Building a positive relationship with food and your body

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Parents and Carers – Selective Eating vs ARFID

Session 4

Expectations and resources

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What to expect

ARFID needs long-term treatment as it takes time to develop a new skill, and the young person will need a lot of support from parents/carers/family members during this time.

It is important to manage your expectations, recovery is not always linear and it will take time.

There is no right/wrong way as each young person is different.
Each step can take days, months and sometimes years. Young people may change their minds multiple times during the process.
Depending on their presentation, they can 'jump' stages (i.e. from square bread to bread and cheese) OR they will need more steps – always ask how they feel about it and explain what to expect.
The new food should not be expected to be eaten straight away, sometimes it is just about exposure.
Remember that there are several steps (i.e. tolerating food in the room, tolerating smell, etc.) before actually eating.

Expectations

We all know that as
parents, we would like our children to eat a good variety of
foods and eat in
restaurants, but the
reality is that
sometimes this will take a long time to happen.

So adjusting our
expectations and
thinking about how
important the 'baby
steps' are is
essential.

We do have successes, but we also have 'good enough'.

So have a think about what success looks like…

What does success look like?

Saying "I am hungry"

Trying something new even if just once

Not having conflict at the dining table

Going to a restaurant

Sitting at the dining table with the family

Not reducing their accepted foods

Weight gain

Height gain

Eating at school/sitting in the dining room with peers

Reduction in hospital admissions

Sitting in the same room as others eating

How to manage others' expectations,
including extended family

We know that the pressures from extended family and a close circle of friends have a huge impact on how parents feel.

Involve extended family members as much as you can, giving them a role to play in supporting the child, e.g exposure and removing pressure.

Acknowledge they may not be able to understand but accepting that the child needs support is the main thing.

Hunger chart

really hungry

really full

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Early Snack
Breakfast
Mid morning snack
Lunch
Pudding
Afternoon snack
Dinner
Pudding
Evening snack

Download this table

My reward chart

Task

	SUN	MON	TUE	WED	THUR	FRI	SAT

WEEKLY GOALS	DONE

Download and print out the reward chart!

Download chart

Helpful resources

Take away lessons!

Step 1 - Explore what type of difficulties are present.

Step 2 - Get help if needed.

Step 3 - Choose the approach together.

Step 4 - Consider a different intervention if the first one doesn't work.

Step 5 - Be consistent and manage expectations.

Everyone is unique

“ Ultimately change will happen
over time, but I know
I have begun my journey. “

Acknowledgements: Selective Eating vs ARFID

Created by:

Module Lead: Dr Paola Falcoski, Advanced Specialist Eating Disorder Dietitian
With contributions: Dr Erica Cini - Consultant Child and Adolescent Psychiatrist ELFT (London)
Bedfordshire and Luton Mental Health and Wellbeing Services

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