What Is ARFID?A Parent’s Guide to a Commonly Misunderstood Eating Disorder
If your child only eats a handful of foods… avoids meals entirely… or melts down at the sight of new textures, you might be worried. You may have been told they’re “just picky,” will “grow out of it,” or that it’s a behavioral phase.
But for some children and teens, the issue runs deeper.
They may be struggling with a lesser-known — but increasingly recognized — eating disorder called ARFID.
Let’s explore what ARFID is, how it differs from other eating disorders, and what parents can do to support healing.
What Does ARFID Stand For?
ARFID stands for Avoidant/Restrictive Food Intake Disorder.
It was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013.
Unlike other eating disorders, ARFID is not driven by body image concerns or a fear of weight gain.
Instead, kids and teens with ARFID avoid food due to:
Sensory sensitivity (taste, texture, smell, appearance)
Fear of negative experiences (choking, vomiting, allergic reaction)
Low appetite or lack of interest in food/eating
What ARFID Can Look Like
ARFID is more than picky eating. The avoidance is severe enough to lead to:
Inadequate nutrition or growth delays
Weight loss or failure to gain weight
Nutritional deficiencies (iron, vitamins, etc.)
Extreme anxiety or distress around food
Reliance on supplements or tube feeding in some cases
Impaired social functioning (e.g., avoiding sleepovers or restaurants)
Children and teens with ARFID often eat a very limited “safe list” of foods and may panic when pressured to try new ones.
Who Gets ARFID?
ARFID can affect:
Children as young as 2–3 years old
Teens and adults
Boys and girls equally
People of any body size or weight
It’s especially common in children with:
Autism spectrum disorder (ASD)
ADHD
Anxiety disorders
Sensory Processing Sensitivities
Research suggests up to 5% of children may meet criteria for ARFID, and it may be underdiagnosed due to lack of awareness (Kurz et al., 2021).
Why ARFID Deserves Serious Attention
Although ARFID doesn’t involve body image concerns, it can be just as serious as other eating disorders.
Left untreated, ARFID can lead to:
Malnutrition and growth impairment
Weakened immunity
Social isolation and anxiety
Family stress and mealtime conflict
Feeding tube dependence
Parents may feel helpless or blamed — but ARFID is not caused by bad parenting. It’s a neurobiological and psychological condition that requires skilled treatment.
How Is ARFID Treated?
The gold standard for ARFID treatment involves a multidisciplinary team:
Medical provider to monitor weight, growth, and labs
Therapist (CBT-AR or exposure-based therapy)
Dietitian familiar with pediatric feeding and sensory needs
Family-based support to reduce power struggles and build safe routines
Treatment goals may include:
Expanding the variety and quantity of foods
Addressing underlying anxiety or trauma
Creating a positive, pressure-free food environment
Supporting nourishment and developmental needs
CBT-AR (Cognitive Behavioral Therapy for ARFID) has shown promising outcomes, particularly in youth (Thomas et al., 2020).
What Can Parents Do?
Validate your child’s distress — even if the fears don’t make sense to you.
Avoid forcing or bribing them to eat.
Focus on creating calm, structured mealtimes.
Celebrate any small wins (even smelling or touching a new food).
Seek out specialized support early — don’t wait for “rock bottom.”
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
Thomas, J. J., Eddy, K. T., et al. (2020). Cognitive-behavioral therapy for avoidant/restrictive food intake disorder: A clinical manual. Cambridge University Press.
Kurz, S., van Dyck, Z., et al. (2021). Prevalence and correlates of ARFID symptoms in adolescents. European Child & Adolescent Psychiatry, 30(3), 391–402.
Kambanis, P. E., et al. (2020). Avoidant/restrictive food intake disorder in youth: Clinical and neurocognitive correlates. International Journal of Eating Disorders, 53(10), 1610–1619.
Final Thought
ARFID is real. It’s not a phase, attention-seeking, or something kids “grow out of.” But with the right support, children and teens can learn to feel safe around food again — and families can find relief from the daily battles.
If your child avoids eating or struggles with extreme food fear, trust your instincts. Early support makes a lasting difference.
Need Help?
We specialize in treating ARFID and pediatric eating disorders using compassionate, evidence-based care for ages 5–25.
