Residential Avoidant Restrictive Food Intake Disorder Treatment in Beautiful Malaysia
Avoidant Restrictive Food Intake Disorder
Avoidant Restrictive Food Intake Disorder (ARFID) is a relatively new diagnosis and addition to the group of mental health concerns known collectively as Eating Disorders. ARFID was first included in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) in 2013.
Although it’s not widely known about, ARFID is very common. Its incidence in pediatric inpatient Eating Disorder (ED) programs ranges from 5%-14%. People with ARFID are typically younger, have a higher male proportion, and often have comorbid psychiatric and medical conditions compared to those with Anorexia Nervosa or Bulimia Nervosa, as demonstrated by multiple studies.
ARFID was previously described in a non-specific group of eating disorders; Eating Disorders Not Otherwise Specified. Young people may have received a change in diagnosis in light of the recent addition of ARFID.
At The Wave, we offer a range of specialist treatments designed especially to help young people overcome ARFID. Alongside clinical treatment, we provide opportunities to learn new skills, try new hobbies, and make long-lasting friendships – giving every young person a chance to grow and realise their dreams after recovery.
We are here to help
The Wave Eating Disorder Admissions Team can be contacted on:
Kuala Lumpur, Malaysia
The Wave Clinic: Specialists in Teen Eating Disorders
+60 327 271 799 (General Enquiries)
+60 125 227 734 (Admissions)
Dubai, United Arab Emirates
The Wave International Group LLC
+971 438 354 01
What Is It and How Does It Work?
Treatment for ARFID
With a supportive, caring environment and a solid treatment programme, young people can recover from ARFID.
The Team at the Wave are trained by Winchester University; one of the first universities to provide specialist training in the treatment of ARFID. The training is made in conjunction with ARFID Awareness UK, and is endorsed by the British Dietetic Association (BDA).
ARFID is a relatively new diagnosis, so the treatments for it are still developing and more research is needed. However, treatments for Anorexia Nervosa have been modified to treat ARFID in teens and young people with promising outcomes.
Young people, teens and children will all experience ARFID in a slightly different way. Treatment success comes with treating each young person as an individual with a unique set of circumstances. We look at the challenges that each young person experiences and develop tailored treatment plans and interventions.
The treatment methods we use that are known to be beneficial in the treatment of ARFID are:
- DBT (Dialectical Behaviour Therapy)
- CBT-AR (An adapted type of CBT for the treatment of ARFID)
- EMDR (Eye Movement Desensitisation Therapy)
- Exposure Therapy
- Desensitisation therapy
The Wave has successfully treated multiple young people with ARFID; they have returned to enjoying life to the full, being able to successfully manage their symptoms and live without unhelpful coping strategies.
Signs and Symptoms of ARFID in Teens
- Avoidance of whole groups of foods or textures (fruit, meat, crusty, chewy, slimy foods)
- Sensitivity to aspects of food service (temperature, heat, cold)
- Gagging at the sight of particular foods
- Difficulty being around other people eating disliked foods
- A list of preferred foods or food substitutes of 10 foods or less
- Not feeling hungry, missing meals, loss of interest in eating
- Avoiding social events and occasions where food is present
- Unable to or struggling to sit at the table during mealtimes
- The use of supplements to replace food and nutritional intake
Children and teens may have:
- A lack of energy and need frequent naps
- Begin to drop on growth charts in height and weight
Children and teens with ARFID:
- May not be underweight
- May be of an average weight for their age
- May be living in a larger size bodies
Eating Disorders of all types can not be weighed. Severe eating disorders are often in children who do not ‘look’ unwell.
Diagnosing ARFID
ARFID is an eating disorder that manifests as an apparent lack of interest in food, avoidance of food based upon sensory characteristics, smell, look, colour, taste, texture.
In ARFID, children and young people will demonstrate significant weight loss, nutritional deficiency, be dependent on enteral feeding or oral supplements to balance nutrition and have persistent issues with psychosocial functioning.
