Understanding and Overcoming Avoidant/Restrictive Food Intake Disorder

When people talk about eating disorders, they usually are referring to the ones most people are familiar with.

Anorexia: extreme food restriction, intense fear of weight gain, and a distorted body image.

Bulimia: cycles of binge eating followed by purging through vomiting, laxatives, or excessive exercise to avoid weight gain.

Binge Eating: eating large quantities quickly, usually followed by shame.

But another disorder is lesser known but can be just as devastating.

Avoidant/Restrictive Food Intake Disorder: This is an eating disorder in which someone avoids certain foods in an extreme manner, which can lead to nutritional deficiencies.

What is ARFID—Avoidant/Restrictive Food Intake Disorder?

You might think you are dealing with a picky eater if you are unfamiliar with ARFID. But the reality is a more complex mental health issue. It has little to do with taste buds and what a person likes.

Someone with this condition will find themselves only able to eat a narrow range of foods and avoid large swaths of food groups.

Imagine someone who avoids most fruits, vegetables, and meats. They eat only white bread, some cheese, and rice. This person will likely experience extreme anxiety at the thought of eating anything outside of these strict parameters. Over time, this kind of eating would result in malnutrition.

And the issues are more profound than just not liking certain foods.

But why does this happen? Let’s dig in.

Why Does ARFID Happen?

Just like any mental health issue, the reasons someone might develop ARFID are complex. There is not going to be a specific situation or reason. And each person diagnosed with this disorder will have a unique experience.

Some people develop food sensitivities because of a traumatic experience with food, such as a choking incident or severe food sickness. Some people have food sensitivities to everything from colors to textures. Of course, this can be concurrent with other anxieties or disorders, which amplifies the issue.

The Brain and ARFID

Humans have one thing in common: our brains try to help us avoid pain, harm, or discomfort. And sometimes, a person’s brain can go into overdrive on this. Indeed, extreme anxiety is an example of this happening.

But if you once had a life-threatening experience that involved choking on a carrot, your internal system is going to begin to warn you to avoid carrots.

The Real-Life Impact of ARFID

As you can see, living with ARFID isn’t just a quirky eating habit. Certain foods or food groups elicit a mental and physiological response from the person who suffers from it. Since eating happens every day, all day and many social situations also include it; life can be overwhelming.

it’s a daily struggle. Imagine navigating a world full of food when most of it feels off-limits. Social gatherings become stressful, and dining out is an obstacle course of anxiety. Beyond those things, depending on the foods, you may have nutritional deficiencies that can lead to several issues.

Diagnosing ARFID

The key to a diagnosis of ARFD is persistent patterns that result in nutritional deficiencies. Significant weight loss could also be part of the decision factor or simply how your relationship with food impacts your typical psychological health.

Does it ruin your life?

Treatment for ARFID

The good news is that ARFID is treatable.

Cognitive-behavioral therapy (CBT) is the cornerstone of mental health techniques that help people change their relationship with food.

Here are a few ways that CBT can help if you or a loved one are experiencing Avoidant/Restrictive Food Intake Disorder:

1. Identifying Negative Thoughts: The first step in CBT is recognizing the negative thoughts that fuel food avoidance. These might include irrational fears about choking, contamination, or negative past experiences related to food.
2. Behavioral Experiments: CBT often includes behavioral experiments where people gradually expose themselves to feared foods.
3. Coping Strategies: CBT also equips individuals with coping strategies to manage anxiety and stress around eating. These strategies include relaxation techniques, mindfulness, and other routines that can help a person manage their approach to eating.

Exposure Therapy

For those whose ARFID is tied to specific traumas or phobias, exposure therapy can be incredibly effective. This approach involves:

1. Gradual Exposure: Exposure therapy works by gradually and systematically exposing individuals to the foods they fear in a controlled and supportive environment.
2. Building Tolerance: By slowly increasing the exposure, individuals build tolerance and reduce anxiety responses. For instance, someone afraid of choking on solid foods might start with pureed versions, then move to softer solids, and eventually more textured foods.
3. Positive Reinforcement: Throughout the process, positive reinforcement plays a crucial role. Celebrating small victories and acknowledging progress helps to build confidence and motivation to continue the therapy.

Medical Monitoring

Given the risk of nutritional deficiencies, regular medical check-ups are vital for a person dealing with ARFID. These visits help monitor physical health and ensure that any deficiencies are addressed promptly.

While ARFID can feel overwhelming, it’s important to remember that with the right support, recovery is possible.

Getting Help for ARFID

The journey might be challenging, but every small step forward is a victory. Whether you’re personally affected by ARFID or supporting someone who is, know that understanding and patience go a long way.

If you want to talk more about ARFID, general eating disorders, or any other mental health condition, contact us at Lido Wellness Center in Newport Beach California: 949-541-8466.

