Treatment

Treatment is often conducted by a team of a doctor, therapist, and a nutritionist or a dietetic

Treatment with ARFID again refers back to the Three-Dimensional model of neurobiology of ARFID. A person can fall under more than one and the severity of each can vary, they can conduct treatment. Treatment is often conducted by a team of healthcare practitioners that specialize in eating disorders.

For people that fall under Avoidance (sensory sensitivity):

This group is categorized by people who often describe non-preferred foods as tasting intensely negative. Traditionally it is understood people in this category do not have experience with non-preferred foods and will come to prefer them with repeated exposure therapy. Studies have shown that even if exposure therapy can not completely eradicate a sensitivity or extreme distaste towards food that’s experimented with, the fear towards those kinds of foods is decreased.

For people that fall under Lack of Interest:

This group is categorized by people who often describe that they do not feel hungry at mealtimes, forget to eat, and/or feel full more quickly than others. Research suggests that these eating patterns show a decreased activation of the hypothalamus. This treatment encourages people to eat not only eat when they are hungry but to establish their own hungry cues. They must push through the lack of appetite and eat however many meals that are recommended by a healthcare practitioner on their meal plans at assigned times throughout the day. Over time this will develop into the activation of the hypothalamus and appetite will grow.

For people that fall under Aversive (Physical Phobias):

This group is categorized by people who often have an intense fear of food following a traumatic experience with food. Such as choking, vomiting, or abdominal pain after eating at some point in their lives. This category is not developed in the same way as the other two. It can manifest at any age and is usually because of a pre-existing vulnerability or condition that contributed to a phobic response. Essentially, the hyper activation of the defense motive system is called an amygdala hijack. Treatment focuses on reversing the amygdala hijack, trauma can be reversed. The brain is always adapting and recovery is possible.

The hypothalamus is what sends out brain appetite signals, in other words “hunger cues”. The amygdala is a part of the brain that detects threat and controls the activates appropriate fear-related behaviors in response to threatening or dangerous stimuli.

The Three-Dimensional Neurobiological Model will not only help characterize the specific ARFID condition, but could also highlight potential risk factors for the disorder.

This model can also predict long term effects and identify areas to intervene with treatment(s). For example, people that fall under more than one category in the model are more likely to relapse as opposed to those who only fall under one. In the case that you fall under more than one category your treatment will target all of your issues and design multifaceted treatments.

In the case of Adults with ARFID there are more steps that can be taken such as Intensive Out-Patient Programs, Part time Hospitalization Programs, and Residency Programs.

All eating disorder centers follow practices like:

• Individual Therapy • Group Therapy • CBT/DBT • ACT • Mindfulness • Meal Support

Additional therapies are offered at some centers like:

• Acupuncture • Art Therapy • Yoga • Exploring Self Care • And Other Holistic Practices

The most important part of treatment is your recovery team. I like to call my recovery team my Care Team. The team consisted of professionals that worked together to come up with a recovery plan for me. A Primary Care physician that specializes in Eating Disorders and a therapist and dietetic I met through Prosperity. Prosperity is an eating disorder and wellness center where I participated in an Intensive Outpatient Program (IOP) for eight months. Without their help, I don’t think I could have gotten to where I am in recovery.