Avoidant/Restrictive Food Intake Disorder (ARFID) and substance abuse are both complex disorders involving psychological, physiological, and environmental factors. While ARFID is a type of eating disorder, and an SUD is a mental disorder affecting the behavior and brain, the two commonly intersect, exacerbating each other’s symptoms.

What is Avoidant/Restrictive Food Intake Disorder (ARFID)?

ARFID (Avoidant/Restrictive Food Intake Disorder) is a type of eating disorder that involves a disturbance in the amount and type of food someone eats. ARFID can lead to significant health issues, weight loss, or emotional and social impairment. Unlike other eating disorders like anorexia nervosa or bulimia nervosa, ARFID is not defined by concerns about body image or weight. Individuals with ARFID, both adults and children, exhibit disinterest in eating or food in general due to sensory properties, such as texture or smell. They often have a fear of choking, vomiting or gagging when in the presence of food, further causing them to avoid it. With a restrictive food intake, children and adults with ARFID often struggle with energy and nutritional deficiencies, which can cause extreme tiredness and laziness in some individuals.

Signs and Symptoms of ARFID

  • Significant weight loss (in adults)
  • Failure to gain weight (for children)
  • Lack of appetite or interest in food
  • Nutritional deficiencies
  • Fear of eating
  • Constipation
  • Vomiting or gagging around certain foods
  • Abdominal pain
  • Low body temperature
  • Social isolation
  • Emotional distress

ARFID can also interfere with social functioning and interactions, significantly impacting psychological well-being and quality of life. This can cause feelings of anxiety and loneliness from not feeling comfortable attending dinner parties or family gatherings with the presence of food. Adolescents and adults with ARFID may turn to alcohol or drugs to cope with the emotional distress and loneliness caused by their eating disorders, leading to dependency and addiction.

The Connection Between ARFID and Substance Abuse

The link between avoidant/restrictive food intake disorder (ARFID) and addiction is a complex interplay of various psychological, behavioral, and social factors that can reinforce and exacerbate each other. When an individual suffers from both an eating disorder and substance use disorder (SUD), each condition can intensify the other. Drug and alcohol abuse can exacerbate the psychological distress that contributes to eating disorders, while ARFID can increase the urge to use substances as a form of escape or control.

Coping Mechanisms

Individuals with ARFID may struggle with severe anxiety or stress related to food and eating. In some cases, they might turn to substances to cope with this anxiety or escape from the pressures of eating. Both disorders exhibit an underlying issue with the ability to cope with complex emotions or stressful situations.

Co-Occurring Mental Health Disorders

Both ARFID and substance abuse have a high prevalence of co-occurring mental health disorders such as depression, anxiety disorders, trauma, and other mood disorders. The behaviors associated with ARFID and SUDs are often a way of exerting control as the individual often feels powerless or overwhelmed by their condition. Co-occurring disorders can complicate the presentation and treatment of substance use disorders (SUDs) and ARFID.

Individuals struggling with a drug or alcohol addiction may also experience feelings of shame and low self-esteem, exacerbating their substance abuse and these negative emotions. Similarly, ARFID can lead to feelings of guilt, inadequacy, or isolation due to their eating challenges. These negative emotions can also further contribute to mental health issues.

Nutritional and Neurochemical Impact

Malnutrition from ARFID can significantly affect brain chemistry, potentially making individuals more susceptible to drug or alcohol abuse and addiction. This can result from shifts in neurotransmitter levels, such as serotonin and dopamine, responsible for mood regulation and reward mechanisms. The brain’s reward system plays a significant role in both ARFID and substance abuse. While avoiding feared foods or situations can provide a sense of relief or ‘reward’ for individuals with ARFID, drugs or alcohol can stimulate the brain’s reward pathways, creating a temporary sense of pleasure and comfortability.

Social and Environmental Factors

Social isolation is a common issue for individuals with ARFID, as they may avoid social situations involving food. Similarly, substance abuse can lead to social withdrawal and difficulties in maintaining healthy relationships. Environmental factors, such as exposure to family members with substance abuse issues or distorted eating habits, can also play a role in the development of both disorders.

Avoidance and Sensory Sensitivities

Individuals with ARFID often have heightened sensory sensitivities and may avoid certain textures, tastes, or food smells. This often stems from anxiety or negative experiences with foods in the past. Drug and alcohol abuse can also be seen as an avoidance behavior, where individuals use substances to escape from emotional pain, stress, or trauma.

Overlooked Symptoms and Treatment Challenges

Symptoms of drug and alcohol abuse can sometimes mask or mimic symptoms of ARFID, leading to misdiagnosis or inadequate treatment. Similarly, the focus on treating a substance use disorder (SUD) can sometimes overshadow the eating disorder, delaying proper treatment and care for ARFID. The co-occurrence of ARFID and addiction requires a comprehensive treatment approach that addresses the underlying mental and physical health challenges associated with both disorders. This often requires a dual diagnosis treatment plan, integrating nutritionists, mental health professionals, and addiction specialists.

Dual Diagnosis Treatment for Substance Abuse and ARFID

Understanding the connection between these disorders is vital for prevention and early intervention strategies. Education and awareness about the signs and risks of substance abuse and ARFID are crucial for individuals to receive the proper care and treatment. When addressing the dual diagnosis of eating disorders like ARFID and substance abuse, addiction treatment centers take a comprehensive treatment approach to treat both conditions properly. An integrated approach often requires a thorough health assessment and screening, covering medical, nutritional, psychological, and social aspects to understand both disorders best. Holistic treatment plans for ARFID and substance abuse are tailored to treat them simultaneously. This may include addressing physical health issues and malnutrition, medical and nutritional intervention, and psychotherapeutic methods. Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) are two types of therapies applied in drug and alcohol rehab to replace negative thought patterns with positive ones.

While there are connections between ARFID and substance abuse, not everyone with ARFID will develop an SUD, and vice versa. Each individual’s experience is unique, and their conditions should receive treatment tailored to their specific needs and circumstances.

If you’re struggling with substance abuse or a co-occurring disorder, decide to take your life back and get sober today. At Coastal Detox, we are here for you!






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  • Cleveland Clinic, 2023. Avoidant/Restrictive Food Intake Disorder (ARFID).
  • National Library of Medicine, 2020. The Risk of Substance Use Among Adolescents and Adults With Eating Disorders.
  • Substance Abuse and Mental Health Services Administration, 2011. Clients With Substance Use And Eating Disorders.
  • American Psychological Association, 2017. What is Cognitive Behavioral Therapy?
  • Psychology Today. Dialectical Behavior Therapy.