What is the treatment for ARFID?
ARFID is best treated by a multi-disciplinary team that includes a doctor, a therapist, and a dietitian nutritionist who specialize in eating disorder care. Sometimes patients will need to work with speech-language pathologists and occupational therapists.
At Side By Side Nutrition, our certified medical nutrition therapy dietitians provide personalized, one-on-one nutrition counseling specifically tailored for individuals facing Avoidant Restrictive Food Intake Disorder (ARFID). We also offer family-based treatment, online support groups, and virtual meal support options for continued guidance and care.
Our approach is grounded in a holistic philosophy that prioritizes behaviors, and overall well-being, fostering a positive relationship with food and our bodies, and practicing self-compassion rather than fixating on numbers. This philosophy forms the foundation of values-aligned, intuitive, sustainable health and well-being. Our focus lies in assisting clients in cultivating a sustainable, empathetic, respectful, and trusting connection with food, body image, and self.
Our dietitians are based in Colorado Springs and Fort Collins, Colorado, as well as Woodinville, Washington, and we work with patients from all over the state and country providing in-person and online nutrition counseling.
What is ARFID?
ARFID, Avoidant Restrictive Food Intake Disorder, also referred to as "selective eating disorder," is a condition that significantly affects an individual's eating and feeding behaviors, presenting notable challenges to their physical and mental well-being. Those dealing with ARFID typically struggle to meet their body's nutritional or energy needs due to either refusing to consume certain foods or persistently avoiding specific types of food.
Individuals with ARFID often demonstrate a reduced interest in eating or food in general. Those affected by ARFID may actively steer clear of certain foods due to sensory characteristics such as textures or smells. Moreover, some with ARFID may experience heightened anxiety or fixation regarding the potential consequences of eating certain foods.
This complex disorder highlights the interaction between psychological and sensory factors, as individuals with ARFID navigate a challenging relationship with food that extends beyond mere dietary preferences. Acknowledging the nuanced nature of ARFID is essential for fostering comprehension and offering appropriate support to individuals grappling with this disorder, emphasizing a holistic approach to addressing both the nutritional and psychological aspects of their well-being.
What are the five type of ARFID?
Avoidant/Restrictive Food Intake Disorder (ARFID) might not be as well-known as anorexia or bulimia, but it's a significant eating disorder that affects many people. The five types of ARFID include avoidant, aversive, restrictive, adult ARFID, and ARFID plus. By working with a dietitian, expert in eating disorders, you can understand the root cause of ARFID and get appropriate care to support sustainable recovery.
While the path to recovery may seem daunting, it's important to recognize that complete healing is attainable and support is available. Our team of specialized eating disorder dietitian nutritionists is uniquely equipped to collaborate with you and the treatment team, guiding you through this journey.
Who is most affected by ARFID?
Avoidant Restrictive Food Intake Disorder can affect people across various demographic groups, with its onset potentially influenced by a blend of factors. While it can emerge in people of all ages and backgrounds, certain populations are more at risk. Here are some groups that may be particularly vulnerable to ARFID:
Infants and Children: ARFID is the second most commonly diagnosed eating disorder in children (under 12), though adults and adolescents can be diagnosed with the disorder, as well. Its onset is most often during infancy and childhood. It goes beyond picky eating. A combination of genetics, temperament, and experiences with food can trigger ARFID.
Sensory Sensitivities: Those with heightened sensory sensitivities, such as aversions to tastes, textures, smells, or appearances of food, may face an elevated risk of developing ARFID. People at risk for sensory hypersensitivity include those with autism, sensory processing disorders, and post-traumatic stress disorder.
Autism Spectrum Disorder (ASD): Those on the autism spectrum might be more prone to ARFID due to sensory hypersensibility and a preference for routine in their eating habits.
Anxiety or Obsessive-Compulsive Disorders: People who have anxiety disorders or tendencies towards obsessive-compulsive behavior may face an increased risk of ARFID, as these conditions can lead to heightened anxieties related to food.
Gastrointestinal Conditions: People who experience gastrointestinal issues, such as chronic abdominal discomfort, GERD, IBS, or reflux, may develop ARFID as a coping mechanism to steer clear of foods linked to discomfort.
Developmental Disorders: People who have developmental disorders or delays may be at higher risk for developing ARFID, often because of challenges in sensory processing or communication.
Trauma or PTSD: Those who have experienced trauma or suffer from post-traumatic stress disorder (PTSD) may develop ARFID as a means of coping, avoiding foods linked to traumatic experiences.
Chronic Illness: People struggling with chronic illnesses, particularly those affecting the digestive system or resulting in chronic pain, may face an increased vulnerability to ARFID.
Recognizing that ARFID can affect individuals from diverse backgrounds, and acknowledging its multifaceted causes, is essential. Timely intervention and support play crucial roles in addressing ARFID and avoiding or reducing potential complications associated with the disorder.
Is ARFID rare in adults?
Although ARFID is often diagnosed in children, many adults also live with this disorder, sometimes for years without a diagnosis. Many adults with ARFID have been struggling with the disorder since childhood. They may have developed coping mechanisms that conceal the severity of their condition. Some adults experience ARFID later in life, often triggered by trauma, anxiety, or other psychological factors. The disorder might seem to appear suddenly, making it more difficult to identify and diagnose. Healthcare professionals frequently overlook ARFID in adults because it does not conform to the typical profile of an eating disorder, which is usually linked to concerns about body image and weight.
If you suspect you or someone you love is struggling with ARFID, it’s important to reach out and get treatment. Recovery is possible.
We believe people are meant to discover true nourishment through a self-compassionate, self-accepting, and holistic lens. In our practice, our clients are empowered to become their own nutrition experts. Our role is to gently lead them towards body trust and acceptance, and ultimately, open up their lives to more.
We want to work with you.
What does a dietitian do for ARFID ED?
Our devoted team of eating disorder (ED) dietitian nutritionists is dedicated to guiding clients towards a path of recovery. Dietitians play a pivotal role in the comprehensive treatment of ARFID. Starting with a thorough assessment, we customize individual meal plans to accommodate specific food aversions, nutritional requirements, and preferences, gradually broadening the variety of foods consumed. Through the implementation of exposure therapy, we systematically reintroduce avoided foods in a supportive manner, addressing sensory sensitivities and texture aversions commonly associated with ARFID. Nutrition education, combined with psychoeducation about the psychological aspects of eating challenges, constitutes a fundamental aspect of our approach. Behavioral techniques, including managing food-related anxiety and establishing regular meal times, are seamlessly integrated into the treatment regimen. Family involvement is encouraged, particularly in cases involving children or adolescents, to foster a positive mealtime atmosphere. Regular monitoring enables us to adjust plans as needed, collaborating closely with mental health professionals and a multidisciplinary team to ensure a comprehensive and patient-centered approach. Our objective is to expand the individual's food options, alleviate anxiety surrounding eating, and promote overall health and well-being.
Throughout your path, we offer unwavering support, accompanying you through the inevitable highs and lows. We applaud your progress and stand alongside you as you reach your goals. We work collaboratively to meet your unique needs and goals! Our mission extends beyond eating disorder recovery to fostering a life that is fulfilling, purposeful, and in harmony with your values. We understand the significance of this journey and the therapeutic alliance, and our committed dietitians are here to assist you at every stage.
Acknowledging that each individual holds the key within themselves, our diverse team of medical nutrition specialists facilitates a journey of self-discovery and empowerment. Recovery from Avoidant Restrictive Food Intake Disorder encompasses more than just overcoming an eating disorder; it entails crafting a life of fulfillment and empowerment through healing around food.
What does nutrition therapy include?
A Comprehensive Initial Assessment
Our holistic approach begins with an in-depth initial evaluation, delving into your individual needs by exploring your history with food, body image, and overall health. With your consent, we engage in a collaborative process to grasp your objectives and hopes for our collaboration and your journey toward full recovery.
Build Trust in the Body’s Natural Cues
Our approach is centered on breaking free from the constant thoughts and behaviors associated with the eating disorder that keep individuals stuck in a cycle of distress. Together, we embark on a transformative journey to build trust in the body's natural cues and become intuitive and trusting eaters, allowing for a renewed sense of freedom and openness in life.
Go Beyond Symptom Management - Shift Body Image Perception
Our focus goes beyond merely managing symptoms; we aim to facilitate a profound transformation in how body image is perceived, fostering self-acceptance and a genuine appreciation for one's unique self. By breaking down the mental and emotional barriers imposed by the eating disorder, we empower our clients to embrace a life free from never-ending negative food and body image thoughts, nurturing a newfound sense of joy, purpose, and opportunity. Follow-up sessions are central to our collaborative efforts. We thoroughly explore your connection with food and body, addressing obstacles and co-creating personalized strategies. We delve into body image examination, dismantling external pressures of food and body negativity, and establishing supportive frameworks as necessary. Our objective is to assist you in broadening the spectrum and adaptability of your eating habits, learning to nuture and tend to your body's signals of hunger and satisfaction, and cultivating a joyful relationship with both food and body.
