Parents and carers – this one is for you! Many children will fear or avoid certain types of food – it is a natural part of growing up. However, for some people, this can develop into Avoidant/Restrictive Food Intake Disorder (ARFID), a serious eating disorder that can have major social, psychological and physical impact. This guide provides strategies for trying new foods through gradual exposure and techniques like food chaining, useful for younger children with food fear as well as anyone with ARFID.
Understanding Neophobia
Neophobia, or the fear of new foods, is a normal developmental stage in early childhood. Unaddressed neophobia can potentially lead to nutrient deficiencies or social difficulties. From an early age, involve your young person in mealtime experiences and introduce a wide range of tastes and textures. It’s important not to panic or pressurise children during this phase. Instead, model eating new foods and engage them in playful activities involving food to reduce anxiety and encourage exploration. This helps them become accustomed to different foods and reduces the likelihood of developing ARFID.
Understanding ARFID
Avoidant/Restrictive Food Intake Disorder (ARFID) is a condition where individuals avoid certain foods or have a restricted intake in terms of the overall amount eaten. This can be due to sensory sensitivities, distressing experiences related to food, or a lack of interest in eating. ARFID is not just ‘fussy’ eating because it has serious impacts on individual’s day-to-day lives and physical and mental health. ARFID does not just affect children, it can continue into adulthood if left untreated. Always seek support from a health professional, like a GP, if you think you or someone you know may have ARFID or eating difficulties.
Addressing Sensory Sensitivity
Children may have sensory issues that affect their food acceptance. Observing your child’s reactions to different sensory experiences (e.g., touching various textures, smelling strong odours) can provide insights into their eating behaviours. Encouraging messy play and introducing a variety of textures can help desensitise them to new foods. Sensory sensitivity is also experienced by children and adults with Autism Spectrum Condition (ASC) which frequently co-occurs with ARFID. Read our top tips for people with ASC and eating difficulties.
Food Chaining
Food chaining is a way of taking a food that you like and slowly adding subtle variations to this food until you can tolerate new ones. It involves gradually and systematically diversifying the foods a person will eat. For example, you can begin with a food that is currently accepted, like chips, and then consider what can be tolerated in terms of changes in colour, brand, texture, or shape. You can then identify a new food to try based on what can be tolerated, such as introducing carrots for their similar colour to chips.
Food Traffic Light
The food traffic light is a helpful tool for planning which foods to try and which ones to avoid initially. It provides a visual representation of the foods you’re more willing to try (green), the ones you’re unsure about (yellow), and the ones you don’t feel prepared to have yet (red). You can download this tool in our ARFID and Selective Eating module.
Strategies for Younger Children
For younger children, maintain a diet of preferred foods, especially during stressful times, and consider supplements if necessary. Gradually introduce foods to ensure adequate nutrition.
Strategies for Older Children/Teenagers
For older children and teenagers, encourage self-management of sensory overload and anxiety, and keep a record of new foods tried. You could also try using a hunger chart so they can get to know their hunger cues. Involve them in the process, set realistic goals, and provide positive reinforcement. Discuss their motivation for trying new foods, such as being able to enjoy social eating situations with friends.
Gradual Exposure to New Foods – The Six Steps to Eating
To introduce new foods, follow a gradual and systematic exposure process:
Visual: Observe the colour, size, and appearance of the food.
Touch: Feel the texture – is it wet, dry, cold, hot, bumpy, or rough?
Smell: Note the strength and pleasantness of the smell.
Taste: Take a small taste and observe the intensity, sweetness, saltiness, or spiciness. It’s okay to spit it out.
Texture/Sound: Observe the texture in your mouth and the sounds it makes when chewing.
Swallow: Take a small mouthful and gradually increase the quantity as comfortable.
Managing Disgust and Appetite Regulation
Avoid forcing children to eat foods that elicit a strong disgust response. Instead, focus on maintaining good growth and nutrition through safe foods and small, frequent meals.
Creating a Supportive Environment
Educate family members and school staff about ARFID to ensure a supportive environment. Provide examples of how they can create a supportive setting, such as avoiding comments about food and allowing safe foods in social situations. Work with health professionals to monitor progress and address any concerns. Read our guide for school staff to support young people with ARFID, or our guide to creating supportive mealtimes.
Encouraging Independence and Social Eating
Involve young people with ARFID in cooking and food preparation to foster a sense of control and accomplishment. Support them in participating in social eating situations to apply their new skills in real-world contexts.
Seeking Professional Help
It’s important to seek professional help from you GP, therapists, or other healthcare professionals specialising in ARFID. They can provide guidance and support in addressing any underlying psychological factors contributing to the condition and ensuring adequate nutrition.
Conclusion
ARFID can be challenging, but with patience, understanding, and the right strategies, individuals can learn to try new foods and enjoy a more varied diet. Remember to address sensory sensitivities, use food chaining and gradual exposure techniques, create a supportive environment, and seek professional help when needed.
For a more in-depth understanding of Avoidant/Restrictive Food Intake Disorder (ARFID) and comprehensive support, Be Body Positive provides an extensive module on ARFID and Selective eating.
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