ARFID is Not ‘Fussy Eating’: The Truth About Avoidant Restrictive Food Intake Disorder
Sky News published an article yesterday titled ‘ARFID: The little-known eating disorder that is on the rise’ and the responses on social media highlight the extent of stigma and misunderstanding surrounding this condition.
Here are a handful of the comments.
‘Another name for a fussy child who’s now got a new label. And no doubt the parents can claim disability for the child’.
‘Children deciding not to eat is a learnt and encouraged response, kids do not enjoy going hungry!’
‘Cook one meal if they don’t eat it they soon will when they get hungry.’
Amongst many others like ‘So they’re fussy?’ and ‘Picky eaters is now a disability?’
ARFID stands for Avoidant Restrictive Food Intake Disorder. It is characterised by the following:
a lack of interest in eating or food
avoidance of food due to sensory sensitivities (hence, it is estimated that up to a third of people with ARFID are autistic)
concern about the negative consequences of eating
Let’s get something clear. ARFID is not just fussy eating. As Dr Gillian Harris (Clinical Psychologist via ARFID Awareness UK) says: “The difference between a ‘picky eater’ and a child with ARFID, is that a picky eater won’t starve themselves to death. A child with ARFID will.”
ARFID is associated with ‘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), dependence on enteral feeding or oral nutritional supplements, significant nutritional deficiency or marked interference with psychosocial functioning.’ ARFID has significant, life-threatening consequences.
It is not a label for fussy eating. It is not children deciding not to eat.
Children with ARFID aren’t being ‘picky’ out of choice. For them, putting certain foods in their mouth can feel so revolting and distressing that withstanding the texture or the act of eating feels impossible. Every meal-time can feel like torture. But ARIFD isn’t new. The diagnosis is, yes - entering the DSM-V (the diagnostic manual of mental disorders) in 2013. But before this, it was called ‘Selective Eating Disorder’ and classified under ‘Other infant and early childhood feeding disorders’ in diagnostic manuals. The clinical presentations seen today are not new, but now it has a name, obviously diagnoses are going to increase.
Buy my mindmaps as PDF downloads here
It is not a way to ‘claim disability’. Currently, there are no treatment guidelines for ARFID in the NICE Guidelines and many services do not have treatment pathways or funding to diagnose or treat ARFID. This means that those with ARFID are often suffering without support and it is difficult to access a diagnosis of ARFID.
ARFID and autism frequently co-exist. Autistic people’s sensory sensitivities often crosses over into food. It doesn’t mean they have ARFID, but if the number of foods they are eating are extremely limited and there is that persistent failure to meet nutritional/energy needs as outlined above, unrelated to worries about body/weight, it might be ARFID.
It is a good thing that ARFID is being spoken about and recognised more. It is one of the least understood eating disorders and more research, treatment guidelines and support services are desperately needed.
Where to find support:
ARFID Awareness UK are a registered charity dedicated to raising awareness and understanding of ARFID. You can join their online communities to connect with others.
Endeavor (run by BEAT) is a carer support group for parents/carers of children aged 5-15 years with ARFID (in some areas of the UK). They offer an 8 week online programme of support for certain areas.
BEAT also provide information about ARFID on their website.
The ARFID journal (@thearfidjournal) created by Ruby Hicks is a self-directed resource which may benefit teens and adults with ARFID.
Lauren Sharifi Nutrition (@arfid.dietitian on instagram) has a wealth of resources on her website and instagram page.
GIRL UNMASKED (The Sunday Times Bestseller) is available to order from Amazon and all major bookstores!
The paperback is out 27th February! :)
https://linktr.ee/girlunmasked