Avoidant/Restrictive Food Intake Disorder
Avoidant/Restrictive Food Intake Disorder (ARFID) is a mental health diagnosis. Children with ARFID are extremely picky eaters and may have little interest in, or fear of, food or eating.
What Is Avoidant/Restrictive Food Intake Disorder?
Avoidant/restrictive food intake disorder (ARFID) is a mental health diagnosis that is defined by extreme picky eating and little interest in, or fear of, food or eating.
Children with ARFID restrict and limit the amount of food, and types of foods, they eat. This is similar to Anorexia or Bulimia, but a child with ARFID is not concerned about their body shape or size. The eating problems seen in ARFID stem from other factors, such as:
- Aversions to certain food groups or textures of foods
- Lack of appetite
- Preferences for specific colors of foods
- Fears of vomiting or choking after eating
As well as being selective about food, someone with ARFID might not eat (consume) enough calories to grow and develop. In children, this may cause stalled weight gain, weight loss, or even stalled vertical growth (growing taller).
ARFID is a mental health diagnosis. A similar medical diagnosis is Pediatric Feeding Disorder. All children with ARFID also meet signs (criteria) for Pediatric Feeding Disorder.
What Are the Symptoms of Avoidant/Restrictive Food Intake Disorder?
- Big drop in weight
- Significant nutritional deficiencies
- Needs tube feeding or food supplements taken by mouth
- Is not hungry, not interested in eating or food
- Child has behaviors to avoid eating or drinking
- Child has trouble pooping, belly pain, cold intolerance, feeling tired or having extra energy
- Constant, vague belly issues (“upset stomach”, feels full, etc.) around mealtimes that have no known cause
- Very limited in foods and amount they will eat
- Picky about food texture
- Fears of choking or vomiting
- Limited range of foods they will eat that gets less over time (i.e., picky eating that keeps getting worse)
- No body image problems or fear of gaining weight
The above signs should not be due to lack of access of food (food insecurity), an eating disorder (such as anorexia), or other medical problems.
What Causes Avoidant/Restrictive Food Intake Disorder?
The risk factors of ARFID involve biological, psychological, and sociocultural issues. Children are more likely to develop ARFID if they have one of the following conditions:
- Autism Spectrum Disorder (ASD)
- Attention Deficit Hyperactivity Disorder (ADHD)
- High anxiety
- Obsessive Compulsive Disorder (OCD)
- Severe picky eating
How Is Avoidant/Restrictive Food Intake Disorder Diagnosed?
Your child will be seen by doctors and health care professionals from different specialties. They will assess your child's feeding and medical history, exercise and eating habits, nutritional status, and food related behaviors.
How Is Avoidant/Restrictive Food Intake Disorder Treated?
Treatment involves medical, nutrition, feeding skills, and psychosocial experts. Based on your child’s needs treatment goals may include:
- Restoring nutritional status through weight stabilization
- Increasing acceptance and variety of foods
- Creating positive mealtime experiences
When Should I Get Help for My Child?
When a child isn’t growing and receiving proper nutrition, the body is not able to function normally. Serious health issues can include:
- Difficulties concentrating
- Fainting/syncope
- Poor wound healing
- Impaired immune response
- Abnormal lab values
- Menstrual irregularities
- Muscle weakness
- Reduced resting metabolic rate, a result of the body’s attempts to conserve energy
Nationwide Children’s Hospital’s Comprehensive Pediatric Feeding and Swallowing Program offers a variety of services, including evaluation and an Intensive Feeding Track for children with ARFID.
We recognize a child’s feeding disorder impacts the entire family. We work with caregivers to develop plans that fit into daily life and meet the unique needs of each child and their family.
