ARFID and Anorexia: Can They Co-Exist?

by Dr. Marianne Miller, Anorexia and ARFID Therapist in San Diego, California

When thinking about eating disorders in San Diego, Los Angeles, and NYC, anorexia nervosa and ARFID (Avoidant/Restrictive Food Intake Disorder) often come to mind. Both types of eating disorders involve avoiding or limiting food, but for very different reasons. So, is it possible to experience both at the same time? Let’s take a look at how these conditions might overlap.

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What is ARFID?

ARFID is a disorder where someone avoids certain foods, but it’s not related to concerns about body weight or appearance. The avoidance stems from fear of choking, strong dislike for certain textures, or simply not being interested in food. Because of this, people with ARFID might become very picky about what they eat, leading to issues like weight loss or nutrient deficiencies.

The key here is that ARFID isn't about wanting to lose weight—it’s driven by anxiety or discomfort around food itself.

What is Anorexia?

Anorexia Nervosa is different because it’s all about controlling weight. People with anorexia restrict their food intake because they have an intense fear of gaining weight. Their body image is often distorted, and they may see themselves as bigger than they are. This drive to be thin leads to extreme food restriction and sometimes over-exercise.

Unlike ARFID, anorexia is focused on controlling weight and body shape, not food-related anxiety or discomfort. Remember that people in California, Texas, New York, or anywhere of the world, regardless of size, can struggle with anorexia.

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Can ARFID and Anorexia Happen Together?

Yes, ARFID and anorexia can coexist, although it doesn’t happen very often. Here are a few ways this might play out:

  • ARFID Developing into Anorexia: A person might start by avoiding certain foods because of sensory issues or fear of choking, and later develop concerns about weight, resulting in anorexia-like behavior.

  • Struggling with Both Issues: Some individuals may have food sensitivities that make eating difficult, along with body image concerns that lead them to restrict their food even further.

  • Different Fears, Same Outcome: ARFID and anorexia both involve restrictive eating, and the motivations are different. In ARFID, people avoid food because of fears like choking or sensory issues. In anorexia, the avoidance is tied to fears of gaining weight. Sometimes, these fears can combine, creating a more complex situation.

Diagnosing Both ARFID and Anorexia

Identifying when someone is dealing with both ARFID and anorexia can be tricky. Body image concerns typically indicate anorexia, but when food avoidance is related to fear or discomfort, ARFID may be the cause. The key is figuring out the reasons behind the restrictive eating behavior.

Given that people might not fit neatly into one category, it’s important to consult a professional like a therapist or dietitian who specializes in eating disorders to get a clear diagnosis.

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Treatment for ARFID and Anorexia

Treating ARFID and anorexia requires addressing both the anxiety around food and the fear of gaining weight. For ARFID, the focus is on helping people gradually overcome their fear of certain foods or textures and increasing their food variety. Attending to sensory needs is key. For anorexia, treatment involves improving body image, reducing the fear of weight gain, and restoring regularly scheduled eating habits.

When both disorders are present, treatment needs to combine different approaches. Therapy like cognitive behavioral therapy (CBT), nutritional counseling, and family support can all help in recovery. The goal is to address both food-related fears and weight concerns. It may be necessary to consider higher levels of care when struggling with ARFID or Anorexia, whether you live in California, Texas, New York, London, UK, or elsewhere.

Taking the Next Steps

Even though ARFID and anorexia come from different sources, they can sometimes appear together, complicating someone’s relationship with food. There also may be co-occurring issues, such as anxiety, depression, which makes it more complex to treat. Understanding the differences between anorexia and ARFID is essential to finding the right treatment path.

If you or someone you know is struggling with restrictive eating or body image issues, seeking professional help is a critical step toward recovery. With the right support, such as eating disorder therapists and eating disorder dietitians, it’s possible to develop a healthy relationship with food and body again. Also, whether you’re struggling with anorexia, ARFID, or both in NYC, Atlanta, or Chicago, reaching out for help and leaning into self-love is an important part of the journey.

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Seeking Anorexia or ARFID Treatment or Support?

Start your journey with Dr. Marianne Miller, a specialist in Eating Disorder Therapy, online course creation, anorexia, and ARFID and Binge Eating coaching. Dr. Marianne is available in San Diego, throughout California, as well as Dallas and all of Texas, plus Washington, D.C., and online worldwide.

Explore Dr. Marianne's ARFID Resources

New ARFID Course Launched!

Dr. Marianne Miller has just introduced a comprehensive ARFID course designed to provide expert guidance and practical tools for overcoming ARFID challenges. This course is an excellent opportunity for tailored support on your recovery journey.

Browse ARFID Support Blogs:

Dr. Miller’s insightful blogs offer practical advice and strategies for creating a supportive mealtime environment for individuals dealing with ARFID.

Connect with Dr. Marianne Miller

Stay informed and inspired by following Dr. Marianne’s content across multiple platforms:

🌟 Instagram – Follow @drmariannemiller for valuable insights on ARFID, eating disorders, and recovery through engaging reels and posts.

🎙️ Podcast – Listen to Dr. Marianne-Land: An Eating Disorder Recovery Podcast on Apple or Spotify for deep discussions on ARFID, nutrition, mental health, and more.

🛠️ ELITE BINGE EATING RECOVERY METHOD** – A 3-month online coaching program offering high achievers personalized support to regain balance in their relationship with food.

💬 DR. MARIANNE-LAND Binge Eating Recovery Membership Program – Start with the self-paced program and get access to ongoing support designed to help you manage binge eating behaviors.

📲 Follow my Instagram account @drmariannemiller!

Note:

The ELITE BINGE EATING RECOVERY METHOD provides virtual coaching and education but does not replace clinical eating disorder therapy or treatment.

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