Notice the increase in media portrayals of individuals battling eating disorders, including binge eating disorder. Imagine sitting at your dinner table, feeling ashamed after consuming double the average portion in a short time.

These episodes are not isolated.

Binge Eating Disorder (BED) may be the underlying cause. It is characterized by recurring episodes of eating unusually large amounts of food.

Recognizing Emotional Signs

Emotional indicators of Binge Eating Disorder (BED) often manifest as profound feelings of guilt or shame following a binge episode. Sufferers may also experience heightened anxiety, which can exacerbate their eating behaviors.

In addition to guilt and anxiety, individuals may feel a “numbing effect.” This occurs as a response to overwhelming situations, where eating becomes a coping mechanism. Over time, this emotional distress can contribute to a deteriorating sense of self-worth, emphasizing the importance of seeking professional support.

Frequent Feelings of Guilt

Guilt can permeate one’s thoughts—particularly after binge episodes—leading to an incessant cycle of negative emotions.

Profound guilt can exacerbate emotional distress, making it crucial to address these feelings promptly.

When individuals repeatedly experience guilt after binge eating, the cycle can impact their mental health and self-esteem. This guilt may drive them to engage in further disordered eating behaviors, perpetuating the cycle.

Addressing the root cause of the guilt through cognitive-behavioral therapy or support groups can be instrumental. These interventions help in developing healthier coping mechanisms and reducing the frequency of binge-eating episodes.

Persistent Emotional Eating

Persistent emotional eating represents a significant aspect of binge eating disorder.

Individuals often turn to food as a means of coping with negative emotions like stress, sadness, or boredom. This can become a habitual response.

Over time, emotional eating diminishes one’s ability to process and handle emotions in a healthy manner. This deepens the reliance on food as an emotional crutch.

Recognizing emotional eating patterns is a crucial first step towards seeking treatment and developing healthier coping strategies. Professional help can be pivotal.

Therapeutic interventions, such as cognitive-behavioral therapy (CBT), can aid in identifying and addressing emotional eating triggers effectively.

Identifying Physical Symptoms

Identifying physical symptoms of binge eating disorder, a clinically recognized eating disorder, entails several tell-tale signs. These may include rapid weight gain, gastrointestinal distress such as bloating and abdominal pain, and chronic fatigue. Additionally, individuals might experience noticeable fluctuations in weight due to cycles of binge eating. Early recognition of these physical symptoms can significantly influence the success of intervention and treatment strategies.

Noticeable Weight Fluctuations

Individuals with binge eating disorder (BED) often experience significant weight changes. These fluctuations are not merely cosmetic concerns.

Since 2016, research indicates a strong association between BED and weight instability, underscoring the adverse health impacts of these fluctuations on metabolic function and psychological well-being.

Thus, it is essential to understand that one’s weight’s instability is not just a symptom of the eating disorder but can exacerbate the psychological difficulties associated with BED.

Beyond the numbers on the scale, drastic changes in weight can lead to comorbid conditions such as Type 2 diabetes, hypertension, and other cardiovascular issues, further complicating treatment and recovery.

Recognizing these signs early and seeking professional help can mitigate the additional health risks associated with frequent and substantial weight changes.

Physical Discomfort After Meals

Many experience discomfort post meals.

In individuals with binge eating disorder (BED), this discomfort can be severe. They might consume large amounts of food within a short period, leading to feelings of fullness and pain beyond what is typical. Consequently, this can result in significant physical discomfort, including stomach pain, bloating, and nausea.

Pain can be both sharp and persistent.

Physical discomfort often results from the stomach stretching beyond its normal capacity – akin to an inflated balloon – leading to intense gastrointestinal distress.

It’s important to note that recurring post-meal physical discomfort can also contribute to a negative cycle of eating behaviors, feeding into the psychological components of BED. Seeking effective therapeutic interventions, such as cognitive-behavioral therapy (CBT) and medical support, can play a critical role in managing both the psychological and physiological aspects of binge eating disorder.

Understanding Behavioral Patterns

Individuals with binge eating disorder often exhibit specific, self-destructive eating habits that persist over time. These patterns can include eating large quantities of food, even when not hungry, and eating rapidly during episodes of bingeing.

Additionally, those struggling with binge eating disorder (BED) might isolate themselves to conceal their eating behaviors, commonly consuming food in secret. The ingestion of food often provides transient emotional relief, which quickly turns into guilt and regret.

Terms like “bingeing” and “compulsive” are frequently used to describe these persistent actions.

Consuming Food Secretly

Eating food in secret is a common symptom of Binge Eating Disorder (BED) and can indicate deeper emotional struggles.

• Isolation: Many individuals prefer to eat alone to avoid judgment.
• Hiding Evidence: Frequently disposing of food wrappers or packages to conceal consumption.
• Unplanned Eating: Engaging in spontaneous, secretive eating sessions.
• Guilt and Shame: Feelings of embarrassment often accompany secret eating.

Engaging in these behaviors can exacerbate feelings of isolation and distress, creating a vicious cycle.

Understanding these patterns is crucial for identifying BED and seeking professional help.

Eating Rapidly and Past Fullness

One significant symptom of Binge Eating Disorder (BED) is eating rapidly and past fullness. This behavior often leads to physical discomfort and emotional distress.

People may eat quickly without noticing how much food they consume. This can result in consuming large quantities of food in a short period.

Recognizing this pattern is crucial for those suffering from BED, as it can signify a problematic relationship with food. Furthermore, it can contribute to various health issues, such as digestive problems, weight gain, and metabolic disturbances.

Seeking help is essential if you identify with these behaviors. Treatment options include therapy, support groups, and medical interventions designed to address both the psychological and physiological aspects of BED. Early intervention can significantly improve outcomes and promote healthier eating habits.

Steps to Seek Professional Help

Seeking professional help for Binge Eating Disorder (BED) involves a series of critical steps to ensure you find the appropriate support. First, acknowledge that you need assistance and reach out to your primary care physician for an initial evaluation.

They can provide referrals to mental health specialists, such as psychologists or psychiatrists, who are experienced in treating eating disorders.

Furthermore, consider joining support groups specifically for BED, where you can gain insights and encouragement from others facing similar challenges. Utilize resources from reputable organizations, such as the National Eating Disorders Association (NEDA), to find certified professionals and evidence-based treatment options. Remember, early and targeted intervention can profoundly impact recovery and well-being.

Exploring Therapy Options

Therapy for Binge Eating Disorder (BED) includes specialized treatments tailored to individual needs.

• Cognitive-Behavioral Therapy (CBT): Focuses on changing negative thought patterns and behaviors.
• Interpersonal Therapy (IPT): Addresses issues in personal relationships and social functioning.
• Dialectical Behavior Therapy (DBT): Combines CBT with mindfulness techniques.
• Acceptance and Commitment Therapy (ACT): Encourages acceptance of negative thoughts and feelings.
• Medication: Prescribed to manage symptoms, often in conjunction with therapy.

These therapies can be highly effective when administered by trained professionals.

Collaborating with a therapist can provide crucial support and coping strategies.

Choosing the right therapy depends on your unique circumstances and needs. Seek advice from healthcare professionals to find the most suitable option.

If you or a loved one is battling binge eating disorder, reach out to Lido Wellness Center in Newport Beach at 949-541-8466 for compassionate and effective mental health treatment. Take the first step towards healing and recovery today.

When I was nine years old, I dreaded going to the beach in the summertime. Visiting my grandmother’s beautiful home in Laguna Beach should have been exciting, fun, and carefree for a young California girl, but to me, the beach meant one thing. Wearing a swimsuit. Unlike other girls my age, my swim attire was not a floral patterned one-piece or two-piece. No, I armored up for the beach in a long sleeve rash guard and board shorts bought from the little boy’s section at Target. This was the beginning of body image issues—a deeply personal topic. 

The Body Shame

It wasn’t a sunburn I was afraid of; it was my body. Somehow, at nine years old I had already internalized the message that my body was “bad” and “shameful.” I didn’t want strangers at the beach to see my body, but even more devastatingly, I didn’t want to see myself.

Sadly, internalizing body shame and body image issues at a young age is a pervasive issue in our

culture. With the rise of social media and platforms such as Instagram and TikTok, kids are gaining access to content earlier and earlier that perpetuates body dissatisfaction through comparison to unrealistic images. According to researchers Kearney-Cooke and Tieger, by 13 years old 50% of girls in the United States report being unhappy with their body; by 17, this number grows to 80%.

But make no mistake, body image issues are not just a “teenage girl phase.” These insecurities and crippling shame can follow us well into adulthood, and without the proper intervention, can even worsen as our bodies change in the natural aging process. Furthermore, in recent years we have seen a massive uptick in both male-identifying and transgender people struggling to accept their bodies. Significantly, body dysmorphia is only 0.03% less prevalent in men than women, and a shocking 16% of trans people have been diagnosed with an eating disorder.

Witnessing Body Image Distress

As a therapist specializing in eating disorders and body dysmorphia, I have witnessed the devastating effects of body image distress on both mental health and physical health. Every summer, I notice a trend of increased anxiety in my patients. Instagram, TikTok, and Facebook are flooded with diet tips and workouts for attaining a “bikini body” before the weather heats up, leaving many of us triggered and on the path to disordered eating, depression, and isolation. You don’t need a formally diagnosed eating disorder or body dysmorphia to feel the effects of societal pressure to change and manipulate your body’s natural shape or size. But it doesn’t have to be this way.

