When picky eaters don’t eat enough for proper development or everyday functioning, they may be living with ARFID.

There’s nothing wrong with selective eating. Maybe your child isn’t a fan of certain textures or food types. Maybe they aren’t hungry at mealtimes.

These things are natural.

But when your child lives with ARFID, food can regularly disinterest them or cause anxiety. They might worry there are negative effects to eating, like choking or vomiting.

ARFID is most often diagnosed in children (though it can occur in adults) and is slightly more common in males.

It’s a newer diagnosis, and a review of preliminary studies suggests ARFID affects between 5 and 22.5% of children with suspected eating disorders.

Regardless of age, living with ARFID doesn’t have to keep taking a toll on your (or your child’s) mental or physical health. Help is available for anyone who lives with symptoms of ARFID.

ARFID — avoidant restrictive food intake disorder — once referred to as “selective eating disorder,” is a type of feeding and eating disorder that primarily affects children.

It’s a recent addition to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), a guide used by mental health professionals to help diagnose mental health conditions.

In the DSM-5, ARFID is defined as a feeding disturbance where energy and nutritional needs don’t get met most of the time, often through:

  • lack of interest in food
  • avoidance of foods with certain traits (colors, textures, or shapes)
  • worry about consequences of eating

ARFID is only diagnosed if it occurs when you have enough access to food and aren’t under any cultural dietary restrictions.

A mental health professional or doctor can also rule out other conditions that might cause the symptoms you or your child are experiencing.

While there are similarities between ARFID and anorexia or bulimia, ARFID has nothing to do with body image or self-esteem.

Picky eating doesn’t mean you or your child have ARFID. Picky eaters often still get the calories they need to function and grow, even if they can be a challenge to please at mealtime.

According to the DSM-5, the primary symptoms of ARFID include:

  • significant weight loss
  • trouble gaining weight
  • stalled growth
  • malnutrition
  • dependence on supplements or feeding tubes
  • trouble doing activities related to day-to-day life

These symptoms aren’t always obvious from the start. There are other, less severe signs to watch for, like:

  • only eating specific foods
  • avoiding whole food groups (for example: fruits, vegetables, or meat)
  • a dislike of foods once enjoyed
  • specific food preparation needs
  • anxiety when trying new foods
  • avoiding social situations related to food
  • feeling nauseous at meal time

You may also notice physical symptoms related to nutritional deficiencies when you live with ARFID, such as:

  • fatigue
  • insomnia
  • feeling weak or dizzy
  • dry skin, brittle nails, or thinning hair
  • stomach cramps
  • acid reflux
  • missed or irregular periods

ARFID isn’t just about eating your vegetables and having good energy levels. Not getting enough nutrition or calories can impact almost every system in the body.

In children, ARFID can be difficult to recognize early. You may think you just haven’t found the right foods for your child to eat. After all, everyone has foods they like and don’t like, even as adults.

To help catch ARFID early, regular doctor’s visits can help ensure children are growing and gaining weight as expected for their age.

Want to learn more about the symptoms of ARFID? We do a deeper dive here.

Since it’s a newly recognized eating disorder, researchers are still investigating the causes of ARFID. Like all eating disorders, a mixture of factors likely contribute, including:

  • biology
  • environment
  • culture
  • personal experiences
  • genetics

Two children may both live with ARFID, but why it affects them and the symptoms they experience can vary.

Other conditions may mean someone has a higher chance of developing ARFID, including:

Higher rates of ARFID could also occur in children who are very picky eaters or who don’t seem to outgrow those habits over time.

Children living with ARFID tend to have higher instances of co-occurring anxiety disorders and other mental health conditions, too.

Living with ARFID isn’t a choice. You didn’t wake up one day and make a decision to dislike foods with fuzz on the outside or those with a smooth consistency.

You can’t help feeling the way you do about food when you live with this condition.

How ARFID presents can vary, and it can feel like those symptoms dictate what it means for you or your child.

One review of cases discussed how a history of choking on food led to more worries about choking during eating and an ARFID diagnosis months later.

A case in 2016 involved a girl who was hospitalized due to stomach problems. Although she was released from the hospital, she was readmitted after losing too much weight due to ARFID that had developed because of a fear of making stomach symptoms worse by eating.

Watching what you eat or how you eat can be exhausting. It can preoccupy your thoughts and keep you from social activities.

As a parent, you may be feeling frustrated and guilty when you can’t get your child to eat. Remember, ARFID isn’t a reflection of your cooking skills, parenting skills, or food choices — and your child isn’t misbehaving.

Parenting a child with ARFID can come with a lot of stress. Navigating strife at mealtimes and worrying about a child’s weight and nutrition can take a toll, especially when other people in your life might chalk your child’s behavior up to picky eating.

If you think you child’s eating habits cross over into ARFID, treatment options can help your child recover.

Due to the physical and mental aspects of ARFID, your medical team might include a number of professionals, such as a:

  • registered dietitian or nutritionist
  • medical doctor
  • psychologist
  • psychiatrist
  • medical specialist

Initial assessments can be performed by your primary doctor, who can evaluate the physical signs of ARFID.

Your doctor might recommend prompt treatment for the side effects of malnutrition, dehydration, or weight loss. They might also recommend specialists for your care.

Once you’ve gotten care for physical effects of ARFID and started working with a nutritional expert, a mental health professional could help you with a plan for long-term recovery and wellness.

These plans might include cognitive behavioral therapy or family-based therapy.

Cognitive behavioral therapy (CBT)

CBT can help people with ARFID feel less anxious about eating. You’ll explore your relationship with food and work toward changing behaviors that might contribute to ARFID.

Family-based therapy

Family-based therapy can be an important tool when you or a loved one lives with ARFID. Understanding the condition can help family members create a support network.

This type of therapy can also help empower family members to focus on nutrition while maintaining compassion for the loved one living with ARFID.

ARFID is an eating disorder that can have serious impacts on both mental and physical health.

While it’s mostly diagnosed in children, it can affect anyone at any age.

Life doesn’t have to stop because of ARFID symptoms. Help is available — and many treatment options can provide support for you and your family.

If you’d like to learn more about ARFID and other eating disorders, these resources could be a good place to start: