How this Windsor, Ont., mom navigates ARFID, her son's little-known eating disorder

There are really just about two solid foods that eight-year-old Mohammad Farhad will reliably eat: boiled eggs, because of the taste, and spaghetti or lasagna because of the shape.

Mohammad, mom Ramzia El Annan explains, has avoidant/restrictive food intake disorder, known as ARFID.

While it’s an eating disorder, it differs from anorexia or bulimia because it isn’t driven by concerns about weight or body image. Instead, it’s a severe, sometimes debilitating, sensory reaction to many or most types of food. 

El Annan says she wants to share her family's story because the disorder is often misunderstood.

"My son is a non-eater. Picky eating could be probably much easier," she said. "It's not about a behavioural issue and it's not about a mental health issue.

"It's really more of hypersensitivity that leads to this fear of trying the food."

The disorder was formally recognized in 2013, though before that was recognized as a pediatric feeding disorder for kids under six.

El Annan said she knew something was different about the way Mohammad ate since he was a baby. It was just last year that she as able to secure a formal diagnosis for Mohammad.

She said people with ARFID often don’t realize they’re hungry until they are starving — but that when they do eat, they don’t eat enough. 

“This is the curve that we keep going up and down,” she said. "It's really challenging, and tiresome for him."

On a Tuesday afternoon, El Annan offered her son a smoothie: Milk with a wheat powder, banana and a vanilla pudding. Blending it up, she asked him about the thickness. Good, he said. The colour? Good too, Mohammad said.

Sipping away on the smoothie through a water bottle with a straw, El Annan decided to prepare an egg the way he likes it, at least right now: Hard boiled, with a little salt and lots of cinnamon.

Sitting next to him, El Annan counted how many times he chewed, with plenty of encouragement, and gentle coaxing for another bite or half-bite. The egg, more than half uneaten by the time it seemed Mohammad had had enough.

Small portions, breathing and facial exercises and taking more time with meals all help, she said, as do regular sessions with a therapist.