When a child only wants to eat a few types of food, cannot tolerate certain textures or smells, or is afraid to swallow, it may be more than typical fussy eating habits. ARFID – avoidant/restrictive food intake disorder (avoidant/restrictive food intake disorder) – can lead to nutritional deficiencies, weight gain problems and growth issues.
Dr Anita Parbhoo, a paediatrician practising at Mediclinic Louis Leipoldt in Bellville, explained in an article on Mediclinic's Infohubwebsite that ARFID differs from other eating disorders because it does not necessarily involve a fear of weight gain or negative body image. People with ARFID may avoid food due to sensitivity to taste, smell or texture, lack of interest in eating, or fear of choking, gagging or pain after eating. The condition can affect both children and adults and can impact their nutritional health, growth and social life. Treatment is determined according to the individual's needs and may involve a doctor, dietitian and psychologist. Parents should seek professional help when a child's diet is extremely restricted, they are losing weight, not growing as expected or showing signs of nutritional deficiency. Forcing a child to eat can worsen tension around meals.
The disorder appears to occur more frequently in people with autism spectrum disorder, ADHD and obsessive-compulsive disorder (OCD). Anxiety disorders can also occur alongside ARFID. However, this does not mean everyone with these conditions will develop ARFID.
ARFID is not the only eating disorder
Other eating disorders that can affect children and teenagers include anorexia, bulimia and binge eating disorder. Anorexia involves, among other things, severe food restriction that is often linked to a fear of weight gain or a distorted body image. Bulimia is characterised by repeated episodes of overeating, followed by behaviour aimed at preventing weight gain, while binge eating disorder (binge eating) involves repeated episodes of overeating with a sense of loss of control.
Pica is a condition in which a person persistently eats non-food substances, such as soil or paper, in a way that does not match their developmental level. In rumination disorder, ingested food repeatedly returns to the mouth and is sometimes chewed, swallowed or spat out again. These conditions differ in their symptoms and treatment. Not every child who is a picky eater has an eating disorder, but when eating habits affect a child's health, growth or daily life, a professional assessment is important.
When should parents seek urgent help?
Do not wait for a routine appointment if a child is losing weight rapidly, showing signs of dehydration, becoming very weak or consuming almost nothing. Seek emergency medical help.
Where can parents get help if they suspect their child's limited eating habits are affecting their health or development?
The first step is to consult a GP or paediatrician. The doctor can assess the child's growth, weight and nutritional status and, if necessary, refer to a dietitian and psychologist with experience in eating disorders. Treatment often involves a team of experts working together.
Dr Anita Parbhoo – paediatrician, Eating Disorders South Africa (EDSA): 081 444 7000
Click here to read Dr Parbhoo's article.
Sources: Mediclinic Dr Parbhoo, Eating Disorders South Africa
This article is an automatic English translation of a Nuusflits article originally published in Afrikaans. Read the Afrikaans original.
