26 May Avoidant Restrictive Food Intake Disorder (ARFID) – Is there a simple solution?
It’s very frustrating as an eating disorder therapist, not to have an effective way of working with a particular eating disorder. If someone comes to me with binge eating disorder or bulimia nervosa, I have a very clear understanding of how to start to break down the perpetuating factors that keep people stuck in these eating disorders.
Anorexia Nervosa is more of a challenge, and I generally have to be a little more inventive to be able to find effective solutions. I have also over the years, tried really hard to develop patience, as eating disorder recovery is usually slow, and requires use of multiple therapeutic modalities over a long period of time.
In the course of my work, a few people have presented to me with Avoidant Restrictive Food Intake Disorder (ARFID). People with ARFID have an inability to eat certain foods. In some cases, individuals with the condition will exclude whole food groups, such as fruits or vegetables. Sometimes excluded foods can be refused based on colour, texture, consistency, or temperature. ARFID is different from other eating disorders as the underlying motivation isn’t to lose weight.
I went looking for some training in an effective method of tackling this disorder which is often misunderstood and sometimes incorrectly perceived just as a ‘version’ of Anorexia Nervosa. I quickly discovered ……well, very little actually!
One name did keep appeared though. Felix Economakis.
Who was this man and why did he keep appearing on my computer?
Felix is a UK based psychologist who achieved some recognition via a TV programme called Freaky Eaters. With the ‘magic’ of TV, he appeared to cure ARFID within minutes. It couldn’t really happen like that could it?
I decided I wouldn’t rest until I knew exactly what methods he used and ideally, I wanted to see his method in action. Felix is understandably protective of his treatment method, which he calls the 4R’s. However, after many emails, and much begging on my part, he agreed to teach me (just to shut me up maybe?)
I travelled to London in March 2020, about a week before COVID 19 forced me to hastily board a plane and escape back to Australia. Eek!
Whilst I was in the UK though, I was lucky enough to spend time with Felix in his London practice, where I learned how to use the 4R’s and saw him practice the method on his clients.
Felix sees ARFID very simply, and to be honest, the 4R’s is a surprisingly simple approach, so I remained sceptical regarding its efficacy. For most clients, only one face to face session is required, and afterwards, they are encouraged to continue to develop their newly discovered eating skills at home.
The 4R’s treatment protocol boosts a success rate of over 90% with adults and around 65% with children over 9 years of age.
Only a select few clinicians have been invited into the ARFID equivalent of the Magic Circle. I say that because in many ways I can see performance aspects in the 4R’s, and ‘magic’ really can happen! After a 2-hour session, I have seen people eat a whole selection of foods that they have always been too scared to try. For sufferers of ARFID that’s more impressive than seeing a rabbit being pulled out of a hat!
Kyla Holley is the Director of The Australian Centre for Eating Disorder and works in private practice in Coffs Harbour.
If you are interested in the 4R’s treatment, you can contact Kyla at firstname.lastname@example.org