As a dietitian, supporting patients with Avoidant/Restrictive Food Intake Disorder (ARFID) requires a compassionate and understanding approach, as well as knowledge of evidence-based strategies. ARFID is a complex eating disorder that can result in severe weight loss, malnutrition, and other health problems. It is important to understand that ARFID is not simply a refusal to eat, but rather a complex condition that requires a multi-disciplinary approach to treatment.
Here are some top tips that can help dietitians support patients with ARFID:
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- Building a Therapeutic Relationship: Establishing a trusting relationship with the patient is crucial in helping them feel comfortable discussing their relationship with food and any related fears or anxieties. Encourage open and honest communication and be an active listener.
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- Assessing Nutritional Status: Conduct a comprehensive nutritional assessment to determine if the patient has any nutrient deficiencies or imbalances that need to be addressed. This will help you determine the best approach to treatment, and ensure that the patient is getting the nutrients they need to maintain their health.
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- Gradual Exposure: Help the patient gradually expand their food repertoire through exposure to a variety of new foods in a non-threatening manner. This can include food chaining, where similar but new foods are introduced, and increasing the variety and portion size of familiar foods.
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- Cognitive-behavioural Therapy (CBT): Encourage the patient to work with a mental health professional trained in CBT, which has been shown to be effective in treating ARFID. CBT can help the patient understand and change the negative thoughts and behaviours associated with their eating disorder.
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- Educating about Nutrition: Provide education on the importance of balanced nutrition and the role of different food groups in promoting health and preventing nutrient deficiencies. Emphasize the importance of a balanced diet, and the dangers of restrictive diets.
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- Addressing Mealtime Anxiety: Help the patient develop coping strategies for managing mealtime anxiety, such as deep breathing, visualization, and progressive muscle relaxation. Encourage them to practice these strategies regularly to help reduce their anxiety at meal times.
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- Working with a Team: Collaborate with other healthcare professionals, such as a mental health clinician, to provide comprehensive and coordinated care for the patient. A multi-disciplinary approach is often the most effective way to treat ARFID.
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- Providing Support: Offer ongoing support and encouragement to help the patient make progress and overcome their challenges with food. Celebrate their achievements and be there to support them through setbacks.
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- Remember that each patient with ARFID is unique and may require a different approach. It’s important to be flexible and responsive to the individual needs of each patient and to continually reassess and adjust the plan of care as needed.
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UK sources for further information and support for patients with ARFID include:
The National Centre for Eating Disorders (NCED) (https://www.eating-disorders.org.uk/what-are-eating-disorders/avoidant-restrictive-food-intake-disorder-arfid/)
Beat, the UK’s leading charity for people with eating disorders (https://www.beateatingdisorders.org.uk/eating-disorders/arfid)
The NHS website (https://www.nhs.uk/conditions/avoidant-restrictive-food-intake-disorder-arfid/)
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