Textures of food shouldn't make me wanna peel my skin off and my tongue out
#arfid

Understanding ARFID: The Psychiatric Disorder Behind Extreme Picky Eating

🤖 IA: It's not clickbait ✅
👥 Users: It's not clickbait ✅

#eatingdisorder #arfid #mentalhealth

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ARFID is much more than picky eating. This eating disorder can cause people to avoid food because of texture, smell, taste, fear of choking, or low interest in eating. It can lead to dangerous weight loss and nutrient deficiencies, so early support matters. 💙 #ARFID

End of the day!

Round two tomorrow

#bacch #ARFID @commchildhealth.bsky.social

Q. What is in your ARFID blood panel?
A. It'll be sent round!

Q. Do you have input from paeds gastro
A. No, but I'd like it!

Q. Do you think we're struggling to differentiate between ARFID and paeds feeding disorder
A. Yes!

#bacch #ARFID

Q. At what age can you confidently diagnose ARFID
A. Tricky question. Research evidence varies. Some situations may say 5-6, some 8yrs. 8-18 makes sense for their local service but they do have younger patients.

#BACCH #ARFID @commchildhealth.bsky.social

Overall learning:
It's a LONG TERM condition
Teamwork and collaboration is needed
Expectation setting is a priority from the start

#BACCH #ARFID @commchildhealth.bsky.social

For high risk:

They have an "ARFID panel" blood screen

A food diary is required

MEED guideline observations completed

#BACCH #ARFID @commchildhealth.bsky.social

ARFID now sits in the CYP Eating Disorder service

Physical monitoring now provided by this team

Moving towards a more workshop-based model

Age accepted moving towards 8-18

#BACCH #ARFID @commchildhealth.bsky.social

Parental expectations were really high
Difficulties of discharge monitoring
System was holding them accountable
Difficulties accessing business support
3 medical record IT systems
Estates - no base

RE-DESIGN INCOMING

#BACCH #ARFID

Other teams would refer to the pathway and discharge, so that reduced the ability of the team to make progress with referrals.

The pathway needed review. It closed to new referrals.

#BACCH #ARFID

Cornwall set up a new referral system for ARFID

Referral criteria were set high, MDT triage was HARD

Often no prior input from other services

MDT assessment and formulation, then attempted intervention (for 4-6 sessions) then aim for discharge to "other" services

#BACCH #ARFID

Electrolyte issues common

Cardiovascular, puberty and menstruation issues UNCOMMON (compared with other eating disorders)

#BACCH #ARFID

Physical impact:
Low weight common (but not universal)
Nutritional deficiencies common can lead to illness
Low bone mineral density

Most severe micronutrient deficiencies have been found in those of health weight or overweight

#bacch #ARFID

Difficulties:
Heterogenous group leading to lots of treatment approaches
At what age do you diagnose?
When do you start a service

Lots of children have restrictive intake, so if there IS a service it will fill up with non ARFID stuff

#bacch #ARFID

Stakeholder review Sept 2026

Fragmented/variable care
Unclear clinical ownership
Lack of national guidance
Parent-parent support may be valuable
Parental awareness outpacing service capacity

#bacch #ARFID @commchildhealth.bsky.social

Avoidant-restrictive #EatingDisorder is new to DSM, and we don't know much about how to treat it.

A family-therapy approach outperformed individual #therapy in new, large trial of children:
psych-partners.com/one-therapy-...

#ARFID #mentalhealth #psychiatry #pmhnp