Many people (especially children or teens) go through phases of “picky” eating. While this is normal developmentally, some children and adults struggle more with these selective eating patterns, leading them to develop problems that can be helped with therapy. This is called Avoidant Restrictive Food Intake Disorder (ARFID).
Children with ARFID often do not consume enough calories to grow and develop properly. Meals may become very challenging, causing parents to become exhausted. Children with ARFID may have an apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating, and struggle to meet appropriate nutritional and/or energy needs, sometimes leading them to be much smaller/less well-developed than peers.
Adults and young adults with ARFID may have similar concerns. They may find that their eating patterns cause problems in their relationships (fights with significant others, inability to engage in social experiences that involve food). They may also struggle with sensory sensitivity or feel that eating is an aversive experience.
Unlike Anorexia, people who have ARFID generally do not have distress about body shape, size, or weight.
At Bucks ESC, we can support people of all ages who struggle with selective eating. We take special care to aid clients and families to rule out any biological underpinnings and post-infectious conditions for acute onset changes in food and eating, as well as other obsessive-compulsive behaviors. Such rule-outs can include PANS/PANDAS. We are a PANDAS-aware collaborative, always looking at the whole picture and working closely with physicians and dietitians. Working closely with a dietitian who specializes in working with ARFID, the team at Bucks ESC uses a variety of techniques that strengthen people’s relationship with food and weight stability. These approaches include:
• Individual therapy to support teens, adults and families with ARFID
• CBT/DBT to teach specific skills and strategies to target anxiety (coping skills, self-soothing)
• Food desensitization to increase nutritional choice and flexibility
Sometimes children develop selective eating following a food-based trauma (i.e. choking on a specific food, food poisoning or illness after eating). In these instances, we can offer many of the services we have mentioned. Additionally, many clients respond well to EMDR, a targeted treatment to resolve food trauma. EMDR can be integrated into someone’s treatment throughout therapy to offer additional support in improving the person’s relationship with food and eating.