What If It's Not Just Fussy Eating But This ...

Learn the signs and symptoms of this misunderstood condition.

It’s normal for children to be fussy eaters at certain times in their lives. One day they like something but dislike it the next. Thankfully, most will leave their quirky eating behaviours behind and go on to enjoy food in a healthy and adventurous way. But some don’t.

Sometimes children have such a deep-seated aversion to food that it goes beyond typical picky eating and continues into adulthood -- interfering with school, relations and health. This is what life's like for someone living with Avoidant/Restrictive Food Intake Disorder -- a recently-listed eating disorder in the Diagnostic and Statistical Manual of Mental Disorders.

Psychologist Clare Mann told ten daily one of the biggest challenges facing parents today is that it can be difficult to tell the difference between choosiness and problem eating. “As a result, children are often misdiagnosed as being overly sensitive or labelled ‘picky eaters’ -- placing them at risk of weight loss and further health issues.”

While the majority of kids affected are highly anxious and depressed, Mann says there will undoubtedly be other social issues and traumatic experiences that contribute to the condition. Here are some of the key facts to know.

What Exactly Is It?

The DSM-5 describes ARFID as an eating or feeding disturbance that leads to an avoidance of certain foods, resulting in weight loss and nutrient deficiency. “While it can affect anyone, it affects mostly people in childhood or infancy,” Mann says.

People may avoid food because of its colour, texture, smell or taste. And some develop a fear of choking, gagging or vomiting. “Unlike other eating disorders, ARFID isn’t characterised by a preoccupation with body shape or weight, and isn’t attributed to underlying disease or mental illness,” she says.

The goal is to reintroduce foods that have been cut from your child’s diet. Image: Getty.
Why Does It Happen?

While there are no singular causes of ARFID, Mann say the condition most likely develops as a result of a combination of genetic, psychological or sociocultural factors. The avoidance may also be due to previous traumatic experience or concerns regarding uncomfortable consequences related to consuming food.

“Whatever the reason is, the family context will undoubtedly influence how children are around something that has emotional/social context (eating), and something the child has control over (restricting eating),” she says.

What Are The Signs?

A child with ARFID may struggle with the very concept of eating to the point of physical repulsion. While it can be difficult to tell the difference between fussiness and disordered eating, the DSM-5 says children will generally display a range of physical and behavioural warning signs.

Some of the red flags to watch for include sudden refusal to eat, fear of choking or vomiting, no appetite for no known reason, very slow eating, inability to gain weight, weight loss, and delayed growth. Some people will also have issues at school or work due to low levels of nutrition -- making it difficult for them to concentrate. If your child displays any of these signs, see your GP.

To get all your essential nutrients, take advice from the food pyramid. Image: Getty.
How Is It Diagnosed?

Before making a diagnosis, your doctor will assess your child for other physical disorders that have similar signs and symptoms, such as digestive tract disorders, hormonal problems and other serious conditions. He will also consider mental health issues that can cause weight loss, and other eating disorders.

“Depression, anxiety, self-harm, eating disorders, and obsessive compulsive disorder are all highly related to someone trying to deal with stress, trauma, and identity issues,” Mann explains. “Eating is something people can have mastery over. For example, anorexia is a way of controlling the one thing you can -- the food you put in your mouth.”

How Do You Treat It?

The treatment for ARFID is similar to anorexia nervosa. At home, the goal is to reintroduce foods that have been cut from your child’s diet. If you child’s weight is extremely low, hospitalisation may be required to focus on giving nutritional support to return them to a healthy weight. If there is an associated mental illness, medications may also be prescribed.

“Treatments may also included Somatic Experiencing therapy to help sufferers make sense of their feelings and sensations, which can be overwhelming or difficult to identify and label. Similarly, Dialectical Behavioural Therapy -- is a special type of CBT often used with borderline personality disorder,” Mann says.

Feature image: Getty.