Commentary by Valerie Weesner and Amanda Garant
Grandparents, let’s talk for a minute. Do you have a grandchild you think of as a picky eater? Do you find yourself telling your son or daughter that:
- You never had trouble getting your own kids to eat.
- Not to be so accommodating with their kids regarding the foods they eat.
- They need to get their kid to stop fussing and “just eat.”
If that’s the case, let us introduce you to ARFID, avoidant restrictive food intake disorder, which officially became a diagnosis in 2013 and which, unfortunately, is still relatively unknown.
ARFID is an eating disorder, not just picky eating. Individuals with ARFID struggle with one or more of several concerns, including either: A lack of interest in eating or food; avoidance of food because of sensory characteristics of the food such as taste, texture or smell; and/or they fear an aversive consequence of eating, such as choking, nausea or vomiting.
Individuals with ARFID can experience significant weight loss or actually fail to gain weight and grow. They can suffer from nutritional deficiencies, can be dependent on supplements and other feeding methods and may have poor psychosocial functioning.
Your “picky eating” grandchild may possibly be that second type.
Question: So why will they eat chicken nuggets and snack foods? Aren’t they just controlling or manipulating their parents?
Answer: Kids with the taste/texture/smell type of ARFID are very sensitive to even small differences in foods. Even though you may say all chicken nuggets are the same, you can’t fool them. They recognize the differences in brands and will often refuse to eat if the brand they like is unavailable. They fear new or different foods and are easily disgusted by certain foods. Snack foods are easier to manage than fresh fruits and vegetables largely because they are predictable and always taste the same.
Question: So why is it so challenging to get them to cooperate?
Answer: Let us ask you this instead. How cooperative would you be if someone served you a wiggling worm, or a bowl of dirt? What if you were served a dish of raspberries and you noticed that some were squishy? When you look at, smell, feel, or taste a food that tastes at all off, how willing are you to take that next bite? Do you really want to finish it, or do you push it away? The difference might be that if it is the only thing available for you to eat, and if I told you that the worm would nourish you, you might choose to eat it if you were really hungry. An individual with ARFID would rather starve.
Question: So, what do we do?
Answer: There are treatments available to help kids, adolescents, adults and their family learn strategies to “try” and “practice” new or disliked foods, to manage fear and disgust, and to expand the repertoire of food. Parents are not to blame for their children’s challenges with food, while at the same time they can be a great resource to help their kids through these challenges.
If your son or daughter is struggling with a “picky eater,” consider helping them to find resources, learn more about ARFID, and support them as the fabulous but very stressed parents they are! For more, visit bridgethefoodgap.com.
Valerie Weesner, Ph.D., HSPP, is a clinical director for IU Health Charis Center for Eating Disorders, and Amanda Garant, M.S., R.D., L.D., is a registered dietitian for Motion 4 Life Fitness.