By We Level Up | Author Nam Tran, PharmD | Editorial Policy | Research Policy

Are you worried about your child’s eating habits? Do they seem to avoid certain foods or have a very limited diet? It’s possible they may have avoidant restrictive food intake disorder (ARFID).

ARFID is an eating disorder that can affect people of all ages, but it’s most commonly diagnosed in children and adolescents. It’s distinguished by a persistent refusal to eat certain foods or food groups, which can lead to nutritional deficiencies and other health problems.

If you suspect your child may have ARFID, it’s important to seek help from a qualified healthcare professional. With proper treatment and support, most people with ARFID can learn to expand their diets and develop a healthier relationship with food.

Key Takeaways

• ARFID is an eating disorder characterized by a persistent refusal to eat particular types of food, which can result in nutritional deficiencies and health complications.
• Common symptoms of ARFID include extreme pickiness about food textures, colors, smells, or temperatures. ARFID can also manifest with frequent fears of choking or vomiting while eating, and avoidance of social situations involving food.
• Physical signs of ARFID may include poor growth, weight loss, low energy levels, nutritional deficiencies, and gastrointestinal issues.
• Treatment for ARFID typically involves a multidisciplinary approach, combining medical care, nutrition therapy, and psychological support such as cognitive-behavioral therapy (CBT) and family-based therapy (FBT).
• Supporting someone with ARFID requires patience, awareness, and encouragement throughout their recovery. It also helps to create a supportive environment, free of judgment or pressure.

Differentiating ARFID from Picky Eating

While picky eating is common in childhood, ARFID is a more severe condition. 

Picky eaters may have strong preferences, but they typically don’t interfere significantly with psychosocial functioning. But children with ARFID often have an intense fear of trying new foods or entire food groups. Individuals with ARFID may avoid family meals, parties, and other situations involving eating altogether.

Picky eating usually doesn’t lead to serious weight loss or nutritional deficiencies. In contrast, ARFID can cause serious health problems due to inadequate calorie and nutrient intake. And children with ARFID may struggle to maintain a healthy weight and growth.

Picky eating habits often improve as children grow older. But ARFID typically persists without professional intervention and can continue into adulthood. People with ARFID may have a limited diet of only a few “safe” foods.

If you’re concerned that your child’s eating habits go beyond typical picky eating, consult a healthcare provider. They can assess whether your child meets the criteria for ARFID and recommend appropriate treatment. Early intervention is key to preventing long-term health consequences and helping your child develop a more diverse, balanced diet.

Prevalence of ARFID and Demographic Insights

ARFID affects an estimated 3.2% of the general population. But the prevalence is higher among those seeking treatment for eating disorders, ranging from 5% to 14% in inpatient programs. ARFID can develop at any age but is most commonly diagnosed in children and adolescents.

Some studies show that ARFID is about equally common among males and females. Other studies suggest that a higher proportion of males present with ARFID. In either case, this sets ARFID apart from other eating disorders, which often affect more females than males. 

ARFID also appears to be more prevalent in people with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD).

Researchers have found that around 50% of children with ARFID have a co-occurring anxiety disorder. Separation anxiety and generalized anxiety disorders may be possible. Social anxiety and obsessive-compulsive disorder are also seen in some cases.

It’s important to note that ARFID can have serious health consequences if left untreated. Children with ARFID may experience delayed growth and development due to inadequate nutrition. Adults may suffer from malnutrition, leading to various medical problems.

Being aware of the signs and symptoms of ARFID early on is critical for effective treatment. If you suspect that you or a loved one may have ARFID, consult a healthcare professional specializing in eating disorders. They can provide an accurate diagnosis and develop an appropriate treatment plan.

Common Symptoms of ARFID

People with ARFID may experience a range of symptoms that can vary in severity. Some common symptoms include:

1. Extreme pickiness about food textures, colors, or smells
2. Refusal to eat certain foods or food groups, leading to a limited diet
3. Lack of interest in eating or low appetite
4. Fear of choking, vomiting, or experiencing discomfort while eating
5. Slow or poor weight gain in children, or weight loss in adults
6. Nutritional deficiencies due to limited food intake
7. Gastrointestinal issues, such as constipation or acid reflux
8. Difficulty concentrating, fatigue, or irritability
9. Avoidance of social situations involving food, such as school lunches or family meals
10. Reliance on supplements or tube feeding to meet nutritional needs in extreme cases

It’s important to note that not everyone with ARFID will experience all these symptoms. The severity and combination of symptoms can differ from person to person. 

If you or your child are experiencing several of these symptoms and it’s impacting daily life, consult a healthcare professional. They can provide an accurate diagnosis and develop an appropriate treatment plan to help manage the condition and improve overall health.

Physical Signs Associated with ARFID

ARFID can lead to several physical signs. You may notice your child has weight loss or poor growth. They might have low energy levels and fatigue. Some kids with ARFID develop nutritional deficiencies like anemia or low vitamin D. Gastrointestinal issues such as constipation, stomach pain, and acid reflux are also common.

Other physical signs can include dry skin, brittle nails, and thinning hair. Your child’s eyes may appear sunken. Cold intolerance and dizziness upon standing could indicate an electrolyte imbalance. Delayed puberty is possible in severe cases of malnutrition.

Keep an eye out for dental problems, too. Limited diets (that often contain highly processed foods) can increase the risk of tooth decay.

If you notice any concerning physical changes, contact your child’s healthcare provider. They can assess your child’s health and run tests if needed. Early intervention can help prevent serious medical complications from ARFID.

