How is ARFID different from picky eating?

Question

Hello doctor,

I recently heard about avoidant or restrictive food intake disorder, a type of eating disorder, and I am starting to worry that my little girl might have it. She turns seven next month and is extremely picky about what she eats. She only eats around 10 or 12 specific foods, and they are not the healthiest options either. She is very thin, almost wire-like, and I am concerned about her growth and overall health. She refuses to try new foods and has a strong aversion to many things we offer her. I am worried this could be more than just a phase. Can you suggest any strategies or treatments that might help her expand her diet and improve her nutrition?

Please guide me.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Avoidant or restrictive food intake disorder (ARFID) can be concerning, especially when it impacts a child's growth and nutrition.

Here are some strategies and treatments that might help:

Gradual exposure: Introduce new foods slowly. Start with very small amounts alongside familiar foods. Repeated exposure to new foods can help. It might take many attempts before she accepts a new food.
Positive reinforcement: Praise and reward her for trying new foods, even if she just takes a small bite. Avoid using pressure or punishment as it can increase anxiety around eating.
Modeling behavior: Eat together as a family and model healthy eating habits. Show enjoyment when trying new foods.
Involve her in meal preparation: Let her help with shopping, choosing, and preparing food. This can increase her interest in trying what she helped make.
Sensory integration: Explore the textures, colors, and smells of foods in non-eating activities to make her more comfortable with them. Activities like playing with food textures in a non-eating context can reduce aversion.

Treatments:

Nutritional counseling: Work with a registered dietitian who can develop a balanced meal plan and suggest nutrient-rich alternatives for her preferred foods.
Cognitive behavioral therapy (CBT) can help address anxiety and negative associations with food.
Occupational therapy may be beneficial if sensory issues are significant.
Feeding therapy: Specialized feeding therapists can work with her to expand her food repertoire in a structured and supportive way.
Additional tips: Consistency is key. Maintain a routine around meals and snacks. Limit distractions during meals to focus on eating. Avoid catering to picky eating by offering only preferred foods. This reinforces the behavior.

Consider a multidisciplinary approach involving dietitians, therapists, and medical professionals to provide comprehensive support. It is important to address these concerns early to ensure her growth and development are on track. Each child is different, so a personalized approach is often the most effective.

Please revert in case of further queries.

Thank you.