Gender-Inclusive ARFID Treatment and Therapy

Outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), ARFID differs from other eating disorders like anorexia nervosa and bulimia nervosa in that it is not driven by concerns about body image or weight. Despite this distinction, ARFID presents significant risks, such as malnutrition, medical complications, and disruptions in daily life and relationships. Therefore, addressing and treating ARFID is crucial to improving the quality of life of individuals who are facing these challenges. 

ARFID was introduced in the DSM-5 in 2013, replacing the previous category of feeding disorder of infancy or early childhood and eliminating age restrictions. 

Because ARFID is a relatively new classification, research on and understanding of the condition are still in their early stages. 

The DSM-5 lists the following criteria for diagnosing ARFID: 

• Significant changes in weight or delayed growth in children and adolescents 
• Nutritional deficiencies or related health complications 
• Reliance on feeding tubes or dietary supplements 
• Interference with daily life and relationships 

Individuals who are struggling with ARFID may avoid or restrict food because they: 

• Don’t like its taste, smell, or texture 
• Aren’t hungry or have no interest in eating 
• Are afraid that something bad will happen if they eat, such as choking or vomiting 

Because of these characteristics, some people may falsely believe that ARFID is merely picky eating or a phase children will outgrow. These misconceptions hinder awareness efforts and prevent individuals from receiving the support they need.  

While the symptoms of ARFID typically start in childhood, they can persist into or emerge in adulthood. Without treatment, the condition poses significant health risks.  

At Carolina House, we are committed to helping our clients overcome these challenges, paving the way for a brighter future.  

Individuals who are suffering from ARFID may: 

• Avoid certain foods based on sensory characteristics 
• Eat very slowly or only in small amounts 
• Rely on specific brands or types of food 
• Have no interest in eating  
• Lose their appetite 
• Feel distressed when eating with others  
• Associate food with negative emotions, such as fear and anxiety 

Physical symptoms may include: 

• Weight loss 
• Irregular menstrual periods 
• Dry skin, hair, and nails 
• Muscle aches 
• Constant fatigue and low energy 
• Digestive issues 
• Frequently feeling cold 
• Poor sleep quality 
• Weakness or fainting 
• Dehydration 

If you or someone you know is displaying any of these signs or experiencing these symptoms, it is essential to seek the guidance of a professional who can determine an accurate diagnosis and provide appropriate treatment.  

The causes of ARFID are not fully understood. However, the National Library of Medicine determined the following risk factors: 

• Genetics: The chance of inheriting ARFID is as high as 79%, making it one of the most genetically influenced eating disorders. 
• Co-occurring conditions: Individuals who suffer from anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), or autism spectrum disorder may be more likely to develop ARFID.  
• Gender: While ARFID can affect anyone, it appears to be more prevalent in males.  
• Early childhood experiences: Experiencing food-related trauma in childhood, such as choking, might trigger ARFID symptoms. 

Since its recent classification, ARFID remains an area of ongoing research. The National Library of Medicine concluded the following based on the results of an ARFID screening tool:  

• Prevalence: Nearly 5% of individuals who completed the screening reported symptoms of ARFID. 
• Populations and ages affected: ARFID seems to be more common among young people, males, and Hispanic populations. Notably, 57% of those who showed signs of ARFID were ages 18-24, which is the second highest prevalence among all eating disorders, just behind anorexia nervosa at 62%. 
• Treatment seeking and accessibility: Only 47% of individuals who screened positive for ARFID planned to seek support, with a mere 2% initiating treatment. Barriers such as financial constraints, lack of awareness, and insufficient treatment options contribute to these low numbers. 
• Symptoms: The most common symptom was a general disinterest in eating (80%), followed by food restriction due to sensory issues (55%) and avoidance of eating triggered by fears like choking or vomiting (31%). 
• Suicidal ideation: Alarmingly, nearly 35% of individuals who experienced the symptoms of ARFID also reported having thoughts of suicide. 

Additionally, ARFID often co-occurs with other conditions, like anxiety disorders, attention-deficit/hyperactivity disorder, and autism spectrum disorder. 

These findings highlight the complex nature of ARFID and the urgent need for broader support and understanding in addressing this condition. 

Untreated ARFID can lead to significant health risks, such as: 

• Heart problems 
• Electrolyte imbalances 
• Liver, pancreas, and kidney damage 
• Infertility and complications during pregnancy 
• Delayed growth in children 
• Gastrointestinal disorders 
• Bone loss 
• Metabolic imbalances 
• Loss of muscle mass 
• Weakened immune system 
• Chronic stress 
• Development of other eating disorders or mental health conditions 
• Social isolation and strained relationships 

These examples illustrate the potential life-threatening consequences of ARFID. However, with early intervention and effective treatment, those who are suffering from ARFID can heal and thrive. 

As described in the “Signs & Symptoms” and “Potential Consequences” sections, ARFID can diminish a person’s overall well-being. 

Benefits of receiving ARFID treatment at Carolina House can include: 

• Nutritional rehabilitation: Receiving the necessary nutrients to restore physical health 
• Therapeutic support: Addressing underlying emotional and psychological concerns that contribute to ARFID 
• Life skills: Developing healthy eating habits and effective coping mechanisms to manage anxiety and fear related to food 
• Community and connection: Fostering a sense of belonging through peer support groups and family involvement  

These aspects of treatment are designed to empower clients on their path to healing and help them find resilience. 

At Carolina House, we offer a range of therapies tailored to meet the unique needs of clients who are struggling with ARFID. These include: 

• Individual and group therapies: Supportive settings where clients can discuss challenges and develop strategies to improve their mental health 
• Family therapy: Educational sessions in which family members can learn how they can support their loved ones during the healing process  
• Experiential therapies: Activities such as cooking classes, gardening, and art therapy that promote emotional and physical well-being 

Clients may also participate in evidence-based practices like: 

• Dialectical behavior therapy (DBT): Individuals learn how to regulate their emotions, develop healthy coping skills, and practice mindfulness. 
• Cognitive behavioral therapy (CBT): Clients identify and change their distorted beliefs about food, eating, and body image. 
• Exposure and response prevention (ERP): Those who participate in this therapy confront anxiety-provoking foods or eating situations to gradually reduce their fears and cultivate a healthier relationship with nourishment. 
• Acceptance and commitment therapy (ACT): Individuals learn to accept their thoughts and feelings instead of fighting them.  
• Motivational interviewing: Clients learn to make positive behavior changes and take an active role in their healing journey. 

Treatment for ARFID extends beyond therapy to include education and resources, helping clients maintain their progress and embrace a healthy lifestyle after leaving our care.  

Choosing Carolina House for ARFID treatment means receiving comprehensive support in a nurturing setting. We offer the following key features: 

• Client-centered approach: We provide individualized care, creating customized treatment plans for each client’s specific requirements.  
• Holistic support: Through medical, nutritional, and therapeutic services, we aim to address all aspects of wellness.  
• Continuum of care: We offer multiple levels of support, including residential, inpatient, and outpatient options, so that we can meet each client where they are on their healing journey.  
• Unique residences: Our Homestead, Estate, and soon-to-open Cottage residences each offer distinct amenities and environments. Clients can enjoy activities like walking in the woods, gardening, and relaxing in outdoor spaces, helping them connect with nature, themselves, and others.  

At Carolina House in Durham, North Carolina, we understand that seeking help for an eating disorder can feel daunting, but you don’t have to fight this battle alone. Our compassionate team is here to help you find healing and step into a future filled with hope and limitless possibilities.