Uh, for those kids that don't meet that medical criteria, what are we doing as primary care providers? What do we, how do we help the kids in real time?

Yeah.

So I think hopefully catching it, right? So catching this concerning pattern.

Like you said, they come back in three months or six months, and they've had such a significant drop.

You then have that conversation about what are the behaviors that contributed to this change.

It becomes clear that they're engaging in these patterns of restriction, um, that they're probably ex- expressing kind of fear of gaining weight, desire to keep losing weight, um, and then you're talking about therapy.

So if you're catching it soon enough, hopefully outpatient therapy, again, kind of the family-based treatment model where caregivers are gonna take over, um, planning and preparing and supervising their meals for a period of time.

And then also curious the breakdown between males and females.

And I wonder if some primary care physicians, myself included, make the mistake of maybe referring to a gastroenterologist before thinking about ARFID and the mental health.

Yeah, I think we definitely see that that happens, and I think some of that is driven by families, right? So one, they just don't think of these things as being eating disorders.

If there isn't that body image component, they don't think, "Okay, my kid's avoiding food for a psychological reason." They think, "There must be something going on with them," right? And kids will say, "I am experiencing pain," or, "My tummy hurts," and so that's what we latch onto.

It makes complete sense.

The challenge with that, then, is sometimes we go down that route, kids are getting these extensive tests done, um, without really any improvement.

And it, it's interesting 'cause I have a lot of, um, integrated psychologist friends and the ones who even work in GI.

Like, a lot of those interventions are things that they could start anyways, 'cause ultimately, even if it was, if it wasn't ARFID, if it was a true, um, like, GI, um, thing going on, they would still be having to make sure that these kids tolerate discomfort to get adequate nutrition.

What are some other ways, you know, uh, all the pediatricians out there can address these issues? Are there online resources or other things that they can do?