Understanding ARFID: More Than Just Picky Eating

When most people hear about food aversions in children, they assume it’s just picky eating—a phase that kids will outgrow. However, for children with Avoidant/Restrictive Food Intake Disorder (ARFID), eating challenges go far beyond personal preference. ARFID is a serious eating disorder that can impact nutrition, health, and daily life, especially for autistic individuals and those with sensory sensitivities.

In this blog, we’ll break down:

• What ARFID is and how it differs from picky eating

• Signs and symptoms of ARFID

• Common causes of ARFID

• Treatment options and strategies for supporting children with ARFID

What is ARFID?

ARFID stands for Avoidant/Restrictive Food Intake Disorder. It is an eating disorder that causes an individual to severely restrict their diet, but unlike other eating disorders, it is not driven by body image concerns or a desire to lose weight. Instead, ARFID is characterized by extreme food avoidance due to sensory sensitivities, fear of choking, vomiting, or other distressing experiences related to eating.

Many people with ARFID have a very limited list of “safe foods” and experience anxiety, distress, or even physical discomfort when presented with new foods.

ARFID is common among autistic individuals and those with sensory processing differences.

ARFID vs. Picky Eating: What’s the Difference?

It’s important to distinguish ARFID from typical picky eating that many children experience.

Picky Eating	ARFID
Common in young children	A diagnosed eating disorder
Kids still meet their nutritional needs	Can lead to malnutrition or failure to thrive
Children eventually outgrow food aversions	Persistent and often worsens without intervention
Some reluctance to try new foods	Extreme fear or anxiety around new foods
Preferences but will eat a variety	Highly restricted diet (10–20 “safe foods” or fewer)

Key Difference: ARFID isn’t just being difficult with food—it’s a medical condition that often requires professional intervention.

Signs & Symptoms of ARFID

Does your child show these signs?

Eating fewer than 10–20 safe foods

Gagging, choking, or experiencing extreme distress around new foods

Fear of food textures, smells, or appearance

Avoiding entire food groups (e.g., no fruits, vegetables, proteins)

Reliance on nutritional drinks or supplements for calories

Weight loss, malnutrition, or poor growth

Many individuals with ARFID experience severe anxiety and stress around mealtime, which can make eating a daily struggle.

What Causes ARFID?

There isn’t one single cause of ARFID, but research has identified three primary factors that contribute to it:

1. Sensory Sensitivities

Individuals with sensory processing challenges may find certain food textures, smells, or flavors overwhelming, making them avoid those foods entirely.

This is common in autistic individuals or those with sensory processing disorder (SPD).

2. Traumatic Eating Experiences

ARFID can develop after a negative experience with food, such as:

Choking or gagging on food

Severe vomiting or nausea

Food poisoning or allergic reactions

This can cause an intense fear response, making the child avoid similar foods altogether.

3. Fear of Gastrointestinal Discomfort

Some individuals fear eating certain foods because they associate them with stomach pain, nausea, or discomfort. This is common in children with gastrointestinal disorders (such as GERD or IBS).

It’s NOT a choice—ARFID is a real struggle!

How is ARFID Treated?

The best approach to treating ARFID depends on the root cause. Here are evidence-based treatment options that can help children expand their diets and reduce food-related anxiety:

1. Occupational Therapy (OT)

For children with sensory sensitivities, occupational therapy (OT) can help with desensitization and improving tolerance to different textures and smells.

2. Feeding Therapy

A speech-language pathologist (SLP) or dietitian specializing in feeding therapy can help children gradually expand their food variety using safe exposure techniques.

3. Cognitive Behavioral Therapy (CBT)

For children with food-related anxiety, CBT can help address underlying fears and emotional responses around eating.

4. Nutritional Support

For children with severe food restrictions, a nutritionist or dietitian may recommend:

High-calorie nutritional drinks

Vitamin supplements to prevent deficiencies

Gradual food exposure strategies

Early intervention is key! The earlier ARFID is identified, the easier it is to address feeding challenges before they worsen.

Final Thoughts: Supporting a Child with ARFID

ARFID is not just picky eating—it’s a serious eating disorder that requires patience, understanding, and professional support. If your child struggles with food avoidance, you are not alone!

Here are some ways you can help:

Create a low-pressure mealtime environment—avoid forcing foods.

Introduce new foods slowly—use play-based exposure (e.g., touching or smelling before eating).

Seek support from feeding specialists—they can help create a plan tailored to your child’s needs.

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