ARFID (Avoidant/Restrictive Food Intake Disorder) is an independent eating disorder that differs significantly from the more well-known eating disorders Anorexia and Bulimia. The focus is not on weight or calorie control, but on the avoidance of specific foods due to fear, disgust, sensory sensitivity, or other distressing perceptions.
The differences to Anorexia and Bulimia are important, as diagnostic procedures, therapeutic approaches, and support strategies are derived from them.
ARFID: Food avoidance without pressure regarding weight People with ARFID develop a severely restricted selection of foods. Often, only a few accepted foods remain, frequently highly processed or one-sided in composition.
Avoidance is not consciously controlled but arises from fear, disgust, or sensory aversions to taste, texture, smell, or color.
ARFID can develop as early as toddlerhood and remains unrecognized for a long time, as weight or body image are initially inconspicuous.
Unlike Anorexia, there is no need for control, power, or a deceptive sense of security through eating behavior.
Emotional compensation through food, as seen in Bulimia, also plays no role in ARFID.
The illness is mostly purely related to eating; other areas of life often remain psychologically unaffected.
Anorexia: Power, control, and deceptive security In Anorexia, conscious control over eating and often body weight is the primary focus.
The reduction of food serves power and security, not just calorie control.
Those affected often feel that they have something “under control” in their lives through their eating behavior.
The psychological beliefs affect many areas of life: body image, self-esteem, control, and sometimes interpersonal relationships.
The avoidance of specific foods is strategic and targeted, not motivated by fear or sensory overload.
Bulimia: Eating for emotional regulation Bulimia is characterized by binge eating and frequently subsequent compensatory measures, but not always with a focus on weight:
Eating is used to cope with or regulate other emotions – e.g., anxiety, sadness, or stress.
Compensation can occur but is a means of regulation, not the primary goal.
The psychological beliefs in Bulimia also affect various areas of life, not just eating behavior.
In ARFID, this form of emotional compensation often does not exist; here, the problem usually remains limited exclusively to food avoidance.
Therapeutic differences: Why diagnosis is crucial Therapy must be tailored to the underlying psychological mechanisms:
ARFID: Treatment focuses on fear, disgust, sensory overload, and food avoidance. Psychological structures in other areas of life often remain unaffected.
Anorexia and Bulimia: Therapy focuses on the disordered beliefs that have developed across many areas of life. These include weight, self-esteem, control, relationships, and eating behavior.
A precise diagnosis is crucial in order to choose the right approach and make the treatment effective.
Core points summarized
ARFID: Avoidance of certain foods due to fear, disgust, or sensory sensitivity; psychological structures otherwise remain stable.
Anorexia: Food reduction as a means of power, control, and deceptive security; beliefs affect many areas of life.
Bulimia: Binge eating for emotional regulation; psychological beliefs also affect many areas of life.