Research has suggested that there are three primary drivers of the development of ARFID behaviours, avoidance based on the sensory characteristics of food, an apparent lack of interest in food or eating, or concern about negative consequences of eating.
Though the onset of ARFID may be at any stage in life, most cases can be linked back to childhood. Furthermore, development may also be noticed following a significant negative event such as an episode of illness, choking or food poisoning. This can encourage an individual to avoid specific foods or entire food groups altogether. Anxiety and trepidation about the consequences of eating, such as fear of choking, nausea, vomiting, an allergic reaction or stomach upset can also lead to ARFID.
Due to the recent recognition of the behaviour, much of the research into ARFID is in its infancy. Early findings from PsychCentral state that “ARFID is one of the most common eating disorders diagnosed in children. One study based in Switzerland estimated that ARFID affects 3.2% of all children between 8 and 13 years old.” It is also thought to affect around 9.8% of adults presenting with an eating disorder, alongside more common disorders like bulimia, binge eating disorder and anorexia nervosa.
There is a higher prevalence of ARFID is in individuals who also have an Autism Spectrum Disorder (ASD) diagnosis than in the general population. While the two diagnoses are not mutually exclusive, the overlap is often associated due to the presence of sensory processing difficulties in individuals with an ASD diagnosis. This can often result in the avoidance of meats, vegetables, and/or fruits due to aversions to specific tastes, textures, or smells. Dr Terence Dovey is a specialist in avoidant and restrictive eating disorders at Brunel University, London. He recently conducted a research trial into the similarities between those with research trial into the similarities between those with ASD and disordered eating of this nature, which was published by Cambridge University Press. He found a notable overlap in eating difficulties, behavioural problems and the sensory profiles of children with ARFID and ASD with more severe aberrations in ARFID (food-responsiveness) and ASD (hypersensitivity and social problems). He concluded: “This study has shown that there are more similarities than differences between children with ARFID and ASD in their eating behaviour… All children (in the study) with feeding difficulties appear to exhibit more internalised behavioural problems, especially within the emotional domain”. This suggests a link between ASD and the development of restrictive eating disorders such as ARFID.
In adulthood, ARFID can continue to manifest if ignored at a younger age or may form as the result of a new, inciting event. The triggers for adults are often similar to those of children such as e.g. fear of vomiting or choking, trauma or sensory aversions. A change in physical health can also lead to the development of the disorder such as being diagnosed with diabetes, heart disease or gastrointestinal conditions and becoming obsessive about the types of foods that are recommended.