Everyone has food preferences – some foods they especially like and others they dislike. However many parents will be familiar with their children voicing a strong dislike of certain foods that, even after strong encouragement, they may refuse to eat. Some children can be picky eaters and strongly refuse a wide range of foods. Within reason such behaviour is not so unusual and can be accommodated, however, some children who appear to be picky eaters may actually be suffering from a recognised eating disorder known as Avoidant/restrictive food intake disorder – or ARFID.
Avoidant/Restrictive Food Intake Disorder (ARFID) is a complex eating disorder characterised by significant limitations in food intake. Children with ARFID may experience intense fear or anxiety about specific food textures, smells, or tastes, leading to a restricted diet and potential nutritional deficiencies.
For parents of children with ARFID, navigating this challenging situation can feel overwhelming. Mealtimes can be very difficult and ARFID can also pose problems for children outside their home, for example at school or when invited to visit friends for birthday parties or sleepovers.
However, understanding the condition and adopting a supportive and positive approach can help to make ARFID a much less stressful problem. This blog aims to provide practical strategies, informed by the latest research, to help families manage ARFID in their children.
Strategies for Coping with ARFID
1. Create a Positive Eating Environment
Focus on a Positive Emotional Context: Research suggests that positive and encouraging strategies are perceived by people with ARFID as helpful in improving attitudes toward food, and minimising social discomfort around eating. Creating a positive emotional context surrounding food and eating with others may help to eliminate psychosocial impairment and increase food approach in those with severe food avoidance.
Avoid force, coercion, or punishment related to food. Such approaches can be counterproductive and can create a negative association with eating. For example, studies have shown that children consume significantly more food when they are not pressured to eat. One study that tracked food-avoidant children from the age of four to nine years old found that coercive parental strategies diminished over the years suggesting that parents eventually learn that these strategies are not effective.
Research shows that creating a positive emotional context around food is a helpful strategy to enhance the food approach in children. Create a predictable and enjoyable mealtime experience. Focus on providing a structured, routine setting that eliminates distractions and creates a positive and relaxing atmosphere. Incorporate pleasurable elements like enjoyable conversations, activities, or music to make mealtimes more appealing and less stressful.
2. Parental Agreement and Emotional Regulation
It is not unusual that parents are not in complete agreement about how to manage a child with ARFID; however, parents should understand the importance of alignment if they are to be successful in changing eating behaviour. Research indicates that parents are more effective when they agree on a consistent approach to dealing with their child’s ARFID and regulating their own emotions. Expressing anxiety, frustration, or anger towards the child’s eating habits can create a negative and stressful environment, hindering progress.
3. Engage Siblings
An emerging Family-Based Treatment for ARFID emphasises the desirability of involving siblings in supporting their brother or sister with ARFID. Siblings can act as positive role models for healthy eating habits, helping to normalise a broader range of food choices within the family. They are also able to provide both context and support for their brother or sister whose change in eating has been acute.
Siblings are often affected by the under-eating of the affected sibling because of parental focus and concern about this issue thus, it can be helpful for them to participate.
4. Expand Food Exposure and Opportunities
Diverse Eating Platforms: Gradually expose your child to various food experiences including going to restaurants, trying different cuisines, and trying new foods in a safe and supportive environment. Even if their eating remains limited, evidence suggests that these experiences can help desensitise them to new foods and broaden their perspectives. It’s beneficial when parents model a wide range of healthy food choices themselves, setting a positive example for their children. The goal is to create a family culture where exploring a diverse range of food is encouraged and celebrated.
Conclusion
Managing ARFID in children requires patience, understanding, and a commitment to a coordinated and positive approach. By fostering a positive emotional context around food and eating, providing opportunities for exposure and exploration, and collaborating with other family members, parents can support their children in developing healthier relationships with food.
Seek professional support from a psychologist specialising in treating ARFID for personalised guidance and tailored strategies to address your child’s specific needs and challenges. Remember, progress takes time, and celebrating small victories along the way can be a powerful motivator for both children and parents.
