Understanding ARFID: What it is and how can we support those affected
What is ARFID?
Avoidant Restrictive Food Intake Disorder (ARFID) is a clinically recognised eating disorder, characterised by the restriction or avoidance of certain foods and persistent failure to meet nutritional requirements that are essential for both physical and psychological development and functioning. Unlike other forms of eating disorders (EDs), such as Anorexia Nervosa or Bulimia Nervosa, the onset of ARFID rarely originates from body image disturbances. Instead, ARFID commonly derives from an individual’s lack of interest in foods, sensory sensitivity or the fear of consequences associated with certain foods (for example, vomiting or choking). Unlike typical ‘picky eating’, which we see in many children, ARFID follows a persistent pattern that interferes with daily life and health.
ARFID often comorbidly exists alongside other psychiatric disorders, such as Generalised Anxiety Disorder or obsessive compulsive disorders; as well as showing increased prevalence in individuals with neurodevelopmental conditions, such as autism.
Why should we be aware of ARFID?
While ARFID has been recognised as a clinical disorder with its own diagnostic criteria since 2013, there is a lack of in-depth research on the disorder and, therefore, a lack of understanding and recognition of what ARFID actually is and how we can support children who are affected.
While ARFID can develop at any age, it has proven to be most common among children and adolescents. Dissimilar to other EDs, males are almost as equally likely to be affected by ARFID as females.
Education around ARFID is an important step to take to understand children’s needs and is essential to being able to support them effectively. Additionally, being aware of ARFID can help to detect the disorder early in children, allowing them to access suitable support and reduce the chance of significant impairments later in life.
How can we support children with ARFID?
- Finding ‘safe foods’ for your child - Children with ARFID will often have foods that they consider to be ‘safe’, normally because they know that they cannot get sick from it, or that the consistency, taste or smell will always be the same.
- Creating an accepting and supportive environment, where your child feels open to sharing their thoughts and anxieties around food.
- Predictability - Trying to create a predictable environment at home, especially around mealtimes. This could involve people sitting in the same seats, using the same cutlery, eating around the same time, or even creating ‘weekly menu/meals’ boards so that your child is aware of what they are going to be eating in advance.
- Try to make mealtimes low pressure and positive. Avoid forcing your child to eat and drawing attention to their plate or food choices, as this can result in increased anxiety and fear of failing to meet expectations around what they eat.
- Food chaining - This involves gradually changing you child’s foods over time, at their pace. For example, moving from plain crackers, to crackers with butter, to toast with butter
- Allowing your child to have some control at mealtimes. For example, giving them a choice between two meals.
- Avoid negative or pressuring language. For example, ‘just have one bite’, ‘I know you will like it’, or ‘you can’t leave the table until you’ve finished’.
If you would like to learn more about ARFID, visit www.arfidawarenessuk.org
