Understanding ARFID: What Parents Need to Know

Sometimes it’s more than just picky eating. And it can be SO frustrating when you hear, over and over again, that it’s just a phase. But sometimes it’s not a phase. And sometimes your child’s feeding struggles have you constantly worrying about their growth and health. If this sounds familiar, than this blog post is for you.

In this blog post, we’ll explore what ARFID is, its characteristics, the different subtypes, and how it differs from other eating disorders and pediatric feeding disorder. Understanding ARFID can help parents navigate their child’s eating challenges, validate their experiences as a family, and seek needed support.

What is ARFID?

ARFID is an acronym for Avoidant Restrictive Food Intake Disorder. It is an eating disorder that is characterized by extremely limited food intake or selective eating patterns without any concern regarding body image. Unlike other eating disorders that are often associated with a desire for weight loss, individuals with ARFID may not exhibit any desire to change their weight. Despite this, their eating behaviors can lead to significant challenges, including:

Weight loss
Nutritional deficiencies
Dependence on nutritional supplements or tube feeding
Eating behaviors that disrupt daily life

Recognizing these characteristics is crucial for parents to understand when a child’s eating habits may go beyond typical picky eating and require professional support.

The Three Subtypes of ARFID

ARFID can manifest in three main subtypes, each with its own unique characteristics:

1. Sensory Sensitivity

Children exhibiting sensory sensitivity avoid foods with specific sensory traits, such as texture, color, or smell. For example, a child may refuse to eat certain fruits or vegetables because of their texture. This aversion can significantly limit the variety of foods they consume, making it important for parents to consider the sensory aspects of the foods they are serving, and how their child responds to those foods. This subtype often accompanies neurodivergence.

2. Lack of Interest in Food

Whether premature fullness, forgetting to eat, difficulty interpreting feelings of hunger, and not enjoying eating, some children may have minimal or no desire or motivation to eat. This could mean that they frequently skip meals or show little enthusiasm at mealtime. As with all subtypes, it’s essential to create a positive eating environment that encourages exploration and enjoyment of food, rather than pressure or coercion. If this lack of interest in food is due to a medical condition, such as gastroparesis, a pediatric feeding disorder (PFD) diagnosis may be more appropriate.

3. Fear of Aversive Consequences

The third subtype involves a fear of negative outcomes associated with eating, such as choking or vomiting. This anxiety can lead to avoidance of certain foods or even meals altogether. Parents should be aware of these fears and consider consulting a pediatrician or psychologist to address these fears appropriately and help their child feel more secure during mealtimes. This subtype may accompany other mental health conditions such as anxiety, depression, or OCD.

ARFID vs. Pediatric Feeding Disorder

As a mental health condition, ARFID is different from pediatric feeding disorders, which may arise from medical issues, such as eosinophilic esophagitis (EoE) or food protein-induced enterocolitis syndrome (FPIES). If your child’s picky eating stems from a medical condition, it’s essential to seek advice from a healthcare professional who can provide targeted support.

Summary

ARFID is a complex eating disorder characterized by extreme picky eating and food avoidance behaviors without body image concerns. By understanding the various subtypes of ARFID—sensory sensitivity, lack of interest in food, and fear of aversive consequences—parents can better understand their child’s specific needs related to their feeding challenges. For both ARFID and pediatric feeding disorders, it is essential to seek guidance from qualified professionals. These may include pediatric dietitians, psychologists, feeding therapists (occupational therapists or speech language pathologists), their pediatrician, a gastroenterologist, and pediatric allergists. Recognizing the nuances of this disorder can lead to better support for your child and a healthier relationship with food.

For more on the difference between ARFID and picky eating, watch this video.

As always, this information is for educational purposes only. If you are ever concerned about your child’s health, nutrition, or eating behaviors, reach out to your pediatric dietitian or pediatrician for help and support.

Sending love and feeding wins your way,

Dr. Taylor Arnold

PS – If you’re looking for a short Instagram video to share with friends and family explaining ARFID, check out this video 👇