Picky eating is a common problem among children, but for some, it can be a more severe condition known as Avoidant/Restrictive Food Intake Disorder (ARFID). ARFID is characterized by avoiding certain foods or entire food groups, difficulty eating with others, and a lack of interest in food. It can result in significant weight loss, malnutrition, or even hospitalization.
Common causes for picky eating
Anxiety and food-related stress are often significant factors in the development and maintenance of ARFID. Children with ARFID may experience anxiety related to food, such as fear of choking or vomiting, or they may have general anxiety that makes it difficult to eat in social situations. Additionally, food-related stress can stem from the pressure to eat certain foods, negative experiences with food or mealtime, or even feeling overwhelmed by the variety of foods available. These stressors can lead to negative associations with food and make it difficult for the child to enjoy eating.
One of the most effective evidence-based strategies for dealing with ARFID is a form of cognitive-behavioural therapy called “Enhanced CBT for ARFID” (E-CBT-AR). This therapy addresses the underlying psychological and behavioural factors contributing to ARFID, such as anxiety, food-related stress, or negative associations with food. It also involves gradual exposure to feared foods and teaching coping mechanisms.
Another effective strategy is Family-Based Treatment (SPACE-ARFID), which involves parents in the treatment process. SPACE-ARFID is designed to help families understand the disorder and make changes to the family dynamic that may be contributing to the child’s ARFID. It also helps the child to learn new feeding skills, increase the variety of foods they eat, and improve their overall relationship with food.
It’s also important to note that in some cases, ARFID may be a symptom of a more significant problem, such as an underlying medical condition or an eating disorder. In these cases, it’s essential to seek the help of a healthcare professional, such as a registered dietitian and a therapist with experience with eating disorders, to assist with finding strategies for eating anxiety and food-related stress, and to help children improve their relationship with food.
Food Stress Reduction Strategies to Try
Here are a few evidence-based strategies to try to reduce food-related stress for your family:
- Gradual exposure: Gradually introducing new foods to a picky eater can help them become more comfortable trying new things. Start with small amounts of new foods and gradually increase the portion size over time.
- Make mealtimes pleasant: Creating a positive and relaxed atmosphere at mealtimes can help picky eaters feel more comfortable trying new foods. Avoiding pressure or criticism can help create a more positive experience.
- Get kids involved in meal prep: Involving children in meal preparation, such as grocery shopping or cooking, can help them feel more invested in the meal and more likely to try new foods.
- Encourage independence: Allowing picky eaters to serve themselves and make their own choices can help them feel more in control and more willing to try new foods.
- Keep offering new foods: Even if a picky eater doesn’t try a new food the first time it’s offered, keep offering it regularly. It can take up to 15 times before a child will accept a new food.
- Incorporate healthy foods in a familiar way: If a child is hesitant to try new foods, try incorporating them into familiar dishes in a less noticeable way, for example, adding grated vegetables to spaghetti sauce.
- Introduce new foods with familiar ones: Picking a food familiar to the child and serving it with a new food can help the child feel more comfortable trying something new.
- Be a good role model: Children learn by example, so if parents are open to trying new foods, children are more likely to follow suit.
At STG La Ronge Counselling, counselling for ARFID in the form of family therapy exists. SPACE-ARFID was developed at Harvard University. Chris de Feijter was trained in implementing SPACE-ARFID in regular counselling and parenting sessions. These sessions focus on improving parenting skills, and the child does not need to attend any sessions.