May marks both Pediatric Feeding Disorder Awareness Month and Mental Health Awareness Month, making it the perfect time to spotlight ARFID (Avoidant/Restrictive Food Intake Disorder). ARFID is a condition that involves both feeding and mental health challenges.
It can be confusing and distressing if your child isn’t eating as expected. That’s why it’s always a good idea to bring up any concerns about your child’s eating habits or food intake with their pediatrician. Westside offers free screenings, where you can speak directly with one of our expert pediatric therapists to discuss your concerns and find out if a full feeding evaluation might be helpful.
What is ARFID?
ARFID stands for Avoidant/Restrictive Food Intake Disorder. It may sound like an eating disorder, but it’s actually a feeding disorder. Unlike eating disorders, which are often driven by concerns about body image, weight, or food intake, a feeding disorder is characterized by a child’s limited intake or aversion to certain foods. This can stem from sensory sensitivities, anxiety, or other underlying factors.
A child with ARFID isn’t concerned about body image or losing weight. Kids with ARFID want to eat, but struggle to do so. Imagine a swimmer who loves the water but freezes up every time they dive in. The skills are there, the desire is there, but the anxiety is overwhelming.
With ARFID, there’s an intense fear or aversion to food that creates significant distress and often leads to nutritional deficiencies or challenges with daily functioning. It can look similar to a food sensitivity, where a child is selective about the types of food they eat, or they might refuse to eat food altogether.
Symptoms can include:
- Lack of interest in foods
- Avoiding certain foods due to sensory characteristics (too chewy, too slimy, etc.)
- Fear of what might happen once food is swallowed (fears of choking or vomiting)
- Anticipatory anxiety prior to a meal (ex: asking if they are going to be okay)
- Associating certain textures or foods with getting sick
- Cutting food into abnormally tiny pieces or mixing with water to assist in swallowing
- Refusal to eat foods that aren’t prepared by their parent/guardian
- Refusal to eat when “safety person” isn’t present (often a parent or caregiver)
- Anxiety when talking about or looking at food
A Psych-Based Feeding Disorder
Even though ARFID is classified as a feeding disorder, it has psychological roots. There’s almost always a component of anxiety around food. This could stem from a past choking incident, a traumatic mealtime experience, or even well-meaning but anxious parental behavior. Over time, this fear can spiral, and mealtimes become something to dread instead of enjoy.
In most cases, counseling is needed in addition to feeding therapy. Feeding therapy alone may not be enough if a child’s fear is so strong that their body physically reacts to the idea of eating. At Westside, we often recommend a dual-approach: feeding therapy (led by speech or occupational therapists) and counseling to work through the anxiety.
Who Does ARFID Affect?
ARFID can show up as early as 18 months, though most diagnoses happen around ages 3 to 4. It can affect children, teens, and adults, but we see it most commonly in kids. Boys are more frequently diagnosed than girls. Some kids might only eat a short list of “safe foods,” like crackers or peanut butter sandwiches, while others may avoid entire food groups.
How Does ARFID Develop?
ARFID can be influenced by:
- Past medical issues
- Parental anxiety
- Mealtime power struggles
- Family dynamics
- Underlying anxiety and control around food
Sometimes, children use food as a way to exert control when other parts of their environment feel overwhelming. This underlying anxiety can drive avoidant eating behaviors. Parents may unintentionally reinforce the anxiety by limiting food options, catering only to “safe” foods, or engaging in mealtime power struggles.
That’s why we take a family-centered approach to treatment. We work closely with caregivers to understand their history, routines, and concerns. Every child’s treatment plan starts with a feeding evaluation, and if anxiety is a major barrier, we recommend counseling from the start.
ARFID vs. Picky Eating: What’s the Difference?
Many kids go through phases of picky eating – it’s a normal part of development. But ARFID goes far beyond that. Children with ARFID may avoid foods based on taste, texture, smell, or fear of choking or vomiting. In some cases, they simply have little to no interest in eating at all.
Here’s how ARFID stands apart from regular picky eating:
| Picky Eating | ARFID |
| Common in toddlers and young kids | Can occur at any age, often continues long past toddler years |
| Usually outgrown over time | Often requires professional support to improve |
| Eats a limited variety, but still meets basic nutritional needs | Intake is so limited it can lead to nutritional deficiencies, poor growth, or weight loss |
| May refuse new foods, but eats when hungry | May experience intense anxiety around eating or food-related situations |
| Mealtimes can be challenging | Mealtimes may be distressing, emotional, or avoided entirely |
ARFID Treatment at Westside
We tailor therapy to each child and encourage them to take part in setting their own goals. Sometimes, the goal is as simple as sitting at the dinner table with family or joining friends in the school cafeteria. Progress can take time, and that’s okay. What matters most is helping kids feel safe and supported enough to take the next step.
If you’re concerned about your child’s eating habits or wondering whether they might have ARFID, call us at (815) 469-1500 or click the link below. We’ll walk you through the next steps and create a plan that supports both your child and your family.
