Some ARFID facts:
- As of 2015, (2 years after ARFID was added to the 5th edition of the DSM), many pediatricians are unfamiliar with the diagnosis (Norris and Katzman, 2015)
- About 22.5 per cent of the patients (7-17y) seen in paediatric tertiary-care centres with eating disorders programs are diagnosed with ARFID (Nicely et al, 2014)
- The average time parents wait for a diagnosis is 33 months (Fisher et al, 2014)
- The estimated prevalence of ARFID among 8-13 year olds in the general population is 3.2% (Kurz et al, 2015)
- Patients with ARFID are less likely to have a co-morbid mood disorder and more likely to have a co-morbid anxiety disorder, learning disorder, or cognitive impairment than patients diagnosed with anorexia or bulimia nervosa. (Fisher et al, 2014)
- There are three main sub-types:
- those who show little interest in eating
- those who accept a limited variety of food due to its sensory characteristics
- those who fear the negative consequences of eating (e.g. choking, vomiting)
ARFID is not a cute little acronym for “picky eating”. It is developmentally typical for children between the ages of 12 – 18 months to experience a sudden drop in appetite, and from the age of 2 until about age 6 to develop strong preferences and dislikes for food. Most children grow out of this phase and eventually accept a reasonable variety of food.
Untreated, children with ARFID tend to grow up to become adults with ARFID who avoid food in the absence of concerns about body size or weight. Individuals may be under- or over-weight, however the majority tend to be within the range of a normal weight for age. Children and adults with ARFID experience strong disgust reactions to the sight, smell and even the mere thought of eating unfamiliar food, which can create significant distress for eating in social settings.
As of 2016, there is no treatment protocol for ARFID. Currently, many therapies focus almost exclusively on getting the individual with ARFID to eat a wider variety of foods. While this result seems like the logical outcome of successful treatment, therapy that focuses exclusively on the eating fails to consider the eating disturbance in its wider context as a relationship between the individual eating the food and the person who provides it.
ARFID is not the result of:
- lazy, molly-coddling parents
- not knowing what healthy foods are
- a ‘sweet tooth’
- ‘bad’ Western eating habits
- spoiled, manipulative, stubborn children
Parents go to great lengths to feed their children healthfully, and adults do their best to feed themselves as best as they are able. Anyone trying to create a balanced diet with only a small variety of foods to work with needs support, not judgement. That’s what Mealtime Hostage is all about – an understanding community of parents supporting parents and adults on their journey toward enjoyable social mealtimes and a healthy relationship with food.
Welcome to the table.