Avoidant Restrictive Food Intake Disorder

This is beyond your child not wanting to eat vegetables! They won’t eat anything hot or even warm to the touch. Maybe they won’t eat anything that crunches in their mouth. Maybe they cry every time you put brown items on their plate. Perhaps you can’t go out to restaurants because they won’t eat anything that isn’t cooked in your kitchen.

Picky eating comes in many forms, but what happens when picky eating has taken a drastic turn for the worse? Now, you’re really worried. Every meal is a battle, and you can see it’s affecting their health. Maybe your child is 6, or maybe they are 16. It doesn’t matter. Forcing your child to eat a balanced meal is impossible. This isn’t anorexia. Your child isn’t bulimic. This is when picky eating goes bad.

Hello, my name is Kristina Campos. I am the founder of the Impactful Parent. Every week I give you parenting videos that can help you in your parenting journey. If you have a particular topic or parenting question about your school-aged child that you would like me to address, please submit it at [email protected] or by messaging me on social media. All submissions are kept anonymous. 

Today, I will be talking about when picky eating gone bad. It’s called Avoidant Restrictive Food Intake Disorder, and it’s a real problem for many of our young people. I will explain what Avoidant Restrictive Food Intake Disorder looks like, the symptoms, and warning signs, and stick around to the end because I will also be giving you tips for how parents can help their child. Let’s get started!

Picky eating gone bad Avoidant Restrictive Food Intake Disorder

Avoidant Restrictive Food Intake Disorder goes beyond picky eating. It is classified as an eating disorder involving an extreme avoidance or low consumption of food. Unlike being a picky eater, Avoidant Restrictive Food Intake Disorder (ARFID) has a distinct level of physical and/or mental distress with eating. The child won’t be able to chew nor swallow their food without gagging or forcing it down. The result is a significant nutritional deficiency usually accompanied by weight loss or even weight gain if all they eat is empty-calorie foods. This eating disorder can also cause dependence on nutritional supplements. It can falter the child’s growth and even affect their ability to socialize normally with their peers. Even their relationships, daily functioning, and well-being are greatly affected.

There are four types of Avoidant Restrictive Food Intake Disorder:

1. The Avoidant Person: This child will avoid certain foods due to sensory sensitivities. This means that the child can’t eat their food because of the smell, the texture, or even how the food looks.
2. The Aversive Person: This child fears eating or the food itself. They are scared of eating the food because they think it might make them choke, vomit, get nauseous, or even give them pain.
3. The Restrictive Person: This child has little or no interest in food. They don’t want or care to eat. There simply isn’t any interest in eating.
4. The ARFID Plus Person: This child has two or more of the Avoid Restrictive Food Intake Disorders types mentioned.

It is also important to mention that this disorder can not be explained by the lack of available food. This means that if a child’s living conditions lack food or a culturally sanctioned practice of not eating (for example, fasting for religious purposes), then the child does NOT have ARFID. Avoidant Restrictive Food Intake Disorder can only be diagnosed if the child does not have a sacristy of food available. There is no cultural or environmental reason why they can’t eat.

This brings me to a few common questions that many parents have.

• “How does Avoidant Restrictive Food Intake Disorder differ from anorexia or bulimia?”
  • The biggest difference is that Anorexia and Bulimia are body subconscious and Avoidant Restrictive Food Intake Disorder does not. Although a symptom of ARFID could be dramatic weight loss, one’s body weight or shape doesn’t abnormally bother a person diagnosed with ARFID like it would with anorexia and bulimia. ARFID patients are not worried about weight gain, weight loss, or body image. They are worried about the food itself.
• “Is Avoidant Restrictive Food Intake Disorder a kid thing?”
  • No, it is not. Adults get ARFID, too, although the disorder is more common in children. Remember that ARFID can start with picky eating, but it goes way beyond that. ARFID patients have real fears about food.
• “What are the most distinguishing features of ARFID?”
  • I would say that ARFID features make it stand out from picky eaters, one is the fear of food, and the other is how ARFID affects social situations for the individual. Adults and kids with ARFID have difficulty socializing due to their disorder because they can’t eat or must have their food prepared a certain way. These individuals miss out on a lot because most social gatherings focus on food consumption

     