Continued Support
Throughout your journey, we offer unwavering support, navigating the inevitable ups and downs. We celebrate your progress and stand by you as you cross the finish line. Our mission is not only eating disorder recovery but also the cultivation of a life that is rich, meaningful, and fully aligned with your values. We believe in the importance of this journey and the therapeutic relationship, and our dedicated dietitians are here to guide you every step of the way.
TESTIMONIALS
Our team of Expert Dietitian Nutritionists Have Been Featured In:
Our Team of Dietitian Nutritionists, Expert ED and Medical Nutrition Counselors
The Side by Side Nutrition team has a team of 12+ outpatient registered dietitians. We provide online nutrition counseling to patients in Colorado and around the country. We offer one-on-one and family nutrition counseling for patients either online or in person, with offices located in Colorado Springs and Fort Collins. We specialize in eating disorder recovery and body image healing.
RD - Registered Dietitian
RDN - Registered Dietitian Nutritionist
MS - Masters of Science
As specialists in ED nutrition counseling our mission is rooted in compassion. We:
Strive to create a safe and nurturing space for individuals on their journey to wellness.
Understand the profound impact that eating disorders can have on one's life.
Are committed to fostering a supportive community where every client feels seen, heard, and understood.
Work from an intuitive eating, HAES (Health at Every Size) Informed Approach.
Believe everyone has the right to high-quality care – accessibility and inclusivity are at the core of our values.
Stand firm in our belief in the possibility of full recovery.
Continually invest in our education to stay at the forefront of the field.
Are committed to ongoing learning.
Channel all our resources into becoming the best eating disorder nutritionist counselors.
Are dedicated to guiding our clients toward a life of lasting health and empowerment.
We Accept Insurance:
We are committed to ensuring that our clients have access to healthcare, and we make every effort to facilitate this. We accept insurance plans such as BlueCross Blue Shield (Anthem/Regence), United HealthCare (Optum), Aetna, and Cigna.
Dietitian for ED and Medical Nutrition Therapy FAQ
What insurance plans do you accept?
Side By Side Nutrition is in network with Cigna, Cigna Localplus, Aetna, BlueCross Blue Shield (Anthem/Regence), UMR, and United Healthcare. Prior to your visit, please call your insurance company to check your benefits. We can not guarantee coverage.
For other insurance companies, we are out-of-network providers. This means we can provide you a superbill to submit to insurance for possible reimbursement. SBS can not submit superbills without a medical diagnosis. Payment is due at time of service for folxs using out of network benefits.
What is the DSM-5?
The Diagnostic and Statistical Manual of Mental Disorders (5th edition), commonly referred to as the "DSM," serves as a comprehensive guide on mental health and conditions related to the brain. The American Psychiatric Association (APA) is tasked with the creation, editing, review, and publication of this manual.
Patients may also hear the term ICD-10. This is the International Classification of Diseases (10th revision), a system used by doctors to classify and code all diagnoses, symptoms and procedures for claims processing.
How does treatment work? What does a typical session look like?
An outpatient team consists of a dietitian, therapist, and primary care physician at minimum. Sessions are highly individualized and change from week to week depending on the needs, goals, behaviors, and journey of each client. Our dietitians are constantly assessing the needs, progress, safety, and next steps with their client’s short and long term goals in mind.
An outpatient team works collaboratively to ensure clients get the best care for their recovery while staying in their day to day life. Clients in eating disorder recovery being treated on the outpatient level will typically visit with their dietitians 1-2x/week, therapist 1-2x/week, PCP monthly, and psychiatrist as needed.
I don’t live in Colorado, can we still work together?
Absolutely! We are passionate about making care accessible for you and offer telehealth services and online nutrition therapy when appropriate. We will meet via a HIPAA-compliant video conference platform and communicate between sessions using email.
We provide nutrition counseling to clients from around the county.
How much do sessions cost?
Side By Side Nutrition session rates for private pay clients are:
$225 for the initial session and $170 for follow up sessions.
Insurance rates may vary from private pay rates depending on the insurance provider and your individual plan. We accept credit cards, debit cards, HSA, and FSA cards.
We offer sliding scale spots open for those who qualify and are experiencing financial hardship.
Do you work with children and adolescents?
Dietitians at Side By Side Nutrition work with teens and adolescents ages around 9+ and up. With treating adolescents for an eating disorder, we typically use a modified family based treatment approach which involves treating the entire family. You can learn more about Family Based Treatment for eating disorders here.
