ARFID in Adults
Eating disorders affect people of all ages. While there are some diagnoses that are more common among certain age groups than others, this doesn’t mean that people outside of those age groups don’t get those eating disorders.
Avoidant restrictive food intake disorder (ARFID) is an eating disorder that’s commonly associated with young children and adolescents. This association makes sense, given that ARFID symptoms do tend to set in by age 12—but adults can and do develop ARFID as well, and the disease is equally serious regardless of a person’s age. Learning to recognize and treat ARFID in adults is an important step toward getting everyone who’s struggling the care they need.
Read on to learn more about ARFID, how it affects adults, and what adult ARFID treatment looks like.
What is ARFID?
The definition of ARFID is the same for all ages. ARFID is an eating disorder characterized by not eating enough food, enough variety of food, or both, to the extent that it negatively impacts a person’s health and life.
People of all ages have foods they don’t like, but ARFID goes beyond mere preferences or picky eating. Those with ARFID severely restrict how much or what they eat, and often have a very short list of acceptable foods (a list tends to grow shorter, not longer, over time). This limited food intake can cause nutrient deficiencies and malnourishment, among other physical health issues, and interfere with a person’s ability to live and enjoy life. Underlying causes of ARFID
Unlike other eating disorders, people with ARFID don’t restrict their food intake out of body image issues or a fear of weight gain. Instead, they may avoid or restrict food for other reasons, including:
- Sensory sensitivity to tastes, textures, smells, and temperature
- Fear of choking, allergic reactions, or sickness (often after a traumatic event involving one of these outcomes)
- Lack of appetite or interest in food
Signs of ARFID
Regardless of a person’s age, signs of avoidant restrictive food intake disorder include:
Significant weight loss or lack of expected weight gain
Severely limited variety of foods eaten
Eating a very small amount of food
Difficulty trying new or unfamiliar foods
Sleep problems
Concentration issues
Heavy dependence on nutritional supplements
How ARFID affects adults
Approximately 3.2% of children have ARFID, which accounts for up to 22% of children being treated for an eating disorder. On average, symptoms of the disorder appear by age 12, though children as young as six or even younger can be diagnosed with ARFID.
But adults get ARFID, too. According to data from one study, ARFID may account for 9.2% of all eating disorders in adults.
Although eating disorders rarely emerge from a singular cause, people may develop ARFID symptoms after an adverse food-related event, like a foodborne illness, an allergic reaction, or choking. Since food-related trauma can occur at any age, this is often what triggers ARFID in adults.
Though ARFID can be particularly scary in young people who are growing and developing, ARFID poses health risks to adults as well. People of any age with ARFID are at high risk of malnutrition, because they’re either not eating enough to give their body the nutrients it needs, or they’re missing specific key nutrients because of the limited variety of foods they’ll eat. This malnutrition can lead to serious medical issues, including heart problems, hormonal disruptions, and weakened bones.
Co-occurring conditions
While eating disorders are mental illnesses on their own, it’s common for people with ARFID to also have co-occurring conditions, including anxiety and mood disorders. ARFID also commonly co-occurs with neurodivergence; there’s significant overlap between those with ARFID and those with autism or ADHD.
9.2%
ARFID may account for 9.2% of all eating disorders in adults
Treating ARFID in adults
1. Diagnosis
The first step toward treating ARFID in adults is to get a formal diagnosis. This can be challenging, since ARFID is a little-known condition to begin with and those who are aware of it tend to associate it with younger people. That’s why it’s important to consult with an eating disorder specialist who understands the nuances of ARFID and the fact that it can affect adults as well as kids. If you’ve noticed concerning signs and symptoms in yourself or an adult close to you, don’t wait to get a professional assessment (learn more about ARFID symptoms here).
2. Weight restoration and nutritional rehabilitation
For both adults and children with ARFID, the next step of treatment is weight restoration and nutritional rehabilitation. When your body is malnourished, your mind can’t function properly, making it nearly impossible to make real progress in other areas of recovery. Not all adults with ARFID are underweight, in which case weight restoration isn’t needed, but usually there are still nutrient deficiencies to address. This can be done with nutritional supplements at first.
3. Weight restoration and nutritional rehabilitation
The next step of ARFID treatment is to normalize eating habits and increase food variety. With the support of your treatment team, you’ll slowly incorporate different foods and learn how to manage any fears you have around them. You’ll also learn healthy coping strategies for reducing anxiety and plan how you’ll manage your ARFID symptoms in the future.
Therapy plays a large role in treatment for adults with ARFID
Unlike other eating disorders, people with ARFID don’t restrict their food intake out of body image issues or a fear of weight gain. Instead, they may avoid or restrict food for other reasons, including:
Cognitive behavioral therapy for ARFID (CBT-AR)
Exposure and response prevention (ERP)
ERP helps you reduce food fears and increase food variety by providing a safe space to try new foods and anxiety-producing foods. Through ERP, you’ll face the distressing feelings caused by certain foods at incremental levels, building your resilience and self-efficacy and slowly reducing food anxieties.
At Equip, you bring your village
Support from your loved ones is essential to achieve and maintain recovery, which is why we encourage adults with ARFID to bring friends, family, or chosen family into the treatment process. At Equip, we provide these support people with education, psychotherapy, and a dedicated mentor who has also helped someone through eating disorder recovery.
Recovery is possible
Having an eating disorder can feel isolating, and adults with ARFID may feel particularly alone. But with the right support, it’s possible to build a better relationship with food, one that lets you live your happiest, fullest life.
Our virtual model means that you start getting help right away, and fit treatment around your life, rather than the other way around.
Get in touch with our team today to learn more about treatment for adults with ARFID at Equip. 
References
1. Nakai, Yoshikatsu, et al. “Characteristics of Avoidant/Restrictive Food Intake Disorder in a Cohort of Adult Patients.” European Eating Disorders Review, vol. 24, no. 6, 2016, pp. 528-30. https://doi.org/10.1002/erv.2476.