My daughter only eats pizza. AMA

[IThinkILikeThisLittleLight]

She has ARFID

Posting to give some insight into what life with ARFID is like

I hope I'm not hijacking, but we chose DD's primary partly based on its approach to food - a very few things were banned from packed lunches, but they were happy for her to have cake and biscuits. It was clear to us, even before primary, that this needed to be something we considered - they were happy for us to negotiate what she'd be able to eat at her residential trip in advance (she eats more widely than OP's daughter, but had a lot of plain pasta and bananas that week) We were lucky to have a choice of school, I understand you may not.

OP, thankyou for the insight into your DD life. Issues around food must be the hardest to manage as it's not like you can "just stop" without actuastarving.
I thought it was more like a food phobia thing, but now understand it's much deeper than that.

Did a doctor agree that being on the first percentile for weight was more important than not eating "junk" food? Most medical professionals will tell you to get calories into the child in whatever form the child will take.

Cow's milk is rich in calcium. You daughter needs calcium.

So funny how the standard things seem to be acceptable. I am an adult with ARFID and like nearly all of these things listed

What medication was this please? I would take anything if it would increase my food intake variety wise anyway.

Chemicals in food and cigarettes are significant risk factors for cancer but they don't cause cancer without additional stressors on the body. Read When The Body Says No by Gabor Maté about this.

An elevated risk of cancer is still less dangerous than certain starvation.

How did you get better?

Reading with interest because I have a 12yo son in a not dissimilar situation. He has severe OCD to the point where he can't attend school at the minute. His diet is very very limited. He latches on to a particular food for dinner and that's all he will eat for weeks. Then he switches to something else. But it's more or less the same meals in rotation. All very very similar. He has one 'proper' meal a day and the rest of the time it's pretzels and chocolate, both specific brands. Like your daughter, he has this inbuilt ability to spot minute differences in the taste of his food. He also didn't eat at school (when he attended) but that was because he thought other people's breath and saliva might get on his food.

Anyway, just a bit of solidarity from me. I know it's not quite the same as your situation, but I completely understand the difficulties.

What do you think orthorexia is? This isn’t about superior/inferior it’s about different approaches to what foods people feel “safe” with in terms of taste, sensory textures etc and also emotional response etc.

@babasaclover I’m sorry but it’s heavy duty anti epileptic medications as well as anti psychotics to cover the Bi-Polar disorder and interestingly they also cover the Tourette’s. I was dreading medicating my son but as time went on I took comfort from the improvements his medication had made to his diet.

I wish there was something you could have to help you enjoy food more.

@AnnieMcFanny The feeling’s mutual.

A lot of it has to do with texture.
Typically, safe foods will always taste and feel the same.
Compare that with a tomato that could be firm, dry, juicy, soft and degrees in between and that's just not safe.

But only Philadelphia cream cheese, right? Textures, and reliably so. When Special K changed their flakes for about 3 years we had quite the time.

He's mid twenties now, and we've been dealing with this since he was tiny. I wish we hadn't had all those years of medical and child development telling us iut was a control thing and he's eat when he was hungry or would grow out of it.

He didn't. I basically tormented him on professional advice. I'm glad he doesn't hold a grudge, he'd have every right to.

I dont have a question but you sound like youre a great parent, you’re doing a wonderful job under hard circumstances.
i work as a dietitian and we are seeing more and more referrals for ARFID all the time, I’m aware of specialist MDTs being set up to support so do keep looking for support.
definitely try to have her bloods taken every 6-12 months to monitor for deficiencies as well.

Costco do a cauliflower base pizza

Thank you for this thread. I'm interested if your DD had/has any other sensitivities? My DS doesnt have any diagnoses but has a restrictive diet and has been v sensitive since birth about a lot of things alongside food which is a daily struggle.

tldr: Processed food is consistent and that helps when managing hypersensitivity.

I'm autistic, luckily without ARFID although there are some foods I cannot eat and others I cannot be in the same room as because of smell/texture/etc. Autistic people can have heightened sensory awareness.

To illustrate this: I just ate a salad and every leaf of my red mini cos lettuce was different from the others, noticeably. The outer ones were floppier and more bitter. The inner ones were crunchier and juicier. Do neurotypical people notice this? Does it bother them? Every piece of chicken felt and tasted different because some of the slices were nearer the skin so firmer and more cooked. Others tasted sweet. The muscle fibres felt different in my mouth for different areas of the same piece of chicken as well as between different pieces.