In my work with patients in mental health treatment, I have found a few simple shifts in behavior and mindset go a long way in dispelling summertime stress and inviting enjoyment back into the warmer months. Not only that, but consistent and repeated practice can help cultivate a new and supportive relationship with your body that can last through fall, winter, and many seasons to come.

Effects of Social Media on Body Shame

Unfollow, Block, Delete! – Take a look at your social media feeds. What accounts are you following right now that trigger comparison and body anxiety? Which influencers and images invoke a sense of guilt, unhealthy envy, and self-criticism? Is Susan from marketing posting about her juice cleanse again? Or maybe Bob from next door is posting his gym selfies for the tenth time this week.

This type of stimulus is not helpful. What’s worse, it’s selling a false narrative. What the influencers don’t show you is the photoshop app they use to reshape their bodies and the hours spent perfecting their angles and lighting. We also don’t get to see how cranky Susan is with her kids because she’s not properly nourishing her brain. And Bob isn’t going to post about his own body image dissatisfaction and anxiety that fuels his compulsive exercising.

Filter for Health and Acceptance

On social media, we are fed information that tricks us into believing idealism is realism. This is harmful because it leaves us constantly striving to achieve something that does not exist and feeling shameful all the while because we can’t do the impossible. Take this opportunity to curate the content you’re consuming to support healthy body acceptance and neutrality.

You don’t have to avoid social media completely to avoid triggering negative body image. There are actually several body positive and body neutral accounts that advocate for health at every size and self-acceptance. Keep an eye out for accounts that provide helpful suggestions for combating body shame and promote rejecting diet culture rather than rejecting your body.

Looking for body positive accounts to follow? Try @iweigh, @alissarumseyrd, and @mynameisjessamyn.

Practice Makes Progress – Not comfortable wearing your swimsuit to the beach? Practice wearing it around your house first! This may seem like a strange thing to do but getting comfortable in a safe place is the first step toward feeling comfortable on a beach full of strangers. Remember, you are probably judging yourself much harder than anyone else would.

Body Neutrality as an Option

While feeling positive about your body might seem like a lofty and far-off goal, a more attainable goal might be body neutrality. If you can find even a moment of feeling neutral about your body in a swimsuit, that is progress. Practicing body neutrality means acknowledging and appreciating the function of your body, rather than the form. If we can shift the focus away from deriving worth from our appearance, and instead derive worth from the soul, we can reclaim peace knowing that we are worthy regardless of the body we live in.

Next time you put on your swimsuit, practice repeating this body neutrality mantra:

My body is one of the interesting things about me.

Talk About Body Image Distress

Talk It Out – Usually our body dissatisfaction and distress come from a deep core belief about who we are. While it’s easy to blame the size and shape of our bodies as the root of all problems, the body is not the real issue here. If body image distress is becoming a pervasive and preoccupying problem in your life, it may be time to reach out to a therapist or mental health treatment center, like Lido Wellness Center.

With the help of a treatment team it becomes easier to understand that the body doesn’t need to change, the mind does! In my work with patients, I prioritize deconstructing and challenging the narratives we’ve been taught to believe about our bodies. We work together to process through the stories and experiences throughout the lifetime that have contributed to these harmful core beliefs.

When we take the time to say it out loud, we begin to hear and understand that the way we think and feel about our bodies often doesn’t originate from us. By tracking the history of our body image concerns, we can more easily identify the underlying cause. Very often, body image distress is a symptom of the real problem: trauma, fear, low self-worth, abuse, rejection, the list of possibilities goes on.

It can feel uncomfortable and scary, but talking about and processing through these deep rooted self-beliefs with a safe and supportive therapist can provide lasting relief. If we can move through the negative stories that have influenced our relationships with our bodies, we can change the narrative to claim stories that emphasize body empowerment, acceptance, and healthy self esteem.

Body Image Issues Help in Newport Beach

Though summertime is typically a season that heightens our body awareness and insecurities (especially here in Newport Beach, California), tending to our bodies’ needs and elevating gratitude for the body year round is best practice for long term healing. While these tips are helpful, it’s important to recognize that there is no quick fix to healing your relationship with yourself and your body. I know from personal experience that like any other relationship, tending to the body and mind is a daily practice.

These days, my trips to Newport beach look a whole lot different. When I step onto the hot summer sand, I’m not thinking about my body or comparing myself to the other people on the beach. I’m witnessing the majesty of the ocean, I’m smelling the brisk salt air, I’m laughing with my friends and family, and I’m enjoying the taste and texture of my seafront picnic. Sometimes, I still hear whisperings from that little girl who was afraid to be seen, and in those moments I remind her this:

Your body is your home. It is the vehicle that lets you experience the world. Let’s be grateful to the body that allows us to participate in this beautiful life.

by Chloe Horner, AMFT
Primary Therapist