As a parent, it’s perfectly normal to worry about your child’s nutritional needs and development, especially during the unpredictable toddler years. Testament to this, nearly half of all parents with a child under two report experiencing picky eating behaviours.

However, while most children outgrow ‘fussy eating behaviours’ by school age,  in some cases challenges persist, and/or other symptoms appear.

You might have heard about, or wonder, what is ARFID? One of the more newly recognised eating disorders, it’s gaining lots of interest right now, particularly in parent circles.

With children’s mental health and wellbeing high on the agenda, this feature covers everything you need to know about ARFID in children. From understanding ARFID symptoms, to identifying eating disorders in toddlers and how to help a child with ARFID.

What’s ARFID?

Previously known as ‘selective eating disorder’, ARFID stands for ‘avoidant restrictive food intake disorder’ and can affect babies, children and adults. ARFID eating disorder has been diagnosed in children as young as two-years' old.

According to the ARFID Awareness UK, the eating disorder can be characterised by a “pattern of eating, that avoids certain foods or food groups entirely and/or is restricted in quantity (eating small amounts).”

Unlike many other eating disorders, ARFID is not affected by someone’s beliefs about their size or shape, and is not related to losing weight.

There can be a number of reasons why a child (or adult) is restricting their food intake, making it all the more tricky to diagnose.

Some of the possible reasons for ARFID include:

• Fear or consequences of eating, often related to upsetting experiences in the past, such as vomiting or choking.
• Negativity or sensitivity to the texture, taste, smell, temperature or appearance of certain foods.
• A general poor appetite, low interest in eating, or an inability to recognise they are hungry.

The difference between ARFID and child picky eating behaviour

One of the main differences between ARFID and a ‘fussy eating disorder’, is that picky or fussy eaters are interested in consuming foods they enjoy. Whereas those with ARFID do not think about food, or experience hunger – some even forgetting to eat. While picky eaters are able to maintain their weight, people with ARFID may not.

Dr. Gillian Harris, Clinical Psychologist. BA, MSc.PhD, CPsychol, AFBPsS, summarises this by saying:”The difference between a 'picky eater' and a child with ARFID, is that a picky eater won't starve themselves to death. A child with ARFID will.”

What are ARFID symptoms?

If you are concerned about your child’s eating behaviours, it’s important to speak to your GP to receive a correct ARFID diagnosis. This is because ARFID symptoms can vary from person-to-person.

ARFID Awareness UK have identified a number of potential signs of ARFID, some of these include:

• Sensitivity to aspects of some foods (such as temperature)
• Avoidance of whole food groups or textures (such as meat)
• A diet limited to less than 10 ‘safe foods’
• Struggling to stay or eat at a table during family mealtimes

Is there a connection between ARFID and Autism?

It is understood that children with autism are five times more likely to have food challenges.

And, according to ARFID Awareness UK, people with autism spectrum conditions, as well as intellectual disabilities are more likely to develop AFRID.

Getting help and ARFID treatment

It can be hard to diagnose ARFID, due to the many characteristics that define the eating disorder. However, the first step towards diagnosis is meeting a medical professional, such as a GP to discuss your concerns.

They will typically look at how much variety your child eats, understand how long avoidance to certain foods has been, review their weight and look at signs of nutritional deficiencies, along with other factors, such as whether their diet is interfering with their lifestyle, to make an accurate diagnosis.

Your medical professional will recommend the right course of action for each individual, based around cognitive and behavioural options and getting the right medical support.

However ARFID treatment begins with setting goals around eating. A few of these according to ARFID Awareness UK could be:

• Eating a larger range of foods
• Increasing interest towards food
• Reducing anxiety surrounding eating

Especially for young children, ‘desensitisation therapy’ may be one of the options advised. This involves a “play time approach, which enables a child to feel comfortable with the feel, smell and sight of foods”.

While AFRID may initially present as picky eating, there is much more depth to it, as outlined in this article.

This article does not constitute professional help. If you suspect that your child may be suffering with ARFID, or if you are concerned about their wellbeing, please seek professional support from your GP,  a qualified caregiver, or Child and Adolescent Mental Health Service.

Below are a list of helpful links and resources for further reading:

NHS - www.nhs.uk

ARFID Awareness UK - www.arfidawarenessuk.org

Beating Eating Disorders - www.beateatingdisorders.org.uk

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