Parent strategies for expanding food variety: Reflections of 19,239 adults with symptoms of Avoidant/Restrictive Food Intake Disorder

Abstract

Objective To characterize helpful parent feeding strategies using reflections on childhood eating experiences of adults with symptoms of Avoidant/Restrictive Food Intake Disorder (ARFID). Method We explored a unique text‐based dataset gathered from a population of N = 19,239 self‐identified adult “picky eaters.” The sample included adults with symptoms of ARFID as evidenced by marked interference in psychosocial functioning, weight loss/sustained low weight, and/or nutritional deficiency (likely ARFID), and non‐ARFID participants. We leveraged state‐of‐the‐art natural language processing (NLP) methods to classify feeding strategies that were perceived as helpful or not helpful. The best classifiers that distinguished helpful approaches were further analyzed using qualitative coding according to a grounded theory approach. Results NLP reliably and accurately classified the perceived helpfulness of caregivers' feeding strategies (82%) and provided information about features of helpful parent strategies using recollections of adults with varying degrees of food avoidance. Strategies perceived as forceful were regarded as not helpful. Positive and encouraging strategies were perceived as helpful in improving attitudes toward food and minimizing social discomfort around eating. Although food variety improved, adults still struggled with a degree of avoidance/restriction. Discussion Adults perceived that positive parent feeding strategies were helpful even though they continued to experience some degree of food avoidance. Creating a positive emotional context surrounding food and eating with others may help to eliminate psychosocial impairment and increase food approach in those with severe food avoidance. Nevertheless, additional tools to optimize parent strategies and improve individuals' capacity to incorporate avoided foods and cope with challenging eating situations are needed.

Obtaining an Avoidant Restrictive Food Intake Disorder diagnosis in The UK for Individuals with Intellectual and Developmental Disabilities: A Qualitative Study of Families’ Experiences

“…The ndings from this study highlighted the importance of families being able to accept the diagnosis in order to be able to divert their focus towards supporting their child with ARFID with their eating behaviours. Research shows the encouragement for parents to continually support their child with ARFID using feeding strategies, albeit continuing to observe some degree of food avoidance [31]. This signi es the value of families, where the knowledge and training of support for the child is abundant.…”

“…The study by Rogers et al (2012) strongly reiterates the negative feelings of parents, especially mothers, as they worry about the health consequences of their child with feeding di culties. Despite this, parents try hard to maintain a positive atmosphere around the individual with ARFID, where research has shown an optimistic perspective around food intake could possibly aid in improving their feeding behaviours [31]. Studies have also shown the family value in support for individuals with ARFID, especially during interventions where parents could independently support their child at home [30].…”

“…Evidence also indicated that professionals can support parents through utilising parent feeding strategies. An optimistic expressive environment during the parent feeding strategy was found to aid in reducing psychosocial impairment and food avoidance [31]. Additionally, family-based therapies have increasingly been popular for when treating ARFID.…”