ARFID Could be to Blame for So-called Picky Eaters

ARFID could be to blame for so-called picky eaters
Mother Erin Krech, left, has sought help from Dr. Kim Dire, right, who is treating her son Ethan for ARFID – Avoidant Restrictive Food Intake Disorder. Dire was at Healing Waters Health Center in Hudson for a training on the disorder. (photo by Meg Heaton)
Story via the Hudson Star-Observer:

Nothing is more basic to human growth and development than food, but for some, including a lot of children, that relationship is fraught with fear.

Avoidant restrictive food intake disorder (ARFID) is a type of eating disorder where the consumption of certain foods is limited based on the food’s appearance, smell, taste, texture, or a past negative experience with the food. It is a physical response to one or more foods that can feel life threatening to someone with ARFID.

Dr. Kim DiRe is a psychologist and therapist who practices near Phoenix but treats patients with ARFID from all over the country. She was recently at the Healing Waters Health Center in Hudson to meet with parents of children with ARFID and professionals who want to learn more about the disorder.

DiRe says that ARFID often exhibits itself early in a child’s life and can be associated with something traumatic that happened at birth or even in utero. It can also develop in older children and adults.

“It is a very deep fear of food and the consequences that will come if they eat it — choking, allergic reaction, vomiting. The fear is very real and they feel like they could die if they eat,” said DiRe.

One of the parents attending the training at Healing Waters was Erin Krech, an IT consultant in the Twin Cities and the mother of 9-year-old Ethan who has had ARFID since birth.

Krech believes trauma surrounding her son’s difficult birth, which included the umbilical cord being wrapped around his neck, is what caused him to have ARFID. Ethan started to exhibit signs of ARFID as soon as he was introduced to solid food.

DiRe says children like Ethan are often labeled “picky eaters,” but it is more complicated than that. Foods that trigger the disorder in a child create a physical response that includes the release of adrenalin and nervous system responses that make eating impossible.

DiRe says ARFID is a sensory disorder where body tissue stores the memory of some trauma and the tissue when stimulated sends the message that the food is harmful, maybe even fatal. “Their first instinct is to survive. The threat is not just a cognitive one but one related to heightened senses which can shut down the digestive tract among other responses, making eating a threat.”

DiRe says it is not that those with ARFID aren’t hungry, they just can’t eat food like others do.

Krech said when Ethan was presented table foods, he had trouble swallowing certain foods and avoided others. As he grew, his mother noticed his eating habits became more limited. The family sought professional help, but traditional therapies for eating disorders seemed to make Ethan more fearful.

ARFID complicates life for those living with it. Krech said school lunch, outings with friends and birthday parties can create problems, even feelings of shame.

DiRe says most of the population doesn’t realize how much food and eating impacts daily life. “It is a very social activity and there can be a lot of anxiety and shame when you feel differently about it.”

DiRe’s therapy for ARFID focuses on the sensory and nervous system, using touch to calm and control the release of adrenalin. She also uses talk therapy to assess the level of anxiety and understand the specifics of what foods create the problem. The goal is to create a chemical shift in the nervous system that diminishes the threat of food.

Krech says DiRe’s treatment is working for Ethan and it is worth the frequent trips to Arizona for the 10-hour weekend therapy sessions. She has also reached out to other parents through her blog. She is a certified nutrition coach and hopes to inform others about ARFID and the therapy DiRe uses.

Both DiRe and Krech want people to know that ARFID is an eating disorder that is recognized by medical professionals and that it is not a choice children make not to eat.

“We tend to reward eating and punish for not eating. But that won’t work with ARFID. What we have to do is get them to place where they feel that it is safe to eat and nothing bad will happen,” said DiRe.