ARFID: Avoidant Restrictive Food Intake Disorder - Know the Signs

ARFID

I have only recently become aware of ARFID and in each of the three cases I came across, the parents really struggled to get their child a diagnoses.
In two instances the children ended up being peg fed and in the other case of an older girl, she had to have a blood transfusion.

Common in Children with Autism
ARFID does present more commonly in individuals with Autism, so in this article, I want to highlight this disorder, as most of us with autistic children witness some form of picky eating at mealtimes.  ARFID however, is an extreme form of picky eating which can have a big impact on your child’s health such as: 

• • Significant weight loss or failure to gain weight appropriately.
  • Nutritional deficiencies due to limited food variety or calorie intake.
  • Potential health crises like the need for tube feeding or blood transfusions.
  • Disinterest in food, eating very slowly, or forgetting meals altogether.

With the release of DSM-5 in 2013 ARFID became a recognised clinical diagnosis. 
Because it’s a relatively new listed disorder clinicians and doctors are still learning about the disorder and how to treat it. There are a few key defining features that set it apart from other eating disorders and it's important to recognise these as red flags.

How to recognise the difference between ARFID and other eating disorders
Children with ARFID don’t particularly care about weight or shape, definitely not in the way that young people with other ‘eating disorders do’. Instead, they avoid certain foods or groups of foods for a wide variety of reasons.

What distinguishes ARFID from other eating disorders is their worry about the taste, texture, colour or even ‘movement’ of food. Also there can be an intense fear of choking or vomiting.

Gender
Boys are diagnosed with ARFID about as often as girls are - unlike other eating disorders where girls are much more likely to be diagnosed. 

Diagnosing ARFID
For a child to be diagnosed with ARFID, their eating habits must have a significant negative impact on their physical and/or mental health. Often, children with ARFID lose an unhealthy amount of weight, or they fail to gain weight and grow as they get older. 

They may also have significant nutritional deficits, which means that they don’t get enough calories or a wide enough variety of nutrients for their bodies to function normally.

When signs typically start to present
ARFID typically shows up in young children. Signs can become clear by the time a child is six or seven, but because it can be hard to tell ARFID apart from normal picky eating, the child may go undiagnosed until other health issues like underweight and malnourishment highlight the issue.

Finally, some kids with ARFID simply have little interest in food or eating. They might forget to eat, get distracted easily during meals, or eat extremely slowly. They also tend to like only a narrow set of foods. This is often called “restrictive” ARFID.

Bodywhys – The Eating Disorders Association of Ireland: As the national voluntary organisation supporting individuals affected by eating disorders in Ireland, Bodywhys provides detailed information on ARFID, including its symptoms and treatment options.

They also have a support network offering support services for individuals dealing with eating disorders, including ARFID. They provide helplines, support groups, and resources tailored to those affected and their families.