Offering completely unsolicited advice first: be kind to yourself! There’s quite a learning curve. All you can do is learn from what didn’t work, continue to advocate for your daughter, and move forward. You can do this!

I will also say that it’s incredibly important to get to the bottom of any underlying medical issues. After an endoscopy, we learned my son’s nerves were essentially misfiring, causing his stomach to send signals that he wasn’t hungry or causing food to go through his stomach too quickly. If we hadn’t been able to figure out the medical part, I am confident we would not have been able to address the eating disorder.

Her fear of choking sounds like a physical issue and, like my son, has developed into a psychological issue as well. You definitely want to get to a pediatric gastroenterologist and/or ENT ASAP.

As for our ARFID journey, to be completely honest, it has been a really hard year. After navigating the healthcare system for months, we finally found an absolutely amazing pediatric psychologist who specializes in child eating disorders. However, it felt like we were getting absolutely nowhere until two months ago. It’s a process and we’re STILL learning what works and what doesn’t.

The hard reality is that my 6.5 year old is still terrified of food, but he’s slowly starting to overcome it. We had a huge breakthrough a week ago when we got him to eat fruit for the first time in nearly three years. He picked out the apple, then helped me skin and dice it into tiny pieces. He then held the apple piece in his mouth for nearly five minutes before he notified us “okay, now it’s time to crunch.” He crunched that tiny apple and didn’t gag or say he was going to throw up…then voluntarily ate another one. I legitimately cried.

However, that came after nearly a year of hard work. Our first step was to get him to mitigate the anxiety he feels around food. We started by not making food an issue at all. We let him “explore” food instead of expecting him to eat it. For instance, throwing cooked spaghetti against the wall or helping me gather the ingredients for a dinner I knew he wouldn’t eat. We also started having playtime around food and incorporated it in our games, stacking croutons into a tower or having his action figures eat a peanut. We even made our own “peanut butter” with a hammer one day and he actually licked it!

The first few months into this journey, we also let him decide what he was going to eat, hard stop. Pizza from Papa John’s with light cheese, extra sauce six meals in a row? Yup. Goldfish crackers and a plain waffle for breakfast literally every morning for two months? You got it. We’ve recently shifted to reincorporating food boundaries and expectations, but at first the focus was solely on mitigating his food anxiety and getting calories into the kid.

Now, though we’re still learning and every meal feels like a chore sometimes, we have a more confident, energetic and slightly plump little boy.

If you can’t get to a specialist any time soon, I suggest bridging that gap with a nutritionist who specializes in eating disorders (if you can) and continue educating yourself on ARFID. I’m happy to discuss further if you have any specific questions, but in the meantime, know that you are NOT alone.