ARFID and Food Avoidance Emotional Disorder....need some help for my 11yr old step-son

RockstarWilson

Hi all!

I need to find some resources on Avoidance/Restrictive Food Intake Disorder as well as Food Avoidance Emotional Disorder. My girlfriend's 11 year old son has been having some emotional/psychological/eating issues, as a result of father abandonment, and I am conducting a study on his eating habits. He is in the 80th percentile of his weight group, however he has lost about 10 lbs over the past 4 weeks and usually eats under 1000 calories per day, mostly due to his appetite and choices to not eat most foods. I already know he has a protein deficiency, because he doesn't eat a lot of meat. He is pre-pubescent.

What I am looking for is any resource that you guys might be able to provide that could help me with this situation. I have already started some google searches. FAED is a little bit harder to search for, but it carries different characteristics than ARFID. Both of these are newly identified EDs. I want to also find out if any studies have drawn any connections to emotional traumas, or even to learning disabilities (he has dyslexia).

Any information would be very helpful as I begin learning how to help him. Thank you very much.

missiontofitness

I would think this is a conversation you and your girlfriend should be having with his doctor, and also with a therapist who specializes in eating disorders as well. I wouldn't try to do any studies or tackle this on your own.

NJGamerChick

I agree with missiontofitness.

From my understanding, ARFID is not to be accompanied by an emotional disturbance. That is part of the DSM6 criteria. You've just identified an emotional issue affecting his eating though. I would consult with professionals and bring up this point in which the child may or may not be willing to talk about. A therapist, not one specific to EDs, could help him find coping mechanisms and help him sort out his emotions.

melimomTARDIS

mealtime hostage (google it). Her son has AFRID.

My son has a sensory processing disorder that limits his food variety, but he eats enough calories, and he is hitting all the growth and developmental markers.

During times of stress his food choices narrow down further to just 2 or 3 "safe foods".

Work on serving him foods he feels comfortable eating. Dont push, wait him out, force feed/punish him etc. That only puts undue stress/causes them further anxiety about food/eating/mealtimes

And see a doctor and nutritionist. My sons pediatrician had me write up a full 2 week food diary for him, and submitted it, then made nutritional recommendations.

Luckily, all he needed was a vitamin supplement ( he eats no meat or beans) fortified with iron.

melimomTARDIS

Also about protien deficiency....

Its not likely. My son drinks milk, eats cheese, eats a particular brand of peanut butter, pistachios,a certain brand of protien bar and a certain yogurt. Not to mention the smaller quantities in bread, which is another food he eats.

In our family, your meal must have a "a plant, a protien, and a bread". Other than that, I dont care what from those catagories you choose.

Dinner sometimes looks like this for him

Apple slices (plant)
2 oz of cheddar cheese (protien)
1 wholegrain roll(bread)

or, cheese pizza (a new food we only "got" this past year!)
in which case the protien is the cheese on the pizza, the plant is the tomato sauce, and the bread is the crust.

On a bad day-
fruit leather (plant)
a glass of milk (protien)
air popped popcorn (bread)

NJGamerChick

I guess it depends on why he's avoidant. The OP feels there is an emotional factor to it, which begs for further digging and working on this factor in order to try and alleviate the condition.

I did go back and reread the section on ARFID and I was partially incorrect. I apologize, but the advice on having the child see someone still stands. There was no mention if this is an official diagnosis from a Psychologist, or just the suspicion of the OP, but abandonment issues are very hard to deal with the longer it is left to fester. It is better to deal with this while he is still young (and before hormones really set it and make things even more complicated, if they haven't already started going).

melimomTARDIS

My son has no emotional disturbance, just an extreme sensitivity to texture and smell.
He ate weird as a baby too. This is a life long battle for my kid, and that is just how it is. I mean, god bless peanut butter, amirite?

There is a great group called PEAS about adult picky eaters, who seem to have a range of diagnosis-es.

My concern is that your kid isnt getting enough calories. From what I have read/learned people with extreme picky eating, or other sensory issue, really do enjoy the foods they feel are safe, and eat good quantities of those foods.

Either way, you gotta get that kid into a doctor.

RockstarWilson

NJGamerChick wrote: »

I guess it depends on why he's avoidant. The OP feels there is an emotional factor to it, which begs for further digging and working on this factor in order to try and alleviate the condition.

I did go back and reread the section on ARFID and I was partially incorrect. I apologize, but the advice on having the child see someone still stands. There was no mention if this is an official diagnosis from a Psychologist, or just the suspicion of the OP, but abandonment issues are very hard to deal with the longer it is left to fester. It is better to deal with this while he is still young (and before hormones really set it and make things even more complicated, if they haven't already started going).

Yeah, we are just starting to scratch the surface, but is issues are multifaceted, and they consume him. The emotional issues are strictly due to lack of involvement with his father. He has pretty much been ignored his whole life, and his mother wasn't aware of too much of a problem until after the fact. He has dyslexia, which is about an 8 on a scale of 1-10, and I know that there could be a link there with regard to axiom growth and neural pathways. How either of those correlate with the food issue is what we are trying to find out. He is not a talker, and he withdraws inwardly with all of these issues, so we can't get information from him about his situation. That, of course, is not his fault, as are not any of the issues he has. I did get information from his mother that he used to throw up to a lot of foods, but this is not a present condition (I have not seen him vomit in the 16 months I have known him). That would fit the profile for ARFID, FAED, and early-onset anemia.

