As a hypnotherapist with a deep specialism in treating functional digestive disorders I have encountered a lot of people with ARFID in my career. So, what is ARFID? ARFID is a condition in which a person avoids certain foods or eats insufficiently in general.
What is ARFID – Clinical criteria
Diagnostic criteria this is primarily a tool for clinicians and researchers, but you may my brief summary of the full criteria useful.:
- Avoidance of food; this may be general (all foods) or specific (just fruits for example) which leads to malnutrition.
- Malnutrition in this context may mean weight loss, vitamin deficiency or in more extreme presentation.
- Impacts can also be described in terms of psychological or social ability to function. An example of this would be the inability to take part in family mealtimes.
- The symptoms need to have no other explanation, such as illness, anorexia nervosa, or cultural practice.
There is an implied assumption that the person with ARFID has developed it due to an anxiety regarding the food. Typical examples I have encountered over the years include;
- Choking anxiety. The person who suffers from this will avoid foods which appear to have a higher risk of choking due to size, density, texture. Alternatively, they will avoid foods where they have previously experienced choking. Most likely both.
- Sensory discomfort. Most people have some foods which they dislike to eat. If a person is pressured into eating those foods their dislike may intensify. Once an anxiety for one type of food has been established it will tend to generalise to similar foods over time.
A third major cause does present;
- Lack of hunger. Slightly different to the other two in that it is an absence of desire rather than the presence of an active counter force (anxiety). However, the social pressure to eat particular foods at particular times whilst not hungry can result in aversions building.
All of the above appear to more pronounced among people who are neurodivergent. This is believed to be due to factors like increased sensitivity and neurological persistence.
Other issues which may present as ARFID
There are many conditions which can present as ARFID, or be an alternative cause of similar symptoms;
- Gastrointestinal issues such as; acid reflux and allergic sensitivity in oesophagus; delayed gastric emptying, swallowing difficulties due to physical changes in the mouth and oesophagus and more.
- Other psychological conditions, such as; anorexia nervosa, bulimia nervosa, pica, rumination disorder and certain presentations of OCD, especially around contamination.
Numerous other physical issues can be present. It is best to rule out potential medical causes before seeking psychological help for ARFID. For this reason;
It is advised that you visit the doctor before seeking psychological help.
Assuming that there is no medical concern, what might a hypnotherapist do to help you?
The Author
Dr Matt Krouwel PhD is a hypnotherapist in Birmingham (UK) with a specialism in digestive and anxiety disorders. He has over 25 years experience of working with clients and patients and is a member of both the BSCH and NCH