Parents and Carers – Avoidant Restrictive Food Intake Disorder

Session 2

Understanding the body

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When anxious, our appetite is
reduced and therefore eating can
be even more difficult

However, the longer they stay without
eating, the more “feeling sick” they
will be, as there is no food in their
body

The anxiety also gives the feeling of “feeling sick” and for some children, they will avoid
eating due to the fear of being sick

Understanding Anxiety and the Link with Hunger

We all feel anxious with various things, however, for some children the anxiety is there all the time
This will impact their ability to
communicate clearly, engage in
activities, sleep and eat
That is why we want them to be
able to understand how the anxiety
impacts their bodies and think
about strategies on how to better
manage this

Anxiety curve

The graph shows 3 lines:

Green – expected anxiety with new situations – anxiety starts lower, during the situation it goes higher and over time, it reduces as you know what to expect
Yellow – expected anxiety when you avoid situations – anxiety starts higher as you know you are avoiding a situation. Over time, the anxiety remains really high as there is no opportunity to exposure ourselves to new situations
Red – expected anxiety when you expose yourselves to situations – anxiety starts lower, goes up when faced with a new situation, but then the more you expose yourselves, the lower anxiety will be

Why preferred foods are important

The preferred foods are often calorie dense food so you can eat more
without feeling full so quickly

That it is for a short period of time for weight gain (if needed)
OR to increase interest about food again

The preferred foods tend to be “processed foods” (in the sense of coming from
a packaging) this is because they know what to expect from that food, there is no
surprises. This is the same reason why they tend to be brand loyal.

Why preferred foods are important

Child doesn’t eat all day at school or eat very little. They are very tired, difficult behaviour try to eat, but feels full very quickly continues to feel hungry

It is important to explain that there might be other hunger signals rather
than a rumbling stomach, i.e. headache, moody, irritable, sleepy, lack of
energy, lack of concentration, more sensitive, hyperactive

Energy levels

That is why eating regularly is SO IMPORTANT

Some strategies:

Talk to school about it and ask them to allow preferred foods at school

Lots of children will tolerate drinking at school – think about fruit juice,
smoothies, hot chocolate, milkshake

See if school can provide a quiet room for them to eat, the
dining hall tend to be quiet overwhelming

Keep a timetable and planned meals

Use of alarms to remind them to eat

Interoception

Interoception is called the
8th sensory system

It is the ability we have to read our internal body signals
when we are hungry, when we are thirsty, when we need
to go to the toilet, if we are hot or cold

Most children, especially those on the spectrum, struggle to recognise these signals and therefore find it difficult to know when to eat and sometimes when to stop eating

Interoception