I’m sure we all know at least one person who is very picky about food, I know people who don’t like fruit, garlic, whole grains, nuts and seeds, etc. For example, we often see in young children that they tend to be “picky” when it comes to food choices. That’s not a bad thing in general – we all have foods we prefer and foods we wouldn´t necessarily need. However, some EXTREMELY picky eaters may also suffer from an eating disorder – the Avoidant/Restrictive Food Intake Disorder also called: ARFID
Certainly, there is at least one food that you absolutely cannot stand. You can hunt me, for example, with Brussels sprouts, pure milk chocolate, savoy cabbage, dumplings and butter made from cow’s milk products. Simply because I either don’t like the taste, the texture or the look. That alone is not a problem and can be part of “normal eating habits”.
Picky eating habits are very common in childhood. For example, around the beginning of school, kids begin to become pickier and tend to prefer carbohydrates – because these promote growth. However, most outgrow their sensitivity. Appetite and flexibility increase with puberty and food choices become wider.
Those affected by ARFID often show the first signs in infancy. For example, they have difficulty switching to mixed foods, don’t want to try anything new and are particularly sensitive to “crunchy” and “mushy” things. However, children usually still manage to meet their nutritional needs.
According to the DSM-IV, the diagnostic criteria for ARFID are as follows:
So now that we’ve cleared up the difference between normal picky eating and the eating disorder, let’s look at who is particularly vulnerable to developing ARFID. The disorder is more common in children and adolescents – but it can also occur in adulthood. The disorder appears to affect a larger proportion of men than in anorexia and bulimia.
The consequences of ARFID can have a negative impact on health and growth in the long term. Depending on the severity of malnutrition and malnutrition, tube feeding should be considered to stabilize vital signs.
Cognitive-behavioural therapy should be used to treat the psychological problems associated with ARFID, such as anxiety. A nutritionist can help create a balanced diet plan and help you gradually face the foods you avoid (exposure).
At ARFID, the goal is often to get the person back to a reasonably healthy and balanced diet, even if that may mean they will never eat the “rainbow” or love or enjoy food like other peers.
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Zimmerman J, Fisher M. Avoidant/Restrictive Food Intake Disorder (ARFID). Curr Probl Pediatr Adolesc Health Care. 2017 Apr;47(4):95-103. doi: 10.1016/j.cppeds.2017.02.005. PMID: 28532967.