loss is not a significant aspect of ARFID, whereas it is the central aspect of anorexia and bulimia.
The core symptoms, as a result, are also very different. Someone with ARFID might avoid certain foods, but they avoid them because of intolerance of things like smell or taste, not because they want to lose weight.
With conditions like bulimia, an adult might binge or purge, vomiting after overeating, whereas with ARFID, there is no overeating, and foods might instead be avoided because of a fear of vomiting.
Summing Up
It is important to recognize ARFID symptoms in adults. Without recognizing ARFID signs and symptoms, there can be significant health risks. If you or someone close to you is struggling with eating-related issues and subsequent health issues, don’t be reluctant to seek help and acknowledge symptoms. With awareness, understanding, and support, you can get the help you need if you are experiencing ARFID.