Picky eating gone bad Avoidant Restrictive Food Intake Disorder

What are the warning signs and red flags of Avoidant Restrictive Food Intake Disorder? If you think your child could have ARFID, here are some things to watch out for:

• Lack of interest in food
• Fear-based food restrictions like being afraid with the sight of certain foods
• A limitation on the amount of food they eat
• Inflexible eating behaviors
• Dressing in layers to hide their body
• A dramatic reaction to food or certain kinds of food
• A child complaining that they are full after only a few bites, if anything bites at all
• Complaining about stomach cramps to get out of eating
• Acid reflux
• A dramatic weight loss or even weight gain due to poor nutrition
• Trouble eating in unfamiliar places
• Trouble eating food prepared by others
• Difficulty concentrating at school
• Anemia
• A person complains they are dizzy, cold, or having sleep problems
• Dry skin
• The growth of fine peach fuzz hairs all over the body because the body is trying to keep itself warm
• And thinning hair on the head,

What causes Avoidant Restrictive Food Intake Disorder? The exact cause is unknown. Doctors say that environmental influences can be a big factor. Children will learn behaviors from the people around them. Moral beliefs about eating meat, dairy, and other items can come from within or be a learned belief from upbringing. Someone might also develop ARFID from a bad experience like choking or from another medical condition like gastroesophageal reflux disease. There are also psychological disorders that can cause ARFID, too. Even genetics might be a factor.

Picky eating gone bad Avoidant Restrictive Food Intake Disorder

Who is more likely to develop Avoidant Restrictive Food Intake Disorder? Unlike other eating disorders, more boys have ARFID than girls. Children with autism, ADHD, and co-occurring anxiety disorder are more likely to be diagnosed with AFRID.

When should parents take their child to the doctor? I know picky eating can be super frustrating, but where is the tipping point between trying to handle your picky eater on your own and start getting medical help? My recommendation is to go see a doctor if you see a sudden and significant weight loss or if you know that your child is not getting the proper nutrition from their diet. Nutritional deficiencies should be taken seriously because AFRID can harm childhood growth. If you notice that your child isn’t growing at the same pace as their peers, it is also time to get them checked.

Lastly, how can parents support their child with Avoidant Restrictive Food Intake Disorder? First, be sure to go talk to your family doctor or pediatrician. There are no medications that specifically treat AFRID yet; however, they may give you some medications for relieving some of the other symptoms of AFRID, like anxiety meds. Your doctor might also suggest you see a mental health professional help your child cope with the psychological side of this disorder. Cognitive Behavior Therapy, Dialectical Behavior Therapy, and Exposure & Response Prevention Therapy are common techniques mental health professionals use to help people lessen the distress and symptoms of AFRID.

Second, parents should not take a “Just eat it!” stance with their AFRID child. Tough love might work with a picky eater. Still, that parenting technique is not recommended for kids with Avoidant Restrictive Food Intake Disorder. Instead, support your child by starting small and encouraging one bite at a time. The goal here is to make your child feel successful in their efforts. Praise, encourage and even reward your child’s efforts. Kids with AFRID will be very emotional about eating and easily be discouraged. Find ways to manage their anxiety and stress around food. Taking a couple of deep breaths can help your child relax. Even yoga, meditation, music, art, dance, and writing can help your child calm their nerves. Studies say that it can take 10 tries before a person accepts a new food they don’t want. This means you will have to be a patient parent and not give up on encouraging your child to eat those feared foods. That’s a lot of tries and a lot of patients! Finally, when your child finds their new food acceptable to eat, parents need to keep the new food in their diet. Don’t stop serving that food! Keeping the food available for your child is important; otherwise, they are likely to regress and reject it again.

It is also important for parents to role model healthy, diverse eating. Kids won’t accept new habits if you can’t do them yourself. Also, schedule regular meals and snack time. Having regular family meals creates stability and security around something that makes AFRID children anxious and unsettling. Avoid struggles during mealtimes. It may also help to make trying new foods a game and give your child the opportunity to have some choice in the food they are trying to eat. Allow them to pick a food to try.

Avoidant Restrictive Food Intake Disorder can be tricky and frustrating for families. I hope today’s episode helped you to get a better understanding of this disorder so you can help those you love.

But until next time, you got this, parents. I am just here to help.

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