What is ARFID?
If you are a parent, you might have witnessed the difficulty of getting your child to try new foods. You might be thinking, “this is nothing new”, but what happens when this involves more foods than you can count? Or, it never seems to go away, or seems to get worse? If you are tired of the constant food battles, or it might be helpful to first understand some characteristics of picky eating, ARFID, and ARFID treatment.
ARFID is commonly referred to as picky eating, but it’s not the same as picky eating. Picky eaters are those that avoid foods because they might dislike the taste, smell, texture, or appearance of food. This is common in childhood. In fact, 13-22% of children ages 3-11 are considered picky eaters. However, Avoidant Restrictive Food Intake Disorder, ARFID, is an eating disorder in which individuals avoid or restrict foods due: sensory characteristics of food, fear of negative consequences, or apparent lack of interest in food/eating. The restrictive behavior of food is not driven by body image concerns or the desire to be thin, like other eating disorders.
Differences Between Picky Eating and ARFID
- With ARFID, the individual may experience sudden or significant weight loss. Picky eaters, for the most part, maintain weight regardless if they have a limited food intake and typically do not experience weight loss.
- Those with ARFID may have difficulty with achieving their expected weight and have fallen off their expected growth trajectory or experience failure to thrive. Picky eaters, maintain their growth within expected ranges on the growth chart.
- People with ARFID may experience interference with psychosocial functioning. These individuals may find it difficult to be around certain foods or in a social setting that involves food and their anxiety around certain foods is usually heightened. A picky eater generally experiences little to no distress around food.
- Someone with ARFID may be dependent on supplements or tube feedings to ensure they are meeting their nutritional needs. A picky eater generally is able to meet their nutritional needs with the food they do enjoy and do not require supplementation.
Now that we have walked through some key differences between picky eaters and ARFID, what are the next steps to ARFID treatment? In this blog, we will discuss ways that you can help your child with ARFID manage their anxiety around mealtimes, how to use food chaining to increase and improve food intake and when to consult with a registered dietitian to help your child thrive.
9 Things to Help During ARFID treatment
1. Help your child manage anxiety at mealtime
As a parent, it is important that YOU are emotionally equipped and supported to be able to create this stress-free environment for your child. You can help decrease anxiety before meals by doing meditation from an app or listening to calm music. Headspace provides great options for both adults and kids. You can also practice distraction by using these recovery cards or playing a game. Another way to decrease anxiety is by having your child involved in the planning and prepping process. Either with food, plating, or setting up the table are all great options. The best way to provide pressure-free meals is by following The Division of Responsibility in feeding, by Ellyn Satter.
2. Start with foods that your child will eat
Making sure your child is eating enough is an essential part of helping your child during their ARFID treatment and recovery journey. When needs are not being met, this puts your child at risk for developing nutritional deficiencies as well as failure to thrive. A dietitian can provide a meal plan to help increase calorie intake. This will include creating a list of preferred food items with your child. Starting with increasing intake of the foods that your child already enjoys ensures they are meeting their needs.
3. Prepare your child for exposure to the new food during ARFID treatment
Exposure to new foods is not easy. To help decrease any anxiety your child might have with this process, you will want to warn your child before a new food is introduced. This will allow your child to prepare themselves mentally and emotionally. This does not need to be long in advance. A simple way to do this is by telling them “In 10 minutes we are going to have this meal/snack with this food.”
4. Give your child options to choose from
Let your child choose between two foods. You will want to give them options as “this or that” rather than allowing them to choose the food from an open-ended question such as “what do you want?” This provides more structure and demonstrates your role as a parent throughout the ARFID treatment process. This also allows your child to be involved in the decision making process. A dietitian can help create a list of preferred foods, fear foods, and “willing to try foods”.
5. The key to ARFID treatment is to start small
The desire to have your child increase variety in their diet is so strong, that the risk of pushing them too fast is often great. Don’t feel as though every meal needs to include a new food to make progress. A dietitian can help create a realistic timeline of trialing new foods during the recovery period to minimize discouragement and frustration.
6. Time meals well so they are hungry at mealtime
If your child isn’t hungry at meals, they are less likely to want to eat and try something new. You will want to time snacks with a long enough time before their next meal so your child has time to get hungry again by meal time. If your child is going into their meal hungry, they will be more inclined to try the new food.
7. Make the eating experience fun
You can make the eating experience more enjoyable by making the eating setting more attractive and fun. Sensory characteristics such as color and texture play a huge role in whether or not your child likes a new food. Your child may find new foods more appealing if they are perceived to be fun. Serving foods that can be served in shapes or bright colors might encourage interest from your child. Make sure your child is as comfortable as possible during meals, ensure they are seated comfortably and that they aren’t slouching.
8. Shift focus away from food during ARFID treatment
Children like to be the center of attention, but focusing on their food and eating habits may make them less likely to try it.
9. Provide rewards for positive behavior
You can motivate your child to try new foods and succeed with rewards and explanations. But, don’t reward negative behaviors if expectations are not met. Younger children are more likely to be motivated by rewards such as gaining privileges at home rather than materialistic things. And older children are more likely to be motivated by explanations such as explaining the benefits behind eating this certain food.
Looking for more information about ARFID and ARFID treatment?
For more information on ARFID, picky eating, or other eating disorders take a look at other similar blogs here.
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Meagan is passionate about working with clients who struggle with disordered eating and eating disorders and sees clients of all ages. She is determined to help others live a life that is free of dieting, food-rules and restrictions, and tune into their body’s internal cues to best enhance their health and well-being.
Thank you so much for this very helpful, information written in such a clear way. My grandson has had a very hard time with food. He is on the spectrum and very reluctant to eat anything except crackers.
Great article! Very informative. I will pass this on to our son. Cameron our grandson may have ARFID. Cameron does like to eat. He has been well below the weight averages for his age. Proud of you Meagan!