The young person is not experiencing eating and feeding disturbances that could be better attributed to Anorexia Nervosa or Bulimia Nervosa. There is no evidence of disturbance in the perception of body weight, desire to change shape or size. ARFID is a disinterest in eating or food, avoidance due to food’s sensory characteristics, or worry about negative outcomes from eating.
At The Wave, we use a range of thorough diagnostic approaches, informed by the DSM-5 to ascertain the presence of ARFID. We may also observe the young person’s behaviour and conduct a medical assessment for malnutrition, low weight and growth delay.
“I came to The Wave about 2 ½ years ago, and I can’t speak highly enough about their service, support, and love I received (and still do) from the team. They have helped me build stable foundations for a life that now feels worth living. I wouldn’t be the person I am today without their amazing help, and I am lucky enough to call them my family.”
Hope, Healing, and Balance
Our Specialised Programs for Teens
We provide expert care for young people classified as high-risk, extremely high-risk, and moderate to mildly severe risk. We tailor our approach to each individual to ensure that they’re getting the precise level of care they need.
The Wave Indigo Program specialises in the treatment of young people classified as high-risk or extremely high-risk. Our team of medical specialists is able to provide dedicated care for young people with increased needs. The facility is complete with ECG machines and labs for around-the-clock monitoring. The Wave Indigo Program has four Intensive Care Beds beautifully appointed for young people with the highest level of needs. Teens and young adults may require chair or bed rest with one-to-one care to assist with medical stabilisation.
The Wave Fuchsia Program provides complete care for young people with a BMI of 16-16.99 who do not otherwise meet the criteria for admission to Indigo Program (this includes recent risk of self harm & recent thoughts of suicide).
The Violet Program is for teens with a BMI of 16.99 -17.5, who do not otherwise meet the criteria for admission to a higher level of care.
ARFID therapies and treatment options
Recovering from ARFID
During a young person’s stay with us, they’ll experience a range of therapies and treatment options. Some of our most popular include:
One-to-One Therapy
During one-to-one therapy, each young person meets regularly with a dedicated therapist. These sessions offer a safe space for them to open up, share any worries and concerns, and get to the root of their condition.
Young people are also encouraged to learn how to handle their emotions and develop positive coping mechanisms and associations with food.
Group Therapy
At The Wave, we place a strong emphasis on team spirit and building relationships. After all, having a strong support network helps many people when the time comes for them to transition back into normal life. That’s why so many of our activities and therapies are focused on cultivating relationships.
Although many young people find it a little daunting to open up, group therapy is a great way to learn from others on a similar journey. Our young adults also find that group therapy enables them to form long-lasting friendships with other people. In addition, hearing from others who’ve battled an eating disorder shows our young adults that they’re not alone and gives them the chance to hear how others cope with the condition. There’s also a greater sense of accountability, as everyone will have each other’s backs.
Eating Disorder-Informed Yoga
A special category of yoga, eating disorder-informed yoga is gentle and non-aerobic, making it ideal for those with ARFID, who may have experienced malnutrition.
Eating disorder-informed yoga is the perfect solution, offering a gentle workout focused on the mental rather than the physical. During sessions, young people are guided through different movements, each designed to help them develop emotional awareness and trust in their bodies. It’s all about developing habits that give young people ownership over their bodies.
Alternative Therapies
From dance and art therapy to reiki and mindfulness, we offer a range of alternative therapies to enhance wellness and promote healing from the inside out. Being exposed to natural healing treatments can relieve stress, helping many people better cope with negative emotions and those moments when they feel like slipping back into old habits.
Creative therapies like art, dance, and drama offers the chance to express emotions and let go of negative associations with food. These therapies also help many develop new skills and hobbies that they can use once they’ve left our clinic – ideal for channelling their energy into something creative.
Gardening Groups
Known as horticultural therapy, our gardening group programmes offer our young people the chance to garden and look after their own bed of flowers and plants. This ownership gives them responsibility for something, empowering them to look after the seeds they’ve sown. Not only does this show them the power of care and compassion, but these skills can also be directly translated into how they look after themselves.
