Avoidant / Restrictive Food Intake Disorder: Causes and Symptoms

Are you or someone you know very picky? Some people can be extremely picky or delicate when it comes to eating, they are those who avoid many foods because they do not like their taste, smell, texture or appearance, which could be said to be due to an eating disorder, known as a disorder avoidant / restrictive by food intake . In most cases, picky food does not interfere with weight, growth, or daily functioning. However, people who experience consequences like these as a result of extremely demanding diets may need treatment.

It is common in childhood, between 13 percent and 22 percent of children between the ages of three and eleven who consider themselves mystical or stubborn to eat at any given time, most young children outgrow their selection, between 18 and 40 percent continue to be demanding in adolescence.

What is avoidant / restrictive eating disorder?

Formerly known as selective eating disorder, it is a type of eating disorder , where the consumption of certain foods is limited based on the appearance, smell, taste, texture, brand, presentation or negative experience with food . It is characterized by a persistent failure to meet appropriate nutritional and / or energy needs.

This condition was thought to be something that developed exclusively in children and adolescents; however, it has broadened the defining criteria to also include adults who have restricted their eating and who may also be affected by a related psychological and / or physiological problem.

Symptoms of avoidant / restrictive eating disorder

This type of disorder is defined according to the following criteria according to DSM-5:

• Disturbance in eating or feeding, as indicated by: Substantial weight loss (or, in children, absence of expected weight gain), nutritional deficiency, dependence on a feeding tube or dietary supplements, significant psychosocial interference.
• Disturbance not due to unavailability of food or observance of cultural norms.
• Disturbance not due to anorexia nervosa or bulimia nervosa , and there is no evidence of altered experience of body shape or weight.
• Anxiety when presented with food.
• Frequent vomiting or nausea after exposure to certain foods.
• Difficulty chewing food.
• Lack of appetite.
• Problems digesting specific types of food.
• Consumption of extremely small portions.
• Social isolation.

The disturbance is not better explained by another medical condition or mental disorder, or when it occurs at the same time as another condition, the disturbance exceeds what is normally caused by that condition.

If in the context of another mental disorder (eg, autism spectrum or anxiety disorder ), the symptoms are severe enough to require specific clinical attention, the diagnosis can be applied.

If in the context of a medical condition (for example, gastrointestinal illness or food allergy), the symptoms are beyond what is directly attributable to the medical condition or the symptoms may persist after the medical condition has resolved , the diagnosis will be applied.

Causes of avoidant / restrictive eating disorder

Like other eating disorders , there is no single cause of this type. However, the evolving scientific literature suggests that this disorderly eating pattern develops from a complex interplay between genetic, psychological, and sociocultural factors.

Genetic factors

Eating disorders are family illnesses, and the temperamental traits that predispose people to developing an illness are passed down from generation to generation.

Psychological factors

Anxiety and obsessive-compulsive characteristics tend to accompany eating disorders, as do concurrent mood and anxiety disorders.

Sociocultural factors

Cultural pressures to eat clean / pure / healthy, as well as the increasing emphasis on food processing, sourcing, packaging, and environmental impact can influence beliefs and food intake.

The cause requires a multidisciplinary treatment team, as it is a complex disorder and requires highly specialized medical, psychological and dietary care.

Treatments for avoidant / restrictive eating disorder

For adults

Over time, the symptoms of acute respiratory failure can diminish and eventually disappear without treatment. However, in some cases treatment will be needed as symptoms persist into adulthood.

The most common type of treatment is some form of cognitive behavioral therapy , working with a doctor can help to change behaviors quickly so that symptoms can disappear without treatment. There are support groups for adults with avoidant / restrictive eating disorder.

For children

Children can benefit from a four-stage home treatment program based on the principles of systematic desensitization. The four stages are check-in, reward, relaxation, and review.

In the recording stage , children are encouraged to keep a record of their typical eating behaviors without attempting to change their habits or cognitive feelings.

The reward stage involves systematic desensitization, children create a list of foods they would like to try one day, these may not be drastically different from their normal diet, but perhaps a familiar food prepared in a different way. Because the goal is for children to try new foods, and that is why they are rewarded when they do.

The relaxation stage is more important for those children who suffer severe anxiety when they are presented unfavorable foods, they learn to relax to reduce it. Children work through a list of anxiety-producing stimuli and can create a story with relaxing images and scenarios, and often these stories can also include the introduction of new foods with the help of a real person or fantasy person. Children then listen to this story before eating as a way of imagining themselves engaging in an expanded variety of foods while relaxed.

The final review stage is important to monitor the child’s progress, include individual sessions with the child, as well as with the parent to get a clear idea of ​​how the child is progressing and if the relaxation techniques are working.