Avoidant/Restrictive Food Intake Disorder

Avoidant Restrictive Food Intake Disorder is a disorder characterized by persistent eating disorders that lead to insufficient nutritional and energy intake. Avoidance or food restriction in some individuals may be based on characteristics such as the quality of the food, extreme sensitivity to its appearance, color, odor, texture, temperature or taste. Individuals with more pronounced sensory sensitivities associated with autism may exhibit similar behaviors. Avoidance or food restriction can also represent a conditioned negative response associated with food intake. Those individuals experience clinically significant difficulties with food that is usually eaten in childhood or adolescence and are not able to eat an adequate amount of calories or nutrients through their usual diet. 

There are many types of eating problems that can justify a diagnosis, including: difficulty digesting certain foods; avoidance of certain colors or textures of food; eating only very small portions of food; lack of appetite; or fear of eating after a frightening episode of choking or vomiting. This disorder brings physical and emotional damage, as it may involve weight loss or failure to achieve expected weight gain or growth in children; nutritional deficiencies, resulting in dependence on enteral nutrition or oral supplements; interference with psychosocial functioning; or anxiety disorders, obsessive-compulsive disorder and neurodevelopmental disorders (specifically autism spectrum disorder, attention deficit / hyperactivity disorder and intellectual development disorders). The symptoms and the family history for the diagnosis must be fully considered, which can be better done in the context of a clinical relationship over time. 

It is still unclear what can lead an individual to not want to eat or to dislike eating almost anything, but it is a fact that food is an extremely complex act, influenced by biological, social, cultural and emotional characteristics, therefore it is essential to let us not forget to consider them when we propose to help someone with difficulties to eat. There are comorbidities that are associated with selective eating behavior, such as anxiety disorder, obsessive and compulsive disorder, autism spectrum disorder, and attention and hyperactivity disorder. This does not mean that individuals who have it have these comorbidities, but that in some cases they may have these relationships. While Avoidant/Restrictive Food Intake Disorder does not yet have a specific treatment protocol, and currently it is a great challenge, there is treatment and it is done in a multidisciplinary way (psychologist, nutritionist, doctor, and/or speech therapist). These professionals need to be trained to meet this specific demand, which requires qualified treatment, in order to have a positive and effective result. 

Food is complex; it is important that professionals are able to identify the causes, so that they can make appropriate interventions. But above all, they need to be aware that they are dealing with a human being who is suffering, thus seeking to alleviate and provide a better quality of life to the patient. 

References: 

https://www.msdmanuals.com/professional/psychiatric-disorders/eating-disorders/avoidant-r estrictive-food-intake-disorder-arfid

https://www.psychiatrictimes.com/view/understanding-and-treating-avoidant-restrictive-food -intake-disorder-children-and-adolescents