Is your ‘fussy eater’ just a typical toddler, who is reluctant to eat their greens and try new foods? Or could their selective eating be a sign of a more serious picky eating disorder?
Lots of children are fussy eaters. It can be frustrating and stressful when mealtimes turn into a battleground. But, with a lot of patience and perseverance, most kids will learn to try new foods. Many grow up to eat and enjoy a whole range of nutritious meals.
If your child’s fussy eating doesn’t get any better (or seems to get worse) they may begin to be very selective about what they eat. This could be a sign of something more serious.
– is sometimes described as ‘extreme picky eating’.
AFRID – Avoidant/Restrictive Food Intake Disorder
AFRID – Avoidant/Restrictive Food Intake Disorder
If you’ve never heard of it, you’re not alone. It’s a condition that can go undiagnosed for years. Concerned parents are often dismissed by medical professionals, who might not be aware of the disorder.
Children with ARFID have a fear of food. They can be extremely anxious around food. They might be sensitive to the taste, texture, smell or appearance of certain foods. Or they may only be able to eat foods at a certain temperature.
The fear of eating a new food is so strong that they restrict their diet to a small selection of ‘safe foods’. These include things like white bread, fries, chicken nuggets, pizza, plain noodles, crackers, and cereal.
Sometimes their sensory-based avoidance means that they don’t just stick to one type of safe food, but even to specific brands.
Dr. Kim DiRé, a trauma and eating disorder specialist, explains that:
Avoidant/Restrictive Eating Disorder (ARFID) is an eating disorder like no other. The fear of food and/or the consequences translates in ARFID individuals as “if I eat that, I will die.”
The physiological constriction of the mouth tissues, throat, and digestive tract from the fear stops the ability to eat a variety of foods. Malnutrition from ARFID causes many medical issues, including fatigue and loss of motivation. Because ARFID is a sensory disorder as well as an eating disorder, its cure is through somatic treatment. Dr. Kim DiRé
Because it’s a little known and recognised disorder getting a diagnosis can be hard.
It is only since 2013 that ARFID was included as a new eating disorder. It featured in the psychiatrists’ bible for diagnosing mental illness – the DSM – 5 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
One mum talks about her fight for medical professions to recognise her son’s condition as more than just fussy eating:
We’d share our experiences and concerns with family, friends, and medical experts, though our explanations and observations were often dismissed. Most reassured us the “picky eating” was just a phase. We felt dismissed and alone in our quest for answers. Anne Bouchard
Another mum, Chloe Bridge, in the blog ‘Sorry About the Mess’, writes about her son’s ARFID, and how she hates the fact that it gets dismissed as ‘fussy eating’. She says:
Being picky with food is a normal and expected developmental phase that occurs in the early years. ARFID is a much more serious physiological condition. It doesn’t go away with time. And yet is consistently gets lumped in under the umbrella term of fussy eating…ARFID is often talked about as something shocking. “Extreme fussy eating”. More shame and guilt heaped upon parents of children with ARFID, who have tried everything possible. More shame and guilt for sufferers of ARFID who already know they should be eating better for the sake of their health, but physically cannot do it. Chloe Bridge
A really important thing to know is that a child does not choose to have ARFID. Just like any other eating disorder, it is NOT a choice. And neither your child, nor you as parents, are to blame.
While there is growing awareness of ARFID there is still a lack of research, resources and support. Doctors do not currently have any guidelines to follow for the treatment and management of ARFID.
It can be difficult to access specialised treatment for ARFID, but there is help out there.
Beat Eating Disorders
Beat, the UK’s eating disorder charity, has lots of information about ARFID and what to do if you are worried about your child. You can find their guide here: What is Avoidant/Restrictive Food Intake Disorder?
They have a free helpline, as well as online support groups, where you can speak to others who are going through similar experiences to you.
Beat’s free, confidential Helplines are open 365 days a year 12–8pm Monday to Friday and 4–8pm Saturday, Sunday and bank holidays.
Is your child a picky eater or have you struggled more with fussy eating?
Have any strategies worked for you?
Share any meal ideas, problems or picky eating concerns in our online parenting community here:
- Avoidant/restrictive food intake disorder (ARFID) – Beat
- Avoidant/restrictive food intake disorder (ARFID): What to know – Medical News Today
- AFRID – My child is a fussy eater (and it’s not my fault) – Sorry about the mess
- It’s Time to Talk About ARFID – NEDA
- Defining the familiar: the birth of Avoidant or Restrictive Food Intake Disorder – ACAMH
- What Exactly Is AFRID – NEDA