Unlike anorexia, avoidant restrictive food intake disorder (ARFID) does not involve a fear of weight gain. Learn more about the differences between ARFID and anorexia.
Most people have likely heard of anorexia, but few may be aware of avoidant restrictive food intake disorder (ARFID). ARFID was previously calledselective eating disorderand is characterized by extreme limitations in the types and amounts of foods consumed. The disorder was initially recognized in children, but diagnostic criteria have since beenupdatedto recognize ARFID across the lifespan. A diagnosis of ARFID can include several different types of the disorder; however, it must involve significant distress or complications that require medical attention. Although they seem similar, there are keydifferences between ARFID and anorexia.
Differentiating ARFID and Anorexia
Some people may confuseARFID and anorexiaor use the terms interchangeably, as both disorders are based on the extreme restriction of food. However, ARFID does not include a fear of being fat or distress about weight, body shape or size. This distinction is important in determining the type of treatment that is appropriate.
Presentation of ARFID
Overall,ARFIDmeans that a person severely avoids or restricts food. However, there are several different ways that ARFID can present, such as:
- Sensory sensitivity, where people avoid foods of certain types or textures, such as meat, fruits or vegetables
- Avoidance of certain foods or food altogether after choking or vomiting
- Restriction or avoidance of food due to low appetite or general disinterest in eating
In all cases, ARFID has a significant impact on a person’s health, leading to malnutrition, poor growth and low body weight. Differentiating betweenARFID symptomsand types is critical to understanding and treating the causes of each disorder.
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Anorexia Characteristics
In contrast to ARFID,thesigns and symptoms of anorexiaare underpinned by an extreme fear of weight gain.Key characteristicsof anorexia include avoidance of food, restriction of energy intake, fixation on weight loss and extreme psychological distress related to body shape and size. The psychological component related to fear of weight gain is an important distinction in theclinical presentation of anorexia.
Populations Affected
The populations affected by ARFID vs. anorexia can vary widely. Initially, ARFID was recognized as extreme picky eating intoddlers and childrenbut is now recognized in adults as well. The age of onset for ARFID is typically in childhood, and although more boys are diagnosed with ARFID than anorexia,rates of ARFIDremain higher in females.
In contrast,the age of onset of anorexiais usually during adolescence and is substantially more common in females compared to males. Anorexia may be more likely than ARFID to persist into adulthood. People with both ARFID and anorexia often experience otherco-occurring mental health conditions.
Treatment Variations
While ARFID and anorexia share some similarities, the two conditions also have many differences. Because of these, it’s crucial that people seek an accurate mental health diagnosis and specialized treatment for their condition.
ARFID Treatment
As a relatively new disorder, there are fewer specific treatment recommendations for ARFID. However, based on thedifferent presentations of ARFID, treatment strategies may vary. For example:
- Avoidance of food based on a traumatic experience may benefit from cognitive treatment strategies to address fears
- Food restriction with extreme weight loss might be helped by behavioral strategies, including re-feeding or supplementation
There is ongoing research to understand the besttreatments for ARFIDto improve outcomes and reduce treatment duration.
Anorexia Treatment
Treatment for anorexiais similar to ARFID butmust addressunderlying fears of weight gain as well as restrictive eating. Anorexia treatment options can include:
- Family therapy
- Cognitive behavioral therapy
- Re-nourishment and nutrition counseling
Including multiple anorexia treatments in a recovery strategy may be beneficial.
Related Topic:Atypical anorexia
Long-Term Prognosis
Thelong-term prognosis for ARFID and anorexiacan differ, based on the additional psychological fear of weight gain in anorexia. In ARFID, it is possible that children may outgrow their disorder, as their tastes and aversions may change as they age. Recovery from anorexia may requireintensive therapy or inpatient treatment. Both full and partial recovery from anorexia are possible, and successful treatments can help reduce the risk of further health complications.
For both ARFID and anorexia, recovery can be impacted by health complications related to malnutrition or other mental health conditions related to disordered eating. In general, recovery rates appear to be higher in ARFID compared with anorexia.
Key Differences: ARFID vs. Anorexia
Although they have similar features, ARFID and anorexia are distinct disorders with unique symptoms and treatments.
- ARFID involves extreme restrictive eating based on aversions, low appetite or disinterest in eating
- Anorexia is characterized by an underlying fear of weight gain
- ARFID typically begins at a younger age and affects more males than anorexia
- Treatments for ARFID and anorexia overlap, but anorexia may require additional psychological treatments to address fear of weight gain
Treatment for both ARFID and anorexia can lead to significant improvements in quality of life and health outcomes. If you or someone you care about are suffering from disordered eating related to a substance use disorder, contactThe Recovery Villagetoday to discuss available treatment options.
