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Causes of ARFID in the Pediatric Patient
Contributor: Crystal Karges, MS, RDN, IBCLC, Director of Content and Social Media at Eating Disorder Hope/Addiction Hope
When it comes to eating disorders, it is easy to conjure stereotypes based on things that circulate in the media. Sadly, these types of stereotypes are what create dangerous misunderstanding about those who struggle with eating disorders.
An eating disorder that is not as relatively known compared to other eating disorders like anorexia, bulimia and binge eating disorder is known as Avoidant Restrictive Food Intake Disorder, or ARFID. Previously known as selective eating disorder (SED), ARFID was recently introduced in the latest revision of the DSM-V. Diagnostic criteria for ARFID have helped create a better understanding about this mental illness as well as improve treatment protocol.
Understanding More About ARFID
Because ARFID is not as well understood compared to other eating disorders, there is often confusion about what ARFID entails. ARFID might be used to describe individuals who struggle with disturbed eating patterns yet do not meet the criteria of a traditional eating disorder diagnosis. Some of the characteristic behaviors of ARFID include avoidance and or lack of interest in food. Individuals with ARFID may avoid foods for various reasons, and eating disturbances may result in many medical concerns due to ongoing failure to meet appropriate nutritional needs.
While ARFID has been expanded to include adults, this eating disorder is more commonly seen in infancy and early childhood, and some individuals who struggle with ARFID go on to develop other eating disorders, such as anorexia or bulimia nervosa. The diagnostic criterion for ARFID clarifies that disruption in eating behaviors are not the result of a lack of food, cultural or religious practices, and does not occur exclusively during the course of anorexia and/or bulimia.
Possibly Factors That Influence ARFID
With such drastic disturbances in eating behaviors that lead to adverse medical consequences, understanding the factors that potentially influence the development of ARFID can be important to recovery and treatment. While the exact cause of ARFID cannot be pinpointed, clinicians and researchers can agree that ARFID is the result of a combination of several different factors, such as biological influences, psychosocial components and environmental influences.
A child who may be predisposed to ARFID due to genetic or other biological factors may be triggered by environmental or psychosocial situations. For example, a child who experienced trauma due to a choking incident with food may become hesitant to eat solid foods.
Other mental disorders that can be comorbid with ARFID can also exacerbate eating and feeding difficulties. This might include but is not limited to autism and anxiety disorders. With autism, developmental disabilities can influence feeding disturbances or make it more difficult for a child to be accepting of certain flavors, textures, smells, and other sensory factors related to foods. Research has found that about 80% of children also have a developmental disability [1].
Anxiety disorders can also influence ARFID, and food phobias can influence avoidant type eating patterns. With other eating disorders, such as anorexia and bulimia, there is often an underlying anxiety and fear of weight gain. However, with ARFID, anxiety experienced can be related to eating certain foods and/or food groups, having to try new foods, fear of choking while eating, or having to eat in social situations.
Importance of Comprehensive Care
Because ARFID can present from many various causes and factors, seeking out specialized and comprehensive care is crucial for effective treatment. A treatment plan should be individualized based on the unique needs of the child, adolescent or adult dealing with this eating disorder.
Incorporating professionals from various disciplines can also be helpful in better addressing the many different causes that can be influencing ARFID. This might include a psychiatrist, registered dietitian, occupational therapist, speech language pathologist, psychotherapist, and physical therapist.
Dealing with ARFID can be overwhelming, as can watching a loved one who may be struggling with this eating disorder. Even though this eating disorder may not be as well understood as the traditional eating disorders, it is still something that warrants professional help. Consider connecting with a specialist today to discuss concerns and undergo a professional assessment for clearer answers.
Community Discussion- Share your thoughts here!
If you have had a loved one recovery from ARFID, what were some of the possible factors that influenced this eating disorder?
About the Author: Crystal is a Masters-level Registered Dietitian Nutritionist (RDN) with a specialty focus in eating disorders, maternal/child health and wellness, and intuitive eating. Combining clinical experience with a love of social media and writing, Crystal serves as the Special Projects Coordinator for Eating Disorder Hope/Addiction Hope, where her passion to help others find recovery and healing is integrated into each part of her work.
As a Certified Intuitive Eating Counselor, Crystal has dedicated her career to helping others establish a healthy relationship with food and body through her work with EDH/AH and nutrition private practice.
References:
[1]: Chatoor,I., Hamburger, E., Fullard, R., & Fivera, Y. (1994). A survey of picky eating and pica behaviors in toddlers. Scientific Proceedings of the Annual Meeting of American Academy of Child and Adolescent Psychiatry, 10′, 50.The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on August 14, 2016
Published on EatingDisorderHope.com”
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on August 14, 2016
Published on EatingDisorderHope.com
Baxter Ekern is the President of Eating Disorder Hope. He is responsible for the management and operations of Eating Disorder Hope. Baxter has been lending his services to Eating Disorder Hope for several years but came on board as the full-time president in November 2016.
