Learn about avoidant/restrictive food intake disorder from AboutKidsHealth
GUEST BLOG: Jessica Fishbein, AboutKidsHealthFrom February 1 to 7, Eating Disorder Awareness Week (#EDAW2018) aims to create a dialogue to help break stigma and combat misconceptions surrounding eating disorders.
Eating disorders can involve a person restricting or purging food due to a distorted body image, or avoiding or binge-eating food for other reasons. If people with eating disorders are not getting enough nutrients, they can become malnourished and are at risk for several long-term medical complications.
Eating disorders affect people of all genders, ages, races and ethnicities, and can harm not only a child’s health and well-being, but their family life as well. However, with the right treatment and support, children with eating disorders can recover — which makes it critical to be able to recognize the signs and symptoms of different disorders.
While more people are learning about eating disorders such as anorexia nervosa and bulimia nervosa, avoidant/restrictive food intake disorder (ARFID) may still be unknown or misunderstood by many.
To mark #EDAW2018, AboutKidsHealth has compiled information about ARFID to raise awareness of this disorder for patients and families. For more information on how to treat ARFID and eating disorders including anorexia nervosa, bulimia nervosa, and binge eating disorder, visit www.aboutkidshealth.ca/mentalhealth.
What is ARFID?
When a child or teen has ARFID, they eat very little food or avoid specific foods. As a result, they do not eat enough to meet their energy or nutritional needs, and often lose a significant amount of weight or fail to gain weight. Unlike anorexia or bulimia, ARFID is not motivated by insecurities about body image or weight gain.
What are signs and symptoms of ARFID?
A person with ARFID can show the following behavioural and physical signs:
Behavioural signs:
• Refusing foods they used to eat.
• A fear of choking and vomiting that causes them to refuse particular foods.
• Complaining of having no appetite without a medical or psychological reason behind it (such as a migraine, depression, or infection).
• Eating extremely slowly or not finishing the food on their plate.
• Having difficulty socializing and eating with friends and family.
Physical signs:
• Not growing or gaining weight — this can be observed if a child does not need larger clothes or shoes, for example.
• Since teens may have already stopped growing, significant weight loss is a more obvious physical sign of ARFID.
ARFID can lead to malnutrition, which occurs when the body does not have sufficient nutrients to perform normally.
How is ARFID different from “picky eating”?
Children who are “picky eaters” often avoid a few select foods, while those with ARFID may refuse all foods that have a particular taste, colour, smell, temperature or texture.
A picky eater may cast away certain foods, but their appetite is unaffected and they eat enough to continue growing and developing normally — whereas a child with ARFID often has little appetite and slower growth.
If a child is a picky eater, they tend to grow out of their eating habits and resume eating more foods as time goes on. Children with ARFID experience more persistent eating problems that require medical and psychological attention.
How is ARFID diagnosed?
Your child should be assessed for physical disorders with similar signs and symptoms to ARFID. Digestive tract disorders, hormonal problems such as diabetes and other conditions such as cancer can also cause weight loss, weight gain, or lack of growth. Weight loss can also be caused by a mental health or eating disorder, such as depression, anxiety, anorexia, and bulimia.
A child or teen will not be diagnosed with ARFID if their symptoms result from:
• A shortage of food available (such as with those who live in poverty)
• Cultural fasting practices, such as Yom Kippur or Ramadan
• A pre-existing medical condition, such as Crohn’s disease or diabetes
• Mental health conditions or eating disorders.
Medical complications of ARFID
ARFID can lead to malnutrition, which occurs when the body does not have sufficient nutrients to perform normally. Children and teens with ARFID are at risk of several other medical complications, including:
• low or irregular heart rate
• low blood pressure and anemia
• weak bones
• mood changes
• reduced hormone levels
• thinning hair
AboutKidsHealth is SickKids’ patient-education website and features more than 3,500 articles on a range of paediatric health topics. For more information on ARFID and other eating disorders, visit the www.aboutkidshealth.ca.
