How to Use Exposure Therapy for ARFID

Avoidant / Restrictive Food Intake Disorder (ARFID), formerly known as Selective Eating Disorder, is an eating disorder that prevents a person from eating certain types of food or enough food to sustain proper nutrition. It can also cause the individual to restrict their intake of specific food groups or textures due to fear of choking, vomiting, or other negative reactions. ARFID often begins in childhood and may persist into adulthood if left unaddressed.

The most effective treatment for ARFID is Exposure Therapy, which slowly introduces different types of foods until the patient's diet expands and they become comfortable with new food items. 

The key to managing this condition is recognizing the triggers that cause anxiety surrounding food and addressing them utilizing techniques such as Acceptance Commitment Therapy, and I-CBT (Inference-Based CBT), which are commonly employed for cases of OCD.  

The person with ARFID always retains agency during this process.  While some persuasion, encouragement, and other motivators may be employed during the exposure process, the most important agent of change must be the person themselves.  

During this process, a psychologist or therapist will typically use desensitization techniques, alongside other cognitive and nutritional strategies.  Additionally, nutritionists can help educate the patient on proper eating habits and introduce healthier food choices into their diet. 

It is important to note that ARFID can vary from person to person.

Some people may have an aversion to a few food items, while others might have a more severe form of the disorder and struggle with eating many types of food or enough food in general. 

Additionally, some individuals may only experience symptoms when trying new foods or even when simply looking at certain food items. In this case, the first level of exposure is simply writing down a list of food items that cause distress.  When the individual starts to feel bored with these lists (ie. no longer triggered by them), we begin to look at photos of avoided foods.  Later, we bring these foods into the treatment room, and a client and therapist go through the session as if the detested food is not present.  Next, the client will hold the food in their hand, and eventually brush it up against their lip. The final stage is a nibble and perhaps even a full bite.  

Through these techniques, we inch a person out of their avoidance and into a state of relative comfort.  It is unlikely that a person with ARFID will never avoid foods, even once no longer clinically meeting the criteria for the disorder.  However, with proper intervention and care, people with ARFID can lead healthy lives free from food-based anxieties or unhealthy restrictions. 

In all cases, it is beneficial to work with a professional who can assess your specific needs and provide tailored strategies for overcoming ARFID.

Please contact Kairos Wellness Collective if you or your child is experiencing ARFID and you would like support.