We are going to have him see a therapist within a couple weeks, once she can figure out stuff with the insurance. I am doing my best to try to be involved with him, whenever possible, but his preferred coping mechanism is isolation. I will correct myself and say that the protein deficiency is an assumption, not a fact, because I haven't analyzed his intake values and definition of weight loss. That would be for the doctors to decide.

I am doing this participant/nonparticipant observational experiment to get involved in the process. I won't be able to diagnose, but that is not the purpose of it. I am simply gathering data, getting varieties (spectrums of what he likes/dislikes/alternates to, what his reactions are). This will provide information to whoever is treating/diagnosing him.

NJGamerChick

Thank you for clarifying some of that. Has he been tested for food allergies and intolerances? That could definitely prevent him from eating and cause vomiting and GI issues as well.

RockstarWilson

melimomTARDIS wrote: »

My son has no emotional disturbance, just an extreme sensitivity to texture and smell.
He ate weird as a baby too. This is a life long battle for my kid, and that is just how it is. I mean, god bless peanut butter, amirite?

There is a great group called PEAS about adult picky eaters, who seem to have a range of diagnosis-es.

My concern is that your kid isnt getting enough calories. From what I have read/learned people with extreme picky eating, or other sensory issue, really do enjoy the foods they feel are safe, and eat good quantities of those foods.

Either way, you gotta get that kid into a doctor.

Yeah, his daily calorie intake is anywhere from 700-1400, as a guesstimation (informal observations). He is 5'1" and 107 lbs. I will confirm this in the formal observations, as I am measuring quantities of intake. I am probably going to set up a faux account on here for him, so I can easily track portions and macro percentages. "George's" major aversion is texture, but there are others, such as homogeneity. If I make eggs, he will not eat them if they are not completely homogenous in color (yellow), and will only like to eat them scrambled (as opposed to omelette style). He will eat it with syrup all day, but will very rarely eat it with cheese on top.

I am tracking the calories of all three of the older ones, so I can kind of have a control when it comes to variety, quantity, and macros. I will also be tracking their weights each day, for statistical purposes (and, conveniently, a learning purpose on health; they are homeschooled).

melimomTARDIS

I did a mock up for my son as well, just to see what a breakdown would look like, and the only thing he was low in was iron. My son eats between 1400 and 1600 per day, and is an active 6 year with a lean build.

RodaRose

There is a reference section in this PDF
http://eatingdisordersreview.com/print/nl_edr_24_3.pdf
Here is a science blog post called Your Eatopia that discusses this topic:
http://www.youreatopia.com/blog/2015/1/31/ucsd-edc2014-review-part-v.html

softblondechick

This is something to involve the school as well, he may be eligible for Special Education services, or a 504. This would mean possible IEP plan, with goals and interventions at school. Definitely at his age, school psychologist should be involved and his teacher. At my school the Speech Therapist worked on eating with children, as many had issues with textures, and swallowing.

RockstarWilson

melimomTARDIS wrote: »

I did a mock up for my son as well, just to see what a breakdown would look like, and the only thing he was low in was iron. My son eats between 1400 and 1600 per day, and is an active 6 year with a lean build.

"George" is 11, but he is very lanky and, although he is active, he eats less than your 6 year old.

In reference to an IEP, he is homeschooled (mothers choice), so are there any options for that for homeschoolers? He is struggling, and he honestly hates school, but he also has severe letter/number dyslexia, so that is why I have an inkling that it is all connected. I just dont know how. Please, any advice or resources would be helpful. I live in Arizona.

PearlAng

Unfortunately I do not have any resources to contribute, but I want to mention my experience, as it seems similar to your step son's. I had problems with textures and homogeneous color, as you have mentioned. Eggs were off the bill completely for me though. I remember asking my mom about things that had spots (bread with seeds, chocolate chip cookies, and a few others). I knew that yes, sometimes cookies have chocolate chips in them, but I remember looking really closely because sometimes I thought it was mold. Same with the bread. I had to give most of my food items a really thorough examination before IAte them and even then I'd get so worried that something I ate was going to make me sick (i had a mild phobia of throwing up or even feeling sick, and thy hasn't quite gone away) I also had texture issues with meat, and began to eat so little of it that I eventually didn't eat it at all. Same with cheese. I eat both now, and I just chalk it up to a change in palate and mouthfeel, but I'm going to assume that's not always the solution. Different causes for the issue will probably require different solutions, and to be honest, were not entirely sure why I was that way (and, in a way, why I still am a little)

Best of luck in your search for resources, I hope all will be well.
ETA:there were times where I got the sensation of choking. I would swallow something (even a food I liked) and it felt like it would get "stuck" for a split second in my throat before actually going down. I ended up legitimately choking twice, between ages 6 and 10