18/11/2021
It may not always be just picky eating...
Could it be picky eating or something else? Sharing a bit of Q & A about Avoidant Restrictive Food Intake Disorder (ARFID), to create better awareness about this condition that I'm seeing more often recently in practice.
What is ARFID?
It is the failure to meet nutritional needs leading to low weight, nutritional deficiency, dependence on supplemental feedings, and/or psychosocial impairment. It is one of the more recent additions to the nomenclature of eating disorders.
This condition usually presents as sensory sensitivity to specific food items (ex. all fruits and vegetables), lack of interest in eating (ex: skips meals or eats little), and fear of aversive consequences (ex. choking, phobia, etc.)
How different is it from Anorexia Nervosa and Bulimia?
One of the main difference is the reason for food restriction. ARFID is not associated with intense fear of gain weight or any distorted perception of weight and body image.
Is it the same as Picky Eating?
They are not the same, although selective eating in childhood is considered as a risk factor. In picky eating, children usually expand their food selection pattern as they grow up. In ARFID, previously dropped foods may no longer be incorporated in the diet, which may also result to entirely avoiding certain food groups.
Are there any psychiatric comorbidities?
It is usually diagnosed in patients with anxiety disorders, autism spectrum disorder and ADHD.
Why is it important to seek professional help?
Low food intake, limited food selection and long-term omission of certain food groups in the diet can lead to different forms of malnutrition, nutritional deficiencies and imbalances that may take a toll on a personโs overall health and wellness.
How can a Nutritionist-Dietitian help?
We can objectively assess and monitor an individual's nutritional status; check for any nutrient deficiencies and imbalances. Specific nutrients can also help support gut health, neurotransmitter imbalances, that can aid in addressing mechanisms behind other psychiatric comorbidities. We usually work with a psychiatrist in carefully planning for nutrition strategies when gradually introducing novel foods (which may be served in various forms) in a very systematic way (ex: see-touch-smell-taste-chew strategy).
Feel free to get in touch if you are a parent with a child or an individual who can relate to this.
If you are a medical/health professional who have managed a patient with ARFID, please connect with me.
Ref: Thomas JJ, Lawson EA, Micali N, Misra M, Deckersbach T, Eddy KT. Avoidant/Restrictive Food Intake Disorder: a Three-Dimensional Model of Neurobiology with Implications for Etiology and Treatment. Curr Psychiatry Rep. 2017;19(8):54. doi:10.1007/s11920-017-0795-5
