The Confident Eater

ARFID – The Confident Eater

ARFID gets the attention it deserves

ARFID has frequently been in the news over the last few years. Although it is a challenging condition, this is really exciting as prior to this it wasn’t something that was being brought to the public eye. Now that there is media attention it will be great to keep it current and squarely front and centre. It is important that it becomes something that everyone is conversant with.

In New Zealand, a Sunday program aired in July 2017 detailing the disorder and the children who suffer from it. This has educated many on the devastating effects of really restrictive eating.

It is not “just picky”

It has also vindicated the gut feelings of countless parents who have lobbied their health providers for years about their children’s eating. They have known that there is something beyond just “normal” fussiness around food that is affecting their children. But until recently there has not been a name or a diagnosis to assign to this extreme form of “picky” eating.

According to Kelly Lavender, a NZ eating disorder specialist the number of children in NZ suffering from ARFID could be as high as 5-10%

Certainly in my experience it is common to find children who have overwhelming food fears and rigidity around food. Parents report to me that their babies could pick up changes in formula brand at 6 months or vomit at the smell of a disliked food. It is definitely more than just “a normal phase” or “permissive parenting”.

Currently there is no standard procedure for treating children with ARFID. Methodology differs from provider to provider and even within providers dependent upon the age of the child. But recovery is absolutely possible.

Below, I’ve tabled the official ARFID diagnosis (taken from the Sheppherd Pratt website).

Diagnostic Criteria for ARFID (Based on the DSM-V)

1.   An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:Significant weight loss (or failure to achieve expected weight gain or faltering growth in children).

Significant nutritional deficiency.
Dependence on enteral feeding or oral nutritional supplements.
Marked interference with psychosocial functioning.

2.  The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice.

3.  The eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced [body image].

4.  The eating disturbance is not attributable to a concurrent medical condition or not better explained by another mental disorder. When the eating disturbance occurs in the context of another condition or disorder, the severity of the eating disturbance exceeds that routinely associated with the condition or disorder and warrants additional clinical attention.