As a parent, it can be worrying when your child has strong food preferences or struggles with eating.
What Is ARFID?
In 2013, a condition called Feeding Disorder of Infancy or Early Childhood was renamed to Avoidant/Restrictive Food Intake Disorder (ARFID) to better describe a wider range of eating problems that affect people of all ages.
ARFID can lead to a number of issues like:
- Weight loss or not growing as expected
- Nutritional deficiencies, meaning the body is not getting the vitamins and minerals it needs
- Dependence on feeding tubes or special nutrition drinks
- Problems with social and emotional well-being, like avoiding meals with others or struggling at school because of food issues
This new definition is more inclusive so ARFID will describe more people’s difficulties than Feeding Disorder of Infancy or Early Childhood.
Why Does ARFID Happen?
There are many different reasons why someone might develop ARFID. Some common causes include:
- Physical health issues: like growth problems
- Fear of choking or other bad experiences with food
- Sensory preferences: meaning some people might be sensitive to how food looks, smells, or feels
- Lack of appetite cues: where someone might not feel hungry or know when to eat
- Food neophobia is a common issue which means a fear of trying new foods.
When people are afraid of trying new things, like different foods, they often stick to eating the same meals over and over again. This makes the difference between their usual food and any new food feel even bigger.
For example, if someone eats the same peanut butter every day for weeks, switching to a new brand or type of peanut butter can make it feel like a much bigger change than it really is.
This is because their brain is used to the taste of the old peanut butter, so the new one feels more noticeable. People with ARFID can find it harder to try new foods because the difference feels much more intense and sometimes overwhelming.
Sometimes, when people eat the same food too many times, people can get tired of it or even find it gross. This is called glut eating.
When this happens, the food can start to feel overwhelming or boring, and people might refuse to eat it. Over time, this can make food choices get smaller and smaller, making it harder to find something to enjoy.
If you are concerned about your child’s eating, it is important to talk to a doctor to rule out any health problems. Sometimes ARFID can be linked to physical health issues that need medical attention.
How To Help With ARFID
ARFID can look different in every person, so therapy plans need to be personalised. Some children with ARFID may also have other challenges, such as autism, anxiety, or specific phobias (intense fears).
It is really important to understand what is going on to develop an individualised plan. Part of this plan will include compassionate caring confidence building to prepare people to try new things. Learning relaxation techniques can also be helpful.
There is a therapy plan that focuses on helping people with food neophobia to try new foods in a gentle, step-by-step way. The plan, described by Fitzpatrick, Fosberg & Colborn (2015), works by slowly increasing the variety of foods a person eats.
At first, you might only add a small amount of different foods, and then increase this over time, aiming for a different food at each meal or snack in a weekly cycle. This can be easier said than done and professional support can be helpful.
The goal is to help people’s taste buds be less sensitive to newness. Often, once someone becomes more comfortable with new foods, they start to feel curious and motivated to try even more.
The treatment also uses positive reinforcement, which means rewarding or praising progress to keep the person motivated.
What If Your Child Is Not Worried About Newness?
If your child has fears which are not related to newness, it is worth being curious about what they are scared of.
It could be helpful to read general advice for parents dealing with worries. General advice for parents for their child’s fears and worries is described in a book, Helping Your Child with Fears and Worries, by Creswell and Willetts (2020).
It might also be a good idea to talk to a professional, like a doctor or therapist, who can help you understand what is going on with your child and give you guidance on how to help them. Every child is different, and getting personalised advice can be the best way to support them.
FAQs About ARFID
How do you tell if you have ARFID?
This is the key diagnostic criteria:
- Weight loss or not growing as expected
- Nutritional deficiencies, meaning the body is not getting the vitamins and minerals it needs
- Dependence on feeding tubes or special nutritional drinks
- Problems with social and emotional well-being, like avoiding meals with others or struggling at school because of food issues
Does ARFID ever go away?
It does when some people stop meeting diagnostic criteria.
Is ARFID just picky eating?
No, the diagnostic criteria need to be met.
What happens if ARFID is left untreated?
People can have health and social problems, as per the diagnostic criteria.
Written by: Dr Marie-Claire Reville, Principal Psychologist at Us Therapy
