ARFID, the acronym version of avoidant restrictive food intake disorder, is defined by an obsessive aversion to eating certain kinds of food. Occasionally called selective eating disorder, ARFID has been recently accepted into the DSM-5 as an official mental health disorder.

It’s much more than “picky eating.” People with ARFID will avoid their disliked food to the point of causing serious health risks including malnutrition.  It’s common for smaller children to be picky, for example refusing to eat broccoli, but as a disorder it can affect young adults and teenagers, affecting their nutrition and post-puberty growth. 

While most children outgrow food pickiness, adults who only eat a limited range of food types may need to seek out professional eating disorder treatment.

Before discussing how to treat ARFID, we should list the ways to identify it.  Please note a doctor or psychologist should be consulted for an official diagnosis, and that can be tricky. False flags of ARFID might include

• A diagnosis of ARFID must not result from cultural values (as in restrictions of pork or shellfish) or lack of access to foods (as in “food deserts”)

• A diagnosis of ARFID shouldn't be confused with the symptoms of another mental health disorder, i.e. anorexia nervosa (in which the individual will barely eat anything)

• A diagnosis of ARFID shouldn’t conflict with another medical reason for avoiding a food, such as a nut allergy or lactose intolerance

In part because of its relative newness as an official eating disorder, and partially because of the difficulty of determining between ARFID and certain kinds of diets, a professional diagnosis is necessary before embarking on specialized treatment.  The good news is, there are various evidence-based therapies available for ARFID and related eating disorders.

Cognitive Behavioral Therapy – A Rational Way to Treat ARFID

CBT is a well-established form of evidence-based psychotherapy that focuses on a back-and-forth process between client and therapist that identifies irrational thoughts and actions and attempts to remove them. It’s especially useful in counteracting the distorted perceptions many eating disorder patients have about their weight and the related self-esteem issues that come with them. 

CBT shows eating disorder patients how powerful an impact their thoughts have on their emotions, attitudes, and beliefs. Validity testing and cognitive rehearsal are central tenets of replacing disordered thoughts with rational ones.

Validity Testing

As treatment progresses for ARFID or another mental health disorder, particularly entrenched thoughts and emotions concerning body image and self-esteem might be challenged with validity testing. The individual in treatment is allowed to defend their viewpoint regarding their eating habits but must support beliefs with objective evidence. 

As an example, if a client refuses to eat potatoes because they think the carbs are making them fat, they would need to show that starches aren’t considered part of a balanced diet with proof from nutritionists and dieticians.

Cognitive Rehearsal

Repetition is the name of the game here. The therapist will ask the individual in treatment to think about a difficult situation that they couldn't cope with productively. They then discuss what choices or actions could have been taken that would have been more positive. By regularly "rehearsing" the implementation of positive thoughts, cognitive rehearsal eventually becomes a habit and those positive ideations can be applied in real-time situations. 

Professional Help for ARFID Is Possible

These aren’t the only possible treatments for ARFID – professionals are working with both new and time-tested methods in clinical and real-life situations.  It’s important to act sooner rather than later if you suspect a loved one has ARFID – picky eating is annoying, but ARFID can be fatal if left untreated for a long period.  Urge your loved one to seek out a session with a therapist who has some expertise in the field – or call an eating disorder treatment center to speak with an admissions specialist. They can get your loved one started on the odyssey that is recovery.

This content was provided by a guest contributor.