ARFID, which stands for Avoidant/Restrictive Food Intake Disorder, is a relatively new eating disorder. It is characterized by extreme selectiveness in food choices and a lack of interest in eating. This can result in a limited variety of preferred foods, leading to inadequate growth and poor nutrition. ARFID typically emerges younger than other eating disorders and is more prevalent in boys.
The signs of ARFID can be grouped into three main categories. Some children are highly selective eaters with strong adverse reactions to foods' smells, tastes, textures, or colours. They may experience a fear of new foods, known as “neophobia,” and may fear negative experiences associated with unfamiliar foods. Other children generally lack interest in eating, with a low appetite and minimal enjoyment of food. They often deny feeling hungry. The third category includes children who have fear and anxiety related to eating, such as the fear of pain, choking, or vomiting.
It is common for children with ARFID to fall into one or more of these categories. Many are underweight, while others may reach an average weight but have a limited diet that affects their school, family, and social lives. Children with ARFID are more likely to have additional conditions such as anxiety or obsessive-compulsive disorder (OCD), autism spectrum disorder, attention deficit disorder (ADHD), and experience problems at home and school due to their eating habits.
ARFID can lead to various problems due to poor nutrition. Children with ARFID may not receive adequate vitamins, minerals, and protein. In some cases, tube feeding and nutritional supplements may be necessary. Poor growth and delayed puberty are also possible consequences. Additionally, the lack of proper nutrition can result in dizziness, fainting due to low blood pressure, a slow pulse, dehydration, weakened bones (osteoporosis), weakened muscles, and stopped menstrual periods (amenorrhea).
The exact cause of ARFID is unknown. However, experts believe that a combination of a child’s temperament, genetic factors, and triggering events like choking may contribute to its development. Some children with ARFID may also have other medical conditions, such as gastroesophageal reflux disease (GERD), eosinophilic esophagitis, allergies, or other conditions that cause feeding problems.
To diagnose ARFID, doctors will examine and inquire about the child’s medical history, eating habits, exercise habits, and emotional issues. They will look for significant weight loss or failure to grow, nutritional deficiencies, poor appetite or lack of interest in food, and food avoidance. It is important to rule out other factors, such as lack of access to food or other eating disorders. Blood, urine, or electrocardiogram (ECG) may be ordered to identify any underlying issues.
Treatment for ARFID is best done by a team of a doctor, dietitian, and therapist specializing in eating or feeding disorders. The treatment plan may include nutrition counselling, medical care, feeding therapy, and addressing food-related anxiety or fear. Medications may be prescribed to increase appetite or manage anxiety. In some cases, more intensive hospital-based programs may be necessary. Children with severe weight loss, malnutrition, or serious health issues may require hospital treatment or tube feeding.
Parents can help by supporting and encouraging positive attitudes towards exercise and nutrition at home. They can be role models by consuming various foods and establishing regular meal and snack times. Family meals should be pleasant without conflicts during mealtimes. Encouraging the child to try new foods without forcing them is essential. Positive eating behaviours can be rewarded, and mechanisms for managing anxiety and stress related to food can be explored.
If you suspect your child may be struggling with ARFID, it is crucial to seek help from professionals specializing in treating eating disorders. Contacting a therapist trained in Cognitive-Behavioral Therapy for ARFID (CBT-AR) and SPACE ARFID approach can provide valuable guidance and support. These experts can offer the necessary tools and strategies to address ARFID effectively. Remember, early intervention is vital to successful treatment. Don’t hesitate to contact an STG therapist with training in CBT-AR and SPACE ARFID to take the necessary steps to support your child’s well-being.