Treatment Options for ARFID

If you or your child has been diagnosed with ARFID, several treatment options can help manage the disorder and improve eating habits. Treatment for ARFID is typically characterized by a multidisciplinary approach, combining medical care, nutrition therapy, and psychological support.

Medical Care

Your healthcare provider will monitor your physical health and address any medical complications resulting from ARFID. They may recommend dietary supplements to correct nutritional deficiencies and ensure proper growth and development. In severe cases, temporary feeding tubes or intravenous nutrition may be necessary to provide essential nutrients.

Nutrition Therapy

A registered dietitian can help develop a personalized meal plan that steadily introduces new foods and textures. They’ll work with you to set realistic goals, such as trying one new food per week, and provide strategies for managing sensory issues related to food. Nutrition therapy aims to expand your diet, meet physiological needs, and foster a positive relationship with food.

Psychological Support

Cognitive-behavioral therapy (CBT) is a common treatment for ARFID. CBT helps you identify and change negative thoughts and behaviors around food. You’ll learn coping strategies for managing anxiety and fear related to eating. You’ll also practice exposure techniques to slowly increase comfort with new foods.

Family-based therapy (FBT) is another potential ARFID treatment, particularly for children and adolescents. FBT is characterized by the whole family’s involvement, with parents taking an active role in meal planning and supporting their child’s progress. This approach helps create a positive home environment that encourages healthy eating habits.

In some cases, medication may be prescribed to manage co-occurring conditions like anxiety or depression, which can contribute to ARFID symptoms. Your healthcare provider will determine if medication is appropriate based on your individual needs.

Keep in mind, recovery from ARFID is a gradual process that requires patience and help. With proper treatment and a strong support system, you can overcome the challenges of ARFID and enjoy a more nutritious diet.

Management Strategies for Individuals with ARFID

If you have ARFID, there are several management strategies that can help. A multidisciplinary approach is often most effective, combining medical care, nutrition therapy, and psychological support.

Your healthcare provider will monitor your physical health and may recommend dietary supplements to ensure you’re getting the necessary nutrients. In severe cases, feeding tubes or intravenous nutrition may be used to prevent malnutrition.

Working with a registered dietitian can be beneficial in creating personalized meal plans that carefully introduce new foods. They’ll help you set realistic goals and provide guidance on expanding your diet in a safe, manageable way.

Cognitive-behavioral therapy (CBT) is a common treatment for ARFID, focusing on addressing negative thoughts and behaviors around food. A therapist will teach you coping strategies to manage anxiety and reduce avoidance of certain foods.

For children with ARFID, family-based therapy (FBT) can be particularly effective. This approach includes the family in the process, promoting a supportive environment and encouraging positive eating habits.

If you have co-occurring conditions like anxiety or depression, your healthcare provider may prescribe medication to help manage those symptoms. Treating underlying mental health issues can improve your overall well-being and make it easier to work on your relationship with food.

Rehabilitation doesn’t happen overnight. Cherish incremental successes along the way, and don’t hesitate to reach out for help when needed.

Supporting Someone with ARFID: Practical Insights

If you’re supporting someone with ARFID, your role is critical. Offer patience, empathy, and encouragement throughout their journey. Educate yourself about ARFID to better comprehend their struggles and challenges.

Encourage them to seek professional help from a multidisciplinary team. This may include a physician, registered dietitian, and mental health professional. A personalized treatment plan will address their specific needs and goals.

Create a supportive environment at home, free of judgment or pressure. Make mealtimes pleasant and relaxed, focusing on conversation rather than food. Avoid commenting on their eating habits or making comparisons to others.

Help them progressively expand their diet by introducing new foods slowly. Start with small portions and variations of familiar foods they enjoy. Celebrate their progress and successes, no matter how small they seem.

Engage them in meal planning and preparation to increase their comfort level. Let them choose recipes, shop for ingredients, and cook alongside you. This can help them feel more in control and less anxious about eating.

Be a good role model by maintaining a healthy relationship with food. Eat a varied selection, express positive attitudes, and avoid dieting. Your actions can strongly influence their perception of food and eating.

Encourage them to participate in social activities involving food when they’re ready. Start with low-pressure situations like family meals or small gatherings with friends. Gently build up to larger events as their confidence grows.

Most importantly, offer emotional support and validation of their feelings. Listen to their concerns without judgment, and reassure them of your unwavering support. Your love and encouragement are valuable in their efforts.

Conclusion and Resources for Further Information

If you suspect that your child may have ARFID, it’s essential to seek help from a healthcare professional. They can provide an accurate diagnosis and develop a personalized treatment plan. This may include medical care, nutrition therapy, and psychological support.

Cognitive-behavioral therapy (CBT) can help address negative thoughts and behaviors around food. For children, family-based therapy (FBT) is another option that involves the entire family.

Remember, recovery from ARFID is an endeavor that requires patience and support. Celebrate small victories along the way. With the right treatment and a strong support system, your child can tackle the challenges of ARFID.

For more information and support, consider these trusted resources:

• National Eating Disorders Association (NEDA) – www.nationaleatingdisorders.org
• Families Empowered and Supporting Treatment of Eating Disorders (F.E.A.S.T.) – www.feast-ed.org
• Academy for Eating Disorders (AED) – www.aedweb.org

Don’t hesitate to reach out to your healthcare provider with any questions or concerns. They can guide you through the process of helping your child develop a healthier relationship with food.

Frequently Asked Questions