ARFID: AVOIDANT/ RESTRICTIVE FOOD INTAKE DISORDER

In the current diagnostic DSM-5 manual, ARFID is detailed in the eating disorders section. ARFID is being presented as a new diagnosis as of the 2015 edition.  It is reserved for people who are clearly struggling with food and eating issues, but do not fit the criteria for anorexia, bulimia, or binge eating disorders.
Individuals might refuse to eat certain textures or colors of food, have trouble digesting certain foods, will only eat small portions at one sitting, are fearful of vomiting or choking, or have no appetite. 
In the DSM-V, ARFID is an eating or feeding disturbance that manifests as a chronic failure to satisfy energy or nutritional needs associated with at least one of the following:

• A significant deficit in nutrition.
• Significant loss of weight, not achieving expected weight gain, or the absence of normal physical development.
• Disruption in psycho-social functioning.
• Reliance on enteral feeding (e.g., feeding tube) or oral nutritional supplements.  

 The eating problem cannot be owed to the unavailability of food or to a culturally sanctioned food observance. ARFID is not accompanied by a distortion of one’s weight or body shape and is not concurrent with symptoms of anorexia or bulimia. An ARFID eating problem must be unrelated to a medical condition and not better explained by a different psychiatric disorder.
Though ARFID typically begins in childhood, it can persist into or begin during adulthood. For treatment, children and adults usually receive behavioral therapy such as gradual exposure to the avoided foods, and are also assessed for possible underlying symptoms of depression or anxiety.
It is good to be aware of ARFID, but having it is uncommon. Most children, and some adults, go through periods marked by strange eating patterns, such as only wanting hot dogs, or refusing to eat fruit. These patterns usually resolve themselves without professional intervention.   As a result of the eating problem, the person isn’t able to eat enough to get adequate calories or nutrition through their diet. There are many types of eating problems that might arise – difficulty digesting certain foods, avoiding certain colors or textures of food, eating only very small portions, having no appetite, or being afraid to eat after a frightening episode of choking or vomiting.
 As ARFID is officially still a new diagnostic category, there is little data available on its development, disease course, or prognosis. We do know that symptoms typically present in infancy or childhood, but they may also present or persist into adulthood.
Complications associated with ARFID have risks which include:

• Cardiac complications
• Heart
• Kidney and liver failure
• Bone density loss/osteoporosis
• Anemia
• Electrolyte imbalances
• Low blood sugar
• Constipation
• Bloating and other gastrointestinal issues.

ARFID is more than just “picky eating”; children do not grow out of it and often become malnourished because of the limited variety of foods they will eat. 
ARFID (Avoidant Restrictive Food Intake Disorder) is one of the new additions to the DSM, and still has that unique strange affliction stigma attached to it. Even among the medical and psychiatric community, it is poorly understood.

I have known of my diagnosis for 3 years and it is not easy to handle. People tell me "just eat."  It is not as simple as that. I can be repulsed by everything in my house and turn to milk to substitute for food.  Sometimes it is just a color or texture, a smell or shape, or my "mind" says that nothing can be put into my mouth.  I do not know why, or how to overcome it. I am hoping to find the right help and make myself healthier, as going this way is definitely going to cause an early death.  It scares me. Right now dealing with healing from a surgery on my left knee to replace it after being laid up for 2 months is my focal, but regaining strength and handling the eating problem so my body will be healthier and the diabetes better is also a goal. I am 64 and need to do this.  One doctor told me that my body hangs on to everything bad as it does not know when I will give it the food it needs, and also overproduces the wrong chemicals in my body, like insulin.  It is all out of wack from starving.
I pray I get the right kind of help and solve this life-long problem.