Flowers take time to grow, but they flourish with the right care and support, just like young people in recovery will. We also offer young people the opportunity to plant fruits and vegetables, enabling them to be involved with food from the moment it’s planted.
Cookery School
At The Wave, we believe in recovery through action. That’s why we get all our young people involved in activities and programmes that promote healthy eating, helping them develop a better relationship with food. One of these ‘living’ recovery activities is our cooking school. Here, we encourage young people to prep, cook, and learn new recipes that they can take with them into their future.
Being around food and learning how to nourish the body through cooking gently helps young people form healthy associations with eating, making it a fun experience rather than a scary one. It also equips them with the basic culinary skills they need in the future if they decide to move away from home or travel abroad.
Nutritional Programmes
During a young person’s stay at The Wave, they have a personalised nutritional programme tailored to their specific needs. This ensures that those in recovery from an eating disorder get all the vitamins and minerals they need to stay strong and recover. We also offer a wide range of education on nutrition, food groups, and how nutrition affects the body.
Over time, young people in our care slowly learn to develop regular eating patterns and meal planning. We take everything at our young person’s pace, helping them adjust to the changes smoothly.
Family Therapy
ARFID can take a toll on the whole family, and it can sometimes be difficult for loved ones to truly understand what a young person is going through and why. Our family therapy sessions are a safe space for everyone to open up, voice their feelings and concerns, and better understand one another.
Frequently asked questions
ARFID FAQ's
Many infants and young children will have favourite and not so favoured foods. Some will be described as picky eaters with relatively few food groups being eaten. Trying new foods often increases with age and for most children and young people the variety, tastes and textures increase into the tween years.
ARFID can result in a very limited and restrictive diet, leading to malnutrition and other health problems. It can also have a significant impact on a young person’s quality of life, as it can limit social and other activities that revolve around food. It’s important to recognize that ARFID is not simply a phase or a choice and requires professional help and treatment.
It’s crucial to distinguish between picky eating and ARFID, as the two conditions require different approaches and treatments. While picky eating can often be managed through exposure and encouragement, ARFID requires a more comprehensive and personalised approach, including therapy and medical interventions.
ARFID has a set of criteria for diagnosis that is somewhat different to anorexia nervosa. Teens with ARFID are not:
- Driven by a fear of being in a larger sized body.
- Restricting their food intake with a goal of losing weight, to diet, reducing calories or fitting into a certain size of clothes.
- Regularly over-exercising, purging to remove food or drinks, counting calories, weighing daily, using smaller plates or cutlery, or many of the other more usual disordered eating behaviours.
Eating patterns in young people with Autism and eating patterns in ARFID can share some similarities. Sensory and tactile sensitivity, high levels of anxiety at mealtimes, skipping meals and particular preferences that are rigid and offer little room for negotiation. Hunger and fullness clues may not be present.
Eating and feeding difficulties in young people diagnosed with Autism and ARFID can be difficult for young people to express. It may be challenging for schools, parents and families to fully understand the additional challenges. Young people with both diagnoses find engaging in treatment tricky and require additional specialist skill and knowledge. The Wave programs specialise in the treatment of eating disorders combined with Autism in young people.
The Wave has provided me with the ability to feel calm with the secure feeling that they are a team of professionals who know exact what my daughter needs. It has not been easy and continues to be a challenging journey.
The consistent communication through WhatsApp, phone calls, in-person and virtual family therapy sessions and weekly report have made being halfway across the world feel as if I am as part of my daughter’s treatment as I possibly can.
I had a great experience when I was on The Wave. It was one of the best experiences in my life. I enjoy all the sessions conducted by the team. I never had a chance to speak in group, specially with friends from other countries before.
It opens my eyes and gives me a new knowledge and experience to be a better person.
It opens my eyes and gives me a new knowledge and experience to be a better person.
