Do you struggle with food textures when eating? Do you find food challenging? Or have you recently been diagnosed with ARFID or suspect you or a loved one has ARFID? Do you need help with ARFID meal planning?
I am especially personally interested in ARFID as I needed to think outside the box with my eldest son, who didn’t start eating until he was three. By understanding that ARFID isn’t intentional and that the lack of interest in food isn’t about weight or shape, we can find strategies that help broaden the overall intake. It is especially important to appreciate that the person we are supporting might never have the broad range of intake that we have, but by looking at what foods could increase their ability to socialise or to travel or to live independently, this helps also manage our expectations.
ARFID, or Avoidant/Restrictive Food Intake Disorder is a form of eating disorder and is characterised by a restrictive eating pattern that is not usually driven by worries of weight or shape as seen in anorexia. ARFID often manifests when toddlers first start weaning but the “pickiness” persists, with a very limited food repertoire. This can often mean that they do not eat enough calories to allow for optimal growth, but this isn’t always the case. Kids or adults diagnosed with Autism are more likely to present with ARFID.
FACTORS INFLUENCING LIMITED VARIETY
Three key factors significantly impact eating behaviours and meal planning in ARFID.
Sensory factors can impact significantly meal planning in a number of ways, including:
- texture aversion
- sensitivity to temperature
- cooking preferences, e.g. how well cooked the meat is
- avoiding sauces
- foods needing to be separate, e.g. rather than having a sandwich, eating the components separately
- sensitivity to smell
LACK OF INTEREST
The concept of “live to eat” versus “eat to live” holds true in the context of ARFID as individuals may choose to skip a meal rather than have something unfamiliar. They typically stick to a limited repertoire of foods and feel overwhelmed at the concept of trying something new.
FEAR OF THE UNKNOWN
Anything unfamiliar can feel overwhelming for someone diagnosed with ARFID, including:
- sensory overwhelm
- fear of gagging, choking or being sick
- fear of germs
- anxiety and food phobias
- lack of routine (as this brings about a lot of unknown)
It is important to understand these contributing factors so that we aren’t impatient or set unrealistic expectations.
It is also crucial to recognise that while progress in dealing with ARFID can be observed during periods of stability in one’s life, it may be necessary to revert to a more straightforward meal plan when faced with stressors like changes in school, friendship challenges, relocation, or the transition to university.
ARFID MEAL PLANNING
When looking at building someone’s repertoire up, I categorise change into 3 stages…
Create a list of foods that are currently being eaten
This list might be quite small, but it is important to focus on what is currently possible, rather than currently impossible. In clinic, I am always given a long list of foods the client CANNOT eat, but I am interested in what they CAN eat, as this is what we want to build on. It is also important to use this list to make a plan for the week.
Here is an example list:
Pasta with dolmio sauce
Soup with fresh bread
Not extensive, but sufficient to make a meal plan from, as shown in the example below:
Create a Meal Plan
It is important to plan the meals over the week for the following reasons:
- predictability and routine
- reduced feelings of overwhelm
- Takes away the pressure of eating something unfamiliar
By creating a plan with foods that are familiar throughout the week, we can then implement changes to the plan in a structured way that feels safe.
Incorporating new foods into the Meal Plan
After setting up a meal plan, it’s crucial to incorporate “challenge days” deliberately into the week. This approach is designed to reduce the sense of overwhelm because it’s an expected and regular part of the plan. I typically recommend scheduling just two challenges per week, allowing you to select a specific day and meal each week. For instance, you might choose Tuesday’s after-school snack and Thursday’s dinner as your challenge events.
It is important to understand that these meal plan changes can take time and it is important to be patient. Sometimes just being able to go from eating one pasta shape to including another pasta shape can be a big win as this means that you can add more pasta shapes and before you know it, it doesn’t matter which pasta it is or if the pasta is eaten at home, with friends or at a restaurant as we are not tied to a particular pasta shape, as an example.
Living with ARFID can be lonely. Although we can’t promise that you will be able to eat as flexibly and spontaneously as someone not struggling with ARFID, we can do the following:
- determine whether any nutrients are missing from your diet
- help you create a plan that feels manageable
- help you to build your weight up, if this is needed
- help you to regular intake
- work with your goals to potentially broaden your food range
For further advice or a more tailored approach, please go to Bookings and book an appointment with Nicky (adults) or myself (adolescents).