This eating disorder hides behind routine and fear and many suffer in silence without a name for it
In recent years there has been increasing talk about ARFID, which stands for Avoidant/Restrictive Food Intake Disorder: a still little-known but steadily growing eating disorder, especially among adolescents and young adults. Unlike anorexia and bulimia, ARFID is not related to a desire to lose weight or alter one's body, but rather to a strong aversion to certain foods, tastes or textures. Sufferers tend to drastically limit their diet, to the point of consuming only a few foods that are considered "safe".
What may seem like simply "being picky" often hides a deep-seated discomfort that can affect both physical health and psychological well-being. Recognizing and understanding ARFID is the first step in addressing it consciously and restoring balance to one's relationship with food.
How ARFID manifests itself
ARFID differs from other eating disorders in its origin and motivation. It is not related to weight or body image, but to fear or disgust of certain foods or eating situations.
People with ARFID may:
- Avoid foods for fear of choking, vomiting or feeling sick
- Reject foods because of color, smell or texture
- Limit themselves to a few "acceptable" dishes, such as white pasta, bread, chips or yogurt
- Experiencing intense anxiety in social settings involving food
- Exhibiting nutritional deficits due to a too restricted diet
In many cases, the disorder appears during childhood, but can persist into adulthood if not recognized and treated appropriately.
The causes: between anxiety, sensory sensitivity and trauma
The origins of ARFID are multifactorial and often complex. There is no single cause, but an intertwining set of biological, psychological and environmental factors:
- Sensory hyper-sensitivity: some people experience smells, tastes or textures much more intensely, making it difficult to tolerate certain foods.
- Traumatic food-related experiences: such as a choking or vomiting episode, can trigger food refusal.
- Anxiety or autism spectrum disorders: ARFID is more common in those with cognitive rigidity or difficulty handling sensory stimuli.
- Family habits and social pressures: in some cases, an overly rigid environment or excessive focus on food can contribute to reinforcing the disorder.
Recognizing these signs is essential to intervene before ARFID impairs physical or relational development.
Consequences for health and daily life
Limiting one's diet to a few foods can have serious health consequences. Deficiencies in vitamins, minerals, iron, and protein cause weakness, lowered immunity, and, in younger people, can slow growth.
However, the effects of ARFID are not only physical. The disorder also profoundly affects the social and emotional sphere: dinners, trips or convivial moments become sources of stress and embarrassment. Over time, sufferers are likely to isolate themselves, developing anxiety, guilt or depression.
Many people describe feeling "different" or "difficult", trapped in a cycle of rejection and fear. This is why an empathic and multidisciplinary approach, combining the work of doctors, psychologists and nutritionists to rebuild a calm and safe relationship with food, is essential.
How to treat ARFID
The good news is that ARFID can be successfully treated, provided it is recognized early. The most effective therapies combine psychological support and nutritional rehabilitation.
The course of treatment may include:
- Cognitive behavioral therapy (CBT), to reduce anxiety and change food-related beliefs
- Gradual exposure to avoided foods, under the guidance of a specialist
- Individualized nutritional support, to replenish missing nutrients
- Family involvement, especially in children and adolescents, to create a calm and pressure-free eating environment
The goal is not to "eat everything," but to regain a balanced relationship with food, based on safety and curiosity, not fear or disgust.
ARFID: an eating disorder not to be underestimated
ARFID is not simply an "eating fixation", but a complex and real disorder that requires attention, empathy, and a targeted course of treatment. The challenge is not only medical, but also cultural: learning to distinguish between normal being selective at the table and eating behavior that becomes limiting and painful.
With cases on the rise in Italy as well, talking about ARFID means doing prevention and spreading awareness. Understanding this disorder is the first step to help those who, every day, face food not as a pleasure, but as a source of fear. Only through information and listening is it possible to restore balance and serenity to the relationship with food.
Daniele Mainieri
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