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Read the following text, and answer questions 1–9 below:
[1] Arfid, a condition identified some years ago, is not just “being a picky eater”. Standing for avoidant/restrictive food intake disorder, adults and children can both be affected by Arfid. The eating disorder can lead people to reject foods based on their smell, taste, consistency or appearance, said Ricarda Schmidt from the Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy at the University of Leipzig in Germany.
[2] Schmidt said many children and adults affected do not feel hungry, are afraid of eating or show little appetite. “Eating is not a pleasure for them but a burden,” Schmidt said. The aversion to food is sometimes so strong that children develop deficiency symptoms or lose weight, she explained. “These children eat so little or so restrictively that they develop physical and psychosocial impairments. For example, they avoid birthday parties or school trips because of the food.” The condition is more than just general fussiness or picky eating, a stage many children go through as they develop and which usually passes.
[3] The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders has recognised Arfid since 2013, and it was included as an eating disorder in the World Health Organization’s International Classification of Diseases (ICD-11) in 2022. But many countries do not recognise the condition, and doctors tend to classify it with other eating disorders. The number of people affected by the disorder remains unclear.
[4] Little is known about Arfid’s causes. A genetic predisposition could play a role, especially in those who are sensitive to smells, textures or flavours, or who have an aversion to many foods, said Schmidt. Fear of eating or other Arfid symptoms could also be triggered by early traumatic experiences, such as choking badly as a child, an allergic reaction, being intubated (having a tube placed in the throat for medical reasons) at an early age or an illness that made it difficult to swallow.
[5] An analysis published in the Psychiatry Research journal by a team led by Laura Bourne from Univesity College London examined 77 studies that suggested possible therapeutic approaches. The analysis noted that the studies were fairly small and without long-term observation, but the approaches suggested were worth investigating. These include family-based therapy, cognitive behavioural therapy and, in some cases, the additional administration of psychotropic medicine. Medics would need to tailor the treatment to the individual involved, depending on their main problem and its severity.
[6] Concerned parents should consult a paediatrician to assess any physical effects of restrictive eating on their child. The paediatrician can also determine whether there are any gastrointestinal problems or food allergies. Parents can also try to create a relaxed atmosphere at the dinner table, even if it’s difficult. A new food should be tried at least 10 times so a child can get used to it, said Schmidt. But it does not help to pressure children to eat.
Source: dpa, May 27
Questions
1. According to paragraph 1, Arfid is …
A. a disorder that only affects young children.
B. seen among both adults and children.
C. more frequent in young adults who were picky eaters in childhood.
D. none of the above
2. Find a word in paragraph 1 that refers to the “physical texture or feel of food in the mouth”.
3. Based on your understanding of paragraph 2, how do individuals with Arfid feel about food?
4. What differentiates Arfid from “picky eating” in young children, according to paragraph 2?
5. In paragraph 2, how might Arfid affect how a child takes part in social activities?
6. In paragraph 3, the inclusion of Arfid in the Diagnostic and Statistical Manual of Mental Disorders and ICD-11 suggests the condition is …
A. under review to determine its seriousness.
B. a cultural phenomenon rather than a medical one.
C. a legitimate and clinically relevant disorder.
D. considered rare and insignificant.
7. List three specific early traumatic experiences mentioned in paragraph 4 that could potentially trigger Arfid symptoms. (3 marks)
8. What does paragraph 4 discuss?
9. What does the phrase “tailor the treatment to the individual involved” in paragraph 5 suggest about Arfid?
Answers
1. B
2. consistency
3. They feel eating is a burden, a stressful and unpleasant obligation. (accept all similar answers)
4. Arfid is a severe aversion to food that leads to physical and social problems, while picky eating is a passing stage many children go through.
5. A child suffering from Arfid might avoid attending social events, such as birthday parties or school trips, where food is present.
6. C
7. choking badly as a child, an allergic reaction, being intubated at an early age or an illness involving difficulty swallowing (any three)
8. the potential factors that cause Arfid (accept all similar answers)
9. The condition’s direct effects and severity vary significantly from patient to patient; therefore, a generalised “one-size-fits-all” treatment may not be effective. (accept all reasonable answers)
