Avoidant Restrictive Food Intake Disorder (ARFID)—Looking beyond the eating disorder lens?

Abstract

Avoidant Restrictive Food Intake Disorder (ARFID) was first included as a diagnostic category in 2013, and over the past 10 years has been adopted by the international eating disorder community. While greater awareness of these difficulties has increased identification, demand and enabled advocacy for clinical services, the heterogeneous nature of ARFID poses unique challenges for eating disorder clinicians and researchers. This commentary aims to reflect on some of these challenges, focussing specifically on the risk of viewing ARFID through an eating disorder lens. This includes potential biases in the literature as most recent research has been conducted in specialist child and adolescent eating disorder clinic settings, bringing in to question the generalisability of findings to the broad spectrum of individuals affected by ARFID. We also consider whether viewing ARFID predominantly through an eating disorder lens risks us as a field being blinkered to the range of effective skills our multi-disciplinary feeding colleagues may bring. There are opportunities that may come with the eating disorder field navigating treatment pathways for ARFID, including more joined up working with multi-disciplinary colleagues, the ability to transfer skills used in ARFID treatment to individuals with eating disorder presentations, and most notably an opportunity to provide more effective treatment and service pathways for individuals with ARFID and their families. However, these opportunities will only be realised if eating disorder clinicians and researchers step out of their current silos.