What is ARFID?Not a new disorder, ARFID has only in recent years become better understood. Toddlers, children, and adolescents are often dismissed as simply picky eaters if they refuse to eat certain foods. While there is the possibility that some kids are just selective about what they eat because broccoli does not appeal to them, many have gone undiagnosed as having ARFID. These young people don’t just shake their heads and refuse to eat new foods. They gag, choke, and often display signs of anxiety if they are forced to try the new foods. Quite often described as a type of picky eating, this eating disorder is quite unlike any other that you may be more familiar with. The person experiences anxiety, fear, and physical symptoms when they try to eat a new food. The mouth, throat, and even the digestive tract can constrict because of the fear of trying something new. The fear of eating can become so intense and overwhelming that some children refuse to eat, even when they are hungry. This goes against the adage that parents have heard for decades: “Your child is just picky. They will eat when they’re hungry. Children won’t starve themselves.” Children and teens who have ARFID will starve themselves, but without the same intention as is seen with anorexia nervosa. This is more of a sensory body disorder that is rooted in fear of choking or throwing up. Broadly speaking, ARFID can be broken into three categories.
- Sensory avoidance. Teens who have sensory avoidance may have concerns with the way food tastes, the texture of food, the temperature of the food, and the way that it smells.
- Simply lacking interest. Some teens may be genuinely disinterested in eating and in the food that you’re offering them. They may also get full quickly and could be described as having an appetite like a bird.
- Fearing one or more aversive consequences. Some may have anxiety about eating due to believing that they will get sick, get nauseous, throw up, choke, or have an allergic reaction to foods.
Possible causes of ARFIDIn truth, there may be no one single cause or ARFID that can be pinpointed. It’s thought that there are several contributing factors to the development of ARFID. They could be psychosocial, biological, or they might be environmental. Traumatic events can trigger someone who is potentially predisposed to developing ARFID because of genetics. There can also be underlying concerns that make children and teens more likely to show the signs of ARFID. This could include autism and anxiety disorders. Those who are autistic or have one or more anxiety disorders could have a heightened sense of their body, responsible for their developing this disorder.
Warning signs and symptoms of ARFIDAs is the case with any disorder, the warning signs and symptoms you see in your teen may differ from those that other teens display. Warning signs of ARFID may include:
- They will have a short list of foods that are considered acceptable. Some may have just a handful of foods that they will eat.
- They eat only foods that tend to have similar textures or colors. Some may prefer crunchy foods, while others don’t like bright colors.
- They avoid entire groups of foods, whether that’s all fruit and vegetables or all sources of protein.
- They prefer specific methods for preparing foods, whether that’s baking or frying.
- They eliminate types of food from their list, without any reason sometimes, and refuse to add them back.
- They have obvious weight gain struggles. Some children are of age-appropriate weight and still do grow despite their reluctance to eat.
- They have nutrient deficiencies. It is common for teens to be anemic and be lacking in vitamins A and C.
- They show signs of anxiety or stress when presented with new foods. They may also become emotional. Whether that looks like anger or crying, the emotions can range.
Potential risks and complications of ARFIDBeing a fussy eater is one thing, but a teen who has ARFID is something else entirely. These teens are at risk of several potentially serious complications that should be addressed, including:
- Gastrointestinal concerns, including severe and painful constipation
- Failing to gain weight or height on par with others their age
- Weight loss or weight gain. This depends mainly on the types of foods deemed acceptable by your teen. A teen who lives off of high fat or high carb foods may gain weight, whereas a teen who picks at lean protein and one small vegetable may struggle to gain weight.
- Developing other anxiety disorders, including social anxiety surrounding food and eating. Some may struggle with depression due to feeling isolated from others.
How can parents help a teen with ARFID?Children and teens alike will get quite frustrated with constantly being told to try new foods or experience something different. Many may even shut you out and completely refuse to eat anything for days on end. Most of those who live with ARFID will have a short and restrictive menu of foods that they consider to be safe. They are rarely healthy choices and tend to lean more towards what we’d consider comfort foods like french fries, chicken nuggets, pizza, chips or crackers, waffles, hot dogs, and a small selection of sweets. Once they have their preferred foods, it can prove challenging to break away from them and explore something different. That said, frustrated parents may find themselves in a constant battle at mealtimes. They may yell, threaten, or punish teens who refuse to eat the meals prepared for them. Just what can be done? Trying to work with your struggling teen is frustrating, but you don’t need to work through it with them on your own. Therapeutic options are an excellent approach to take. With increasing knowledge and increasing diagnoses of this disorder comes an increase in understanding how to treat it. Several types of therapy could help your teen and your family:
- Dialectical behavioral therapy
- Cognitive behavioral therapy
- Exposure therapy
- Family therapy
- Peer therapy