ARFID is a disturbance in eating often triggered by lack of interest in eating or food. One may avoid specific food items due to sensory characteristics of the food, such as temperature, color, smell, or texture. A persistent concern with potential negative consequences of eating of specific foods may also be present, such as fear of vomiting or choking.
These aversions to food contribute to inadequate nutrition and the body’s energy needs are not met, often manifesting as weight loss in adults and failure to meet growth expectations for children. Significant nutritional deficiencies or medical concerns may also be present and one may develop a dependency on supplements in an attempt to meet nutritional needs.
When someone struggles with ARFID they often have difficulty engaging in daily activities and relationships with others due to these eating behaviors.
AFRID is equally common in male and female infants and children, although when co-occurring with autism spectrum disorder (ASD), is more prominent in males. Research has also suggested that those suffering from ARFID tend to be younger and male, compared to other eating disorders.
Anorexia nervosa is characterized by persistent restriction of food, combined with an intense fear of being fat or gaining weight. There is a disturbance of body-image and irrational thoughts pertaining to one’s body shape and size. Significant effort is also utilized to engage in behaviors that interfere with weight gain, such as excessive exercise and calorie counting. The presence of these characteristics results in significantly low body weight.
There are two subtypes of anorexia nervosa, restricting type and binge-eating/purging type. Restricting type describes when someone is primarily engaging in dieting, fasting, and excessive exercise, whereas binge-eating/purging type consists of eating significantly larger quantities of food in a short period of time compared to most people followed by vomiting or laxative abuse or enemas.
Approximately .3%-.4% of females and .1% of males will suffer from anorexia nervosa at any given time.4 Some studies have suggested a higher prevalence of anorexia nervosa where .9% – 2% of females and .1% and.3% of males will develop anorexia.5
Bulimia nervosa is characterized by recurrent incidences of binge eating consisting of eating significantly larger quantities of food in a short period of time compared to most people. This is combined with an overwhelming sense of lack of control where one does not feel they have the ability to stop eating or control how much they eat.
Binge-eating typically continues until the individual is physically uncomfortable or in pain. Binge-eating is then followed by attempts to offset the eating behavior in order to prevent weight gain. These behaviors are termed purge behaviors and may include vomiting, use of laxatives or enemas, fasting, or excessive exercise. One’s self-evaluation is also unjustifiably influenced by body shape and weight.
Some studies suggest a higher prevalence of bulimia nervosa where 1.1% – 4.6% of females and .1% and .5% of males will develop bulimia. Bulimia nervosa commonly begins in late adolescence or young adulthood. Onset prior to puberty or after the age of 40 is uncommon.
Similar to bulimia nervosa, binge-eating disorder is characterized by recurrent episodes of binge eating consisting of eating significantly larger quantities of food in a short period of time compared to most people. This is combined with distress and an overwhelming sense of lack of control where one does not feel they have the ability to stop eating or control how much they eat.
Binge-eating episodes are associated with at least three of the following:
- Eating much more rapidly than usual
- Eating until feeling physically uncomfortableEating large amounts of food when not feeling physically hungry
- Eating alone because of feeling embarrassed by the amount of food one is eating
- Feeling disgusted with oneself, depressed, and guilty afterwards
Binge-eating disorder has a less defined gap in prevalence between genders compared to anorexia nervosa and bulimia nervosa. Approximately 1.6% of females and .8% of males will suffer from binge-eating disorder at any given time. Some studies suggest a higher prevalence of binge-eating where 3.5% of females and 2% of males will develop binge-eating disorder.
On occasion, someone struggling with an unhealthy relationship with food and disordered eating may not meet every characteristic or behavior described for a particular eating disorder. When this occurs, and behaviors contribute to significant disturbances and difficulty with functioning, an alternative diagnosis of other specified feeding or eating disorder or unspecified feeding or eating disorder may be given.
Sometimes, they may eat non-food objects, which results in a diagnosis of pica. These alternative diagnoses allow for communication of concerns and needs in order to receive effective treatment.