Understanding the Different Types of ARFID

As a parent, it can be overwhelming when your child struggles with food. Avoidant/Restrictive Food Intake Disorder (ARFID) is a serious condition that goes beyond typical picky eating, potentially impacting your child's health and development. Recognizing the specific subtype of ARFID your child may be experiencing can provide valuable insights into their behavior and guide appropriate interventions.

1. The Avoidant Subtype: Sensory Sensitivities

Children with the avoidant subtype of ARFID often have intense reactions to certain food textures, smells, or tastes. They may be comfortable eating only a limited range of "safe" foods that meet their specific sensory preferences, while anything outside of this selection can cause anxiety or physical discomfort. This subtype is often associated with sensory processing issues, where the sensory characteristics of food are overwhelming or unpleasant. citeturn0search0 For example, a child might accept smooth mashed potatoes but refuse anything crunchy or lumpy.

Signs of the Avoidant Subtype:

• Extreme Sensory Sensitivities: Rejection of foods based on their texture, appearance, or smell.
• Limited "Safe" Foods: A very restricted list of acceptable foods with strong resistance to trying new items.
• Nutritional Concerns: Potential deficiencies in essential nutrients due to the limited variety in their diet.



2. The Aversive Subtype: Fear-Based Avoidance

If your child has had a negative experience with food—such as choking, vomiting, or an allergic reaction—they might develop a fear of eating certain foods. This aversive subtype of ARFID is characterized by anxiety around eating, leading to avoidance of specific foods or even entire food groups. This fear-based avoidance is not related to body image concerns but is instead a protective response to past traumatic experiences. citeturn0search0

Signs of the Aversive Subtype:

• Fear of Eating: Avoidance of certain foods due to fear of adverse reactions like choking or vomiting.
• Mealtime Anxiety: Increased stress or anxiety before or during meals.
• Weight Loss or Poor Growth: Potential weight loss or inadequate growth due to restricted food intake.

3. The Restrictive Subtype: Lack of Interest in Eating

For some children, the issue isn't about fear or sensory sensitivities—they simply lack interest in eating. This restrictive subtype of ARFID involves a diminished appetite or indifference to food, leading to inadequate nutritional intake. Children with this subtype may not experience hunger in the same way others do and might view eating as a chore rather than a pleasurable activity. citeturn0search0

Signs of the Restrictive Subtype:

• Low Appetite: Minimal interest in food and prolonged periods without eating.
• Unintentional Weight Loss: Weight loss or difficulty maintaining appropriate weight for age and height.
• Nutritional Deficiencies: Potential deficiencies in essential nutrients due to insufficient food intake.

What Can You Do?

Understanding that your child may have ARFID can be daunting, but identifying the specific subtype they are experiencing is a crucial step toward effective intervention. Consulting with healthcare professionals who specialize in eating disorders can lead to tailored treatment plans that address your child's unique needs. Early recognition and intervention are essential in helping your child develop a healthier relationship with food and ensuring their overall well-being.

References:

Cleveland Clinic. (2023). Avoidant/Restrictive Food Intake Disorder (ARFID). Retrieved from https://my.clevelandclinic.org/health/diseases/24869-arfid-avoidant-restrictive-food-intake-disorder

Thomas, J. J., Lawson, E. A., Micali, N., Misra, M., Deckersbach, T., & Eddy, K. T. (2017). Avoidant/restrictive food intake disorder: A three-dimensional model of neurobiology with implications for treatment. Current Psychiatry Reports, 19(8), 54. https://doi.org/10.1007/s11920-017-0807-y

Zucker, N. L., Copeland, W., Franz, L., Carpenter, K., Keeling, L., Angold, A., & Egger, H. L. (2015). Psychological and psychosocial impairment in preschoolers with selective eating. Pediatrics, 136(3), 582-590. https://doi.org/10.1542/peds.2014-2386