ARFID: Not Picky Eating and Not Driven by Body Image
Avoidant Restrictive Food Intake Disorder (ARFID) is not picky eating, but a serious and complex clinical disorder that prevents many children from obtaining the caloric intake needed to physically thrive. ARFID typically shows up in infancy or childhood;1 as the child becomes fearful of or restricts food, they often end up limiting the entire family, preventing them from eating out at restaurants or attending social events that include food. When a child suffering from ARFID must eat around peers at school, they can be bullied for their behaviour and the family can find itself in crisis mode. ARFID is different from more widely recognized eating disorders such as anorexia or bulimia in that it does not include body dysmorphia or distress over weight gain/body shape.2
ARFID presents uniquely in each child, and needs to be treated just as uniquely. Behavioral interventions can deepen the symptoms via repeated traumatization. Cognitive Behavioral Therapy (CBT) can be ineffective as young children simply do not have the language skills to fully participate in counselling.
Psychological Exposure Therapy: Treating Young Children Suffering from Eating Disorders
At Varsity Natural Health Center, Sue Fortune MSc uses Psychological Exposure Therapy to help children manage and overcome their fears. Since the exercises are done with their minds, the child remains safe, with no fear of choking or vomiting. In her Psychological Exposure Therapy sessions, Sue asks children to:
● visualize the food they fear or avoid
● imagine themselves successfully overcoming or dialing down these feelings of fear
● feel in their body new confidence in being able to eat the food they fear
● use breathing techniques to visualize themselves eating that same food with confidence and success
● feel the new nutrients of the food nourishing their bodies
● feel the new energy the food is giving them
● imagine themselves in the near future having the ability to try expanding their food choices
● imagine themselves in the future being able to go over to a friend’s house for the day and not fearing food
As ARFID was only defined as a distinct eating disorder in the DSM-V (released in 2013), it is difficult to know precise occurrence rates. However, the National Center for Biotechnology Information estimates that rates of ARFID “have ranged from 5% to 14% among pediatric inpatient [Eating Disorder] programs and as high as 22.5% in pediatric ED day treatment programs,”3 and notes that “studies have consistently demonstrated that, compared to those with [anorexia nervosa] or [bulimia nervosa], ARFID patients are younger, have higher proportion of males, and are commonly diagnosed with comorbid psychiatric and/or medical symptoms.”4
This clinical diagnosis is affecting entire family units and limiting normalized family events. Help is possible! To book an appointment or a consultation, please call Varsity Natural Health Center at (403) 202-8658.
Our Hypnotherapist and Counsellor – Sue Fortune
Sue Fortune is a registered with the Canadian College of Professional Counselors and Psychotherapists (CCPCP). She also holds a Masters of Science degree in Psychology and is D.B.T. Certified. As a Registered Counselor, Sue uses person-centered therapy in a safe and non-judgmental environment. She counsels children, adolescents, individuals and couples. Her experience includes (but is not limited to) anxiety, depression, stress, bullying, thoughts of self-harm, and cutting behavior.
Sue is also trained as a Clinical Hypnotherapist. Hypnotherapy is used for a wide range of issues such as weight loss and smoking cessation. Her unique approach of combining hypnotherapy and D.B.T. works well for anxiety, depression, compulsive behaviors such as eating disorders and addiction. Sue is also fully Certified with the Child and Youth Care Association of Alberta and has considerable experience with children and youth. Her experience includes treating phobias, Restrictive Food Intake (AFRID), anxiety, low self-confidence and mood regulation.
1. Avoidant/Restrictive Food Intake Disorder (ARFID). (n.d.). Retrieved from https://eatingdisorder.org/eating-disorder-information/avoidantrestrictive-food-intake-disorder-arfid/
2. Norris, M. L., Spettigue, W. J., & Katzman, D. K. (2016). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725687/