How Missed ARFID Diagnoses in Parents Could Be Affecting Their Children’s Relationship with Food

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Children learn a lot from their parents through observing, analysing, and adopting their behaviours. This includes eating attitudes and behaviours, whether they are positive or harmful.

Parents with ARFID avoid certain foods or food types and/or restrict the amount of food they eat. Unlike anorexia or bulimia, these behaviours are not motivated by concerns about shape and weight. When ARFID is undiagnosed and untreated, children may watch and learn from these behaviours, affecting their attitude toward eating and their relationship with food.

This blog offers some information about ARFID and why missed diagnoses are common. It explores the effect of parents’ eating habits on children and their risk of developing eating disorders. It also outlines how ARFID may be treated and the importance of parental interventions in eating disorder prevention.

What Is ARFID?

Avoidant food restriction disorder (ARFID) is a type of eating disorder. People with ARFID avoid eating certain foods or types of foods and often eat only a small selection of foods. They may also have a low intake of food in general.

It’s normal for people to dislike or choose not to eat some foods. However, people with ARFID feel unable or find it very difficult to eat the food they need. When this prevents someone from receiving their energy or nutritional needs, it may become an eating disorder. People with ARFID may experience weight loss, nutritional deficiency, dependence on supplements, and/or emotional and social challenges.

ARFID can look very different in one person from another. ARFID is an umbrella diagnosis for food restriction and avoidance that may have a variety of causes. These include:

Sensory-Based Avoidance 

Someone with sensory-based avoidance is very sensitive to the texture, smell, taste, or appearance of certain foods. They may also only be able to eat foods at a certain temperature.

Anxiety or Fear of Food 

Some people have a distressing experience involving food that causes ongoing fear and anxiety. This might include experiences of choking, vomiting, or severe abdominal pain.

Other people have more general anxieties around eating that they can find hard to express verbally. They may only be able to eat a few foods that they feel are ‘safe.’

Low Interest in Food

Some people with ARFID may have a very low appetite or not recognise that they are hungry in the same way as other people do. Eating can feel like a chore and not something they want or enjoy, making it hard to get the nutrients and energy they need.

How Common Is ARFID Among Adults?

ARFID is a serious but underresearched eating disorder. This means that studies on ARFID – especially among adults – are lacking.

However, limited research suggests that it may be as common as other eating disorders. Prevalence estimates range from 0-3 – 15.5% among the general population.

ARFID: Underrecognised and Underdiagnosed

Unfortunately, ARFID is unrecognised and underdiagnosed. This means that many people, including parents, do not receive the treatment and support they need. They may not be aware they have an eating disorder or even serious eating problems. 

ARFID can look very different from one individual to another. This means that identifying and referring people with ARFID can be difficult, and the condition is often overlooked. 

Clinicians often lack knowledge about ARFID and may hold misconceptions that it is less serious than eating disorders like anorexia or bulimia nervosa. Some adults with ARFID also feel judged or stigmatised and may delay seeking help.

How Can Undiagnosed ARFID in Parents Affect Their Children’s Eating Behaviours?

Young people learn a lot from those around them. They observe and adopt the behaviours, attitudes, and opinions of others, particularly those closest to them. This means that parents’ behaviours can impact a young person’s attitudes and behaviours, even those that are not directed toward them.

When young people see a parent restricting the foods they eat, they may be more likely to do the same. Research shows that children whose mothers have dysfunctional eating attitudes are at a greater risk of developing ARFID themselves.

Children of parents with undiagnosed ARFID may also be more likely to develop other eating disorders, including anorexia nervosa, bulimia nervosa, or binge eating disorder. While food restriction in ARFID does not involve motivations surrounding body shape and weight, this may not be clear to a young person. Their parent’s eating behaviours may reinforce social norms and pressures surrounding dieting and ideal body types, making it more likely that they’ll develop or maintain harmful attitudes and behaviours.

Research has found that young people whose parents diet are at a greater risk of dieting themselves. While ARFID behaviours are different from dieting (because they are not motivated by weight loss), they can look similar and may have a comparable impact on young people.

ARFID: Diagnosis and Treatment

While undiagnosed ARFID in parents may have a harmful impact on their children’s eating behaviours, this can be prevented through diagnosis and treatment. With effective support, parents can recover from ARFID and develop positive and healthy eating habits. Moreover, family and parenting interventions can teach parents skills to encourage positive eating attitudes and behaviours within the family and avoid the transfer of harmful behaviours.

As knowledge and research about ARFID continue to grow, new services and treatment tools are developing. Currently, treatment for ARFID usually involves evidence-based therapies like cognitive-behavioural therapy, behavioural interventions like exposure therapy, and anxiety management skills training. Some people may also benefit from medication that helps them to manage and reduce their anxiety around eating.

How Can Parental Interventions Help?

Parental interventions help parents to understand eating behaviours that negatively impact their children’s attitudes towards eating and their relationship with food. They work with parents to change these behaviours and replace them with eating habits that reinforce positive eating attitudes and behaviours. This process is not always easy and may involve learning and practising a variety of skills.

Research shows that parenting interventions may be a valuable tool for preventing the development of eating disorders among young people. Some studies have found that parental involvement in prevention programs significantly improves child outcomes on disordered eating (and body dissatisfaction). Parenting interventions can also support young people’s recovery from eating disorders and may be offered as part of a recovery program.

The Wave Clinic: Specialist Mental Health Support for Young People

The Wave Clinic offers transformative mental health support for young people with sensitivity, care, and unequaled expertise. Our programs focus on building life advantages for children, teenagers, and young adults through a diverse range of treatment modalities and a journey of exploration and growth.

Our residential space in Kuala Lumpur, Malaysia, combines exceptional clinical care with education, enriching experiences, and social responsibility, supporting young people to grow in self-confidence and develop life skills. Our outpatient centre offers specialist, tailored support for young people who need a little extra help alongside programs for the entire family.

We understand the importance of parents and other family members in a young person’s recovery and prioritise the involvement of families throughout our programs.If you’re interested in our programs, contact us today to find out more.

Fiona - The Wave Clinic

Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).

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