Avoidant/Restrictive Feeding Intake Disorder
At Mind Body Health, we treat avoidant/restrictive feeding intake disorder (ARFID) in children, adolescents, and adults.
ARFID often begins in childhood, but can be prolonged into adulthood if not treated early on. Clients struggling with ARFID often have difficulty swallowing foods or digesting foods not for organic reasons, but psychological reasons (mainly anxiety). They often have had a negative experience or have a fear of vomiting, choking, or having food poisoning around the food that they avoid. Many clients with ARFID may have difficulty with eating foods that have different textures, smells, or tastes than the foods they are used to eating. Clients with ARFID may only eat a very select few foods that they feel comfortable around. This can lead to nutritional deficiencies or lack of adequate weight gain for children if they are not eating enough in quantity and quality.
Treatment for ARFID involves cognitive behavioral therapy (CBT) and mindfulness training for clients of all ages. With CBT, we will work on helping clients learn relaxation strategies to manage their physiological anxiety response to new foods. We will also work on addressing the anxious thoughts by using mindfulness training. Instead of getting caught up in the anxious thoughts about food, clients will learn to shift their attention to think more about the taste, texture, and flavor of food. In this way, clients connect more with food instead of avoiding it. In treatment, we create a hierarchy where we gradually expose clients to difficult or challenging foods they may be avoiding.
Treatment also involves family members of young children. Parents will learn not to cater specifically to what the client prefers in terms of food, but learn techniques that help foster trying new foods vs. reinforcing the avoidance of different foods. Families will learn to eat together at the dinner table with no other distractions to help facilitate connection with food vs. being distracted from the experience of food.
Lastly, another important part of therapy with clients suffering from ARFID is assessing for other forms of anxiety. Often if there is a diagnosis of generalized anxiety disorder or trauma, for instance, food can be a mechanism used to help clients feel more in control of their day-to-day environment and their emotions. Helping clients feel better about managing their anxiety creates less of a need to depend on control of the food that they eat. This will help foster exposure around new foods.