If I try to eat cooked broccoli, I spit it out and if I try to swallow it, I vomit. The combination of the smell and the bitter taste and the fibrous stems and the weird lumpy top causes my stomach to heave. Just thinking about it makes me queasy. I am very lucky because I have maybe ten foods (most are lettuce types) that have that effect on me. With ARFID, you have maybe ten foods that don't have that effect on you.

But, I have days when I can't face the salad because it's too variable. I cannot always deal with the possibility that today's batch of lettuce might be more bitter than yesterday's. I cannot always deal with today's banana being softer and sweeter than yesterday's. Fresh fruit and veg is a horror to deal with because it can be less or more ripe and is difficult to predict.

Processed food is the same every time, no surprises. Today's Goodfella's gluten-free pizza from the frozen aisle is like last week's pizza. Today's Huel is like yesterday's Huel and will be like tomorrow's Huel. This means that processed food is safe, from a sensory point of view. I could eat broccoli as a child until one day, in my teens, mum served a "bad batch" and ever since then all broccoli makes me sick because the smell triggers the memory of that one bad batch. A single bad red cos lettuce serving could move red cos lettuce to the inedible list for the rest of my life, reducing further my scope for eating salads. I have to check the riskier fresh foods carefully before eating them to make sure that they stay safe. Processed foods are consistent and do not carry the risk of suddenly becoming a no-go food, which is why autistic people prefer them.

How frustrating that some posters are conflating merely fussy eaters with ARFID. A child with ARFID (probably adults too, but it's children I know about) will starve rather than eat an unsafe food. There's a heck of an association with ASD, presumably because of the heightened sensory awareness. Texture is often a very major trigger (not just flavour or smell, though they matter too), which is probably one reason why quite a few children with ARFID have relatively UPF safe foods, and they tend to have a consistent texture. A pear unpredictably might be crisp, or juicy, or succulent, or even woolly. Pringles melt in the mouth the same way every time. Many children with ARFID (or indeed with ASD related food issues not extreme enough to be labelled ARFID) are so sensory aware that they can absolutely tell if it's a different brand of safe food, or if the right brand has slightly changed the recipe, and that can turn a safe food into a never eaten again food, which can be pretty catastrophic, making well meaning advice about adding pureed veg to the tomato sauce somewhat naive.

My sympathies. I have known some young people manage to somewhat widen their repertoire, when they felt safe and unsecure and unpressurised, so you are absolutely right not to try to push it. And it's really good that you've found a tolerable multi vit. I don't think I was bad enough as a child to truly be ARFID, but as a young child I survived for months on bananas and milk, which had to be fed to me by the correct person using the correct crockery, and drove my mother to despair with the number of foods that made me gag in trace quantities. Things did improve with time, and I now enjoy food, though I still cannot eat onions, mushrooms, egg white, partially cooked tomatoes, or some vegetables without the texture making me gag.

Sorry, went on a bit there. But wanted to back you up about how real and important this condition is.

A passing paediatrician.

You managed in two paragraphs what I needed a tome for.

Weirdly, a bad tomato doesn't stop me from eating tomatoes again. I suspect this because tomatoes can't be smelled from the other end of the house, unlike broccoli. Tomatoes are, however, a brilliant example of a food that is wildly unpredictable.

Pears are the work of satan. If I wanted to eat a mouthful of sand, I'd go to the beach and fill my lunchbox. Horrible gritty bits sticking between my teeth.

Yet filtered pear juice is delicious and perry is my favourite alcoholic drink.

Don't tell me, neurotypical people are seldom bothered by the stone cells?

When do you think she will want to address it? What kind of treatment is there?

I bet this girl can tell the difference. I can, when I've been given cauliflower pizza base as the gluten-free option.

@DataPup

Since agricultural civilization started around 10,000 years ago, a single carbohydrate became the staple - rice, wheat, tubers, maize etc, with things like milk.

So I should imagine someone with ARFID in the UK 400 years ago would have eaten mainly bread and butter, China - rice, South America - corn.

The fact that poor Irish lived on a diet almost exclusively of potato mixed with milk, butter and kale is evidence of just how narrow diets have been until recently.

ARFID can be hereditary, just keeping my ds eating anything he will is my goal.

Well done OP for an insightful thread, some people don't get it but that's probably a theme throughout their daily lives 🙄

@MaidOfAle Broccoli I can deal with. Tomatoes I can smell from a mile off. Raw. Cooked is ok. It doesn't make any sense to me but the revulsion is real. And physical.