preteen son has ARFID- protein powder or other suggestions?

[Anonymous]

My son is 12, small and just fell off the growth curve. I just discovered the term ARFID and am positive my son has it.
He eats no meat, veggies, limited fruits and only white items, consistent since he was a toddler. Basically his diet consists of buttered noodles, rice, french bread, crackers, french fries, and his only protein is dairy (chocolate milk, milkshakes, mozzarella snack cheese sticks). And he gets full after just a small bowl of anything (Actually I think he gets tired of eating and has a hard time swallowing). I think he has food fear also, because he has a severe nut allergy (and other allergies he's mostly grown out of)

I'm so worried about him. His growth has seemed to stall in the last couple years, while all his friends are really growing. and he is skin and bones.

I'm searching for a food therapist/speech/occupational therapist, but ones I've talked to are fully booked already.

What can I put in his milks/milkshakes to make him gain weight? He hates the taste of anything new- I've had no luck with some protein powders/supplements in the past. But I'm willing to try again. What seems to have the best acceptance rate amongst the pickiest of kids?
Anything else I can try?

[Anonymous]

An experienced Behavior Analyst could help with this. You should rule out medical concerns first.

[Anonymous]

Yogurt-based smoothies work great for us - I look for the highest protein yogurt I can find (currently Siggi's nonfat vanilla has 16g/single serve 5oz cup), and mix with frozen fruit, whole milk (or half&half for more calories), and hot cocoa powder. 1 part yogurt, 1 part milk, 2 parts frozen fruit (I just use the yogurt cup to measure everything) and 3 Tablespoons or one packet of Swiss Miss hot cocoa powder.

~23g protein and 365 calories (22g protein and 450 calories if using half&half).

Hugs - it's scary and stressful and so hard to let go of our cultural conditioning about "eating right" while you feel like the whole world is judging you - but the bottom line is Fed Is Best, and eating literally anything is still better than eating nothing.

(I met with a dietician at https://www.drdaisy.com/ but the one I worked with is no longer there. I would still go back to them, but I have heard others on this forum had less success with them.)

[Anonymous]

+1. You are not alone! Wish I had an answer.

[Anonymous]

Anonymous wrote:My son is 12, small and just fell off the growth curve. I just discovered the term ARFID and am positive my son has it.
He eats no meat, veggies, limited fruits and only white items, consistent since he was a toddler. Basically his diet consists of buttered noodles, rice, french bread, crackers, french fries, and his only protein is dairy (chocolate milk, milkshakes, mozzarella snack cheese sticks). And he gets full after just a small bowl of anything (Actually I think he gets tired of eating and has a hard time swallowing). I think he has food fear also, because he has a severe nut allergy (and other allergies he's mostly grown out of)

I'm so worried about him. His growth has seemed to stall in the last couple years, while all his friends are really growing. and he is skin and bones.

I'm searching for a food therapist/speech/occupational therapist, but ones I've talked to are fully booked already.

What can I put in his milks/milkshakes to make him gain weight? He hates the taste of anything new- I've had no luck with some protein powders/supplements in the past. But I'm willing to try again. What seems to have the best acceptance rate amongst the pickiest of kids?
Anything else I can try?

OP, I am a registered dietitian.

Question Number One: What does his pediatrician say? Did the doctor refer you to one of the specialists you mentioned? If so, doctor should be able to get you a more immediate appointment. I would also add a psychotherapist who specializes in pediatric and/or eating trauma to your list.

For the immediate, try Vital Protein powdered protein supplement. It's available at Giant, among other places. It's the only one many of my clients will use because it does not add any additional flavor to food or beverages.

To your immediate que

[Anonymous]

I’ve used Benecalorie in my son’s shakes. It is a Nestle product and is expensive and sometimes hard to order on Amazon. It is a little cup of a couple ounces of fat and protein, clear and flavorless and my son didn’t mind it. I am the one who can feel/taste protein powder and I can tell it is in something but he can’t.

You can also add pure fat - butter, whatever kind of oil you like - to smoothies.

At 12 my son was also skin and bones and his eating was so restricted and he ate so little. He’s 18 now and while he doesn’t eat as much as his friends do he is healthy and an athlete. It was very, very gradual.

Good luck - I know it is scary and worrisome.

[Anonymous]

My 13 year old son struggles with extremely picky eating. He’s normal weight, but has a very limited, routinized diet. He realizes that his eating is problematic, so we’ve been working together to try to increase variety in his diet. Him understanding that there’s a problem and wanting to work on it makes it a LOT easier. Is your son engaged in wanting to change his diet, recognizing that it’s very difficult for him?

We’ve had the best luck with introducing foods that are similar to what he already eats. Recent additions to his diet are certain flavors of the “flip” yogurts and the bare naked chicken nuggets at Costco. He’s also trying two “new foods” each day.

I agree with the previous poster who suggested going to your pediatrician and asking for help.

[Anonymous]

Find a good GI who can check him for reflux or obstructions

[Anonymous]

We have had good results with Lauren from The Eating Disorder Center.

Nutella and white bread is a great one for calories. Agree with PP who said give him anything he will eat.

[Anonymous]

Don’t worry about protein powder - he sounds like he gets enough protein (white bread and milk are both fortified with it).

Focus on calories. Just calories.

[Anonymous]

Anonymous wrote:Don’t worry about protein powder - he sounds like he gets enough protein (white bread and milk are both fortified with it).

Focus on calories. Just calories.

White bread and milk are NOT fortified with protein. Milk CONTAINS protein, in its natural state. White bread has some, but very little.

Do you know what "fortified" means, PP?

[Anonymous]

Agree with smoothies. Switch from milkshakes to smoothies. High protein yogurt and a way to get fruit into him.

Have you tried beans and/or lentils?
My kid likes the Annie’s brand lentil soup. I drain it slightly and put it over rice with some shredded cheese on top.

[Anonymous]

If he’s falling off his growth curve you need to talk to his doctor. I agree with getting lots of calories in him in the meantime. Ice cream every night, whatever he is willing to eat.

If he has a low appetite or difficulty chewing there may be something like adenoids going on or they might be able to give an appetite stimulant. The dietitian approach is just one of many.

[Anonymous]

Toren Wolf on insta is 16 now, ND with ARFID. Hundreds of reels. Some be discussed trying new foods, even demos. Might be helpful.

[Anonymous]

My 7yo also fell off the growth curve and we are trying to push food. We have had limited success with Darigold FIT milk- it has 14g of protein per cup in the whole milk version (not sure about other versions). There are some protein brownies that are also sometimes deemed acceptable. Also, peanut butter on crackers/banana/anything worked briefly before DC got sick of peanut butter.

I got a book on CBT for ARFID that said changing up tastes (eg, several different flavors vs a lot of one thing) can help, so sometimes if we hit a block with one food we offer alternatives. We also have developed a point system (bc I don’t want my 7yo “counting calories”) and we target a total of 7 points (each point is 200 calories) per day, which is a huge stretch compared to where we are many days. We push for 2 points at breakfast, 2 at lunch, 1 snack, 2 dinner. Usually by dinner we have failed to hit all those so we try for 3 at dinner to make up for it. Sometimes the points are helpful with protein because 1 cup of milk = 1 point (which is a faster/easier way of getting a point vs less calorically dense stuff which has more volume)