More Than Picky Eating: Supporting Kids with ARFID

As we recognize Social Work Month and Nutrition Month

Many children go through phases of picky eating. However, for some kids, eating challenges go beyond typical preferences. Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder that involves significant restriction in the amount or variety of foods a child eats, which can affect their nutrition, growth, and daily life.

Unlike other eating disorder diagnoses, the primary concern in ARFID is not body image or weight related. Instead, children may avoid food because of strong sensory sensitivities (taste, texture, smell), low appetite, or fear of negative experiences like choking or vomiting.

ARFID is increasingly recognized in children and adolescents and can sometimes be mistaken for severe picky eating.

What ARFID Might Look Like

Children with ARFID may:

• Eat a very small range of “safe” foods
• Avoid foods due to texture, smell, or appearance
• Avoid full food groups (i.e., protein, vegetables, fruit, etc.)
• Show little interest in eating or poor appetite
• Have fear of choking, gagging, or vomiting
• Experience stress or anxiety around meals

When food intake becomes too limited, children may experience poor growth, nutritional deficiencies, or difficulty participating in social activities that involve food.

How Professionals Can Support

Supporting a child with ARFID often involves a team approach, including healthcare providers, mental health clinicians, and registered dietitians.

Dietitians help ensure children get the nutrition they need to support optimal growth and development, while gradually introducing new foods in manageable ways.

Social workers and therapists help address anxiety, sensory challenges, and the emotional stress that can come with eating difficulties. They also support families in creating positive, low pressure mealtime environments.

Together, this approach helps children build confidence with food and improve their relationship with eating.

Tips for Caregivers

If your child struggles with restrictive eating, these strategies may be supportive:

1. Keep mealtimes calm
   Pressure to eat can increase anxiety. Focus on creating a supportive environment instead.
2. Think small steps
   Looking at, touching, or smelling a new food can be an important step before eating it.
3. Stick to routines
   Regular meal and snack times can help support appetite.
4. Celebrate progress
   Tolerating a new food on their place, interacting with a new food through play based exposure or trying even a small bite are all examples of meaningful success.
5. Reach out for support if needed
   If your child eats very few foods or their eating habits are affecting growth, energy, or family life, it may be helpful to speak with a healthcare professional.

ARFID can be challenging for both children and caregivers, but with the right support, children can make meaningful progress. During Social Work and Nutrition Month, we recognize the important role that collaboration between families, social workers, and dietitians plays in supporting children’s health and wellbeing.

Sources

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).

Cleveland Clinic. Avoidant/Restrictive Food Intake Disorder Overview.

Norris, M. L., et al. (2018). Clinical presentations of ARFID. Journal of Eating Disorders.

Thomas, J. J., et al. (2017). Avoidant/Restrictive Food Intake Disorder: A Three-Dimensional Model. Current Psychiatry Reports.