What states do you work in?
We have offices in Colorado and WA but we see clients all over the United States! We can see clients virtually in Nevada, Kentucky, Minnesota, New York, Arizona, Wisconsin, Kansas, Missouri, Alabama, Illinois, Connecticut, California, Florida, Washington DC, Maryland, Oregon, Texas, New Hampshire, Utah, Virginia, Wyoming, Georgia, Michigan, Pennsylvania, and Ohio.
We are moving more virtual because our goal is to make nutrition counseling as accessible, affordable, and stress-free as possible. Appointments with your dietitian are rooted in conversation. We have found that exchanging information during nutrition counseling sessions is far more effective and less stressful when you aren’t rushing to get to our office or worried about getting stuck in traffic. Want to talk to your dietitian in your pjs? Feel free! We use HIPAA-compliant Zoom for all of our appointments so you can easily and comfortably connect from home, work or wherever you are, on any device you choose.
Do you have a cancellation policy?
Because many patients wait several weeks for an appointment and to protect our providers time, we must strictly adhere to a 48 hour cancellation/late change policy. This policy states that you must cancel your appointment at least 48 hours ahead if you need to make any changes to your appointment. Failing to respect this policy will incur the full session fee. We appreciate your understanding as all clients who wish to be seen sooner benefit from this policy.
Why do you keep a credit card on file?
The main reason we do this is to encourage our clients to communicate promptly with us about changing or canceling an appointment (see “Do you have a cancellation policy?” above).
What is body dysmorphia?
Body dysmorphic disorder, also known as BDD, is a mental health condition characterized by excessive preoccupation with perceived flaws in one's appearance. This condition can affect individuals of any gender identity, including male, female, transgender, or non-binary. While it often emerges during adolescence, BDD can persist into adulthood and can affect individuals at any stage of life.
What is Health at Every Size?
Health at Every Size™ is a compassionate care framework that recognizes and promotes body diversity and holistic health. We recognize a focus on intentional weight loss causes harm, does not improve health, and further invokes weight stigma and discrimination. We believe any person in any size body can pursue health and create positive behavior change that prioritizes their individual health desires.
What is intuitive eating?
Intuitive Eating is an approach to eating that incorporates building body trust, intuitive responses, emotional awareness, and listening to your body. It encourages self-compassion, curiosity, trust, and a gentle attitude towards food in order to cultivate and maintain a sustainable, healthy, and trusting relationship with food and body image.
What is the difference between a nutritionist and a Registered Dietitian?
In summary, all Registered Dietitians (RD or RDN) are qualified nutritionists, but not all nutritionists hold the Registered Dietitian Nutritionist credential. The term "nutritionist" is not regulated, allowing anyone to use it, which complicates distinguishing individuals with comprehensive nutrition education (e.g., CN or CNS) from those with minimal training such as weekend courses or self-study.
The Registered Dietitian Nutritionist (RD or RDN) designation is nationally recognized and provides certain assurances. It indicates that the individual has met specific criteria, including obtaining at least a bachelor's degree in nutrition science, completing a supervised practice program of over 1200 hours, passing a national registration exam, and fulfilling extensive continuing education requirements for license renewal. Our dietitian nutritionists are also licensed in states where licensure is mandatory.
Other practitioners who may identify as nutritionists, such as health coaches, holistic nutritionists, nutrition therapy practitioners, and personal trainers with "nutrition certifications," may lack formal nutrition training. Consequently, their services are ineligible for insurance reimbursement nationwide because they are not recognized as nutrition experts.
Recent “graduate” from Side by Side Nutrition. I started working with SBSN to figure out how food worked after having an eating disorder for years. And I’m so happy I got so much more than that! SBSN introduced me to Self-Compassion and met me with an approach that never included shaming me. I looked forward to our sessions every week, even if I hadn’t done any of my work, because I knew she’d be understanding and work with me to figure out what I needed to make it happen. And none of that compassion and presence was lost when we had to switch to telehealth. When I started, I didn’t think healing from an eating disorder was possible. And I never in my wildest dreams imagined that I’d come out of it with an unshakable love for my body (certainly not a plus size body with chronic illness)! I’m so glad circumstances sent me here because I know I wouldn’t have gotten to this place with my previous dietician! I am STRONG, I am CONFIDENT, and I am in LOVE with myself! Thank you so much for helping me on my journey here! It wasn’t easy, but it was so worth it!
— Michaela Myers