is to be patient, willing to experiment, and avoid demanding or forceful feeding.”
At the same time, “parents will also need to work with other therapists as well to address any psychological aspects [to the problem], and a speech therapist to determine if there are any physical concerns with swallowing certain textures or thickness of liquids.”
Warning signs of ARFID
The following are warning signs of ARFID to look out for:
Behavioral and psychological
- Dramatic weight loss
- Dresses in layers to hide weight loss or stay warm
- Reports constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy
- Reports consistent, vague gastrointestinal issues (“upset stomach”, feels full, etc.) around mealtimes that have no known cause
- Dramatic restriction in types or amount of food eaten
- Will only eat certain textures of food
- Fears of choking or vomiting
- Lack of appetite or interest in food
- Limited range of preferred foods that becomes narrower over time (i.e., picky eating that progressively worsens).
- No body image disturbance or fear of weight gain
Physical
Both anorexia and ARFID involve an inability to meet nutritional needs. Both disorders have similar physical signs and medical consequences:
- Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)
- Menstrual irregularities—missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period)
- Difficulties concentrating
- Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate)
- Postpuberty female loses menstrual period
- Dizziness
- Fainting/syncope
- Feeling cold all the time
- Sleep problems
- Dry skin
- Dry and brittle nails
- Fine hair on body (lanugo)
- Thinning of hair on head, dry and brittle hair
- Muscle weakness
- Cold, mottled hands and feet or swelling of feet
- Poor wound healing
- Impaired immune functioning
If and when a child is diagnosed with ARFID, Sandon urges parents to “seek professional help from a team of health professionals, including a registered dietitian nutritionist, to assure the child is offered a diet that provides adequate calories and nutrients for growth and development.”