Dealing With a Very Picky Eater? All About ARFID (Avoidant/Restrictive Food Intake Disorder)

Has your child limited what they eat to a worrying extent? It’s one thing for kids to be picky in the sense that they’ll only focus on a few favored foods for a time, like mac and cheese or peanut butter and jelly sandwiches. 

But what if they’re abnormally selective, overly concerned about choking on their food, or experience noticeable weight loss? These can all be signs of an eating disorder called Avoidant/Restrictive Food Intake Disorder (ARFID). 

Unfortunately, since ARFID is considered an eating disorder, which is a medical condition that requires treatment — children affected by it won’t outgrow it, and it doesn’t just go away.

The knowledgeable and sensitive team at Clarity Psychiatric Care has extensive experience treating a variety of eating disorders in people of all ages, including ARFID. Once a child is accurately diagnosed, we can help them regain a healthy relationship with food.

ARFID: A lesser-known but alarming eating disorder 

We know that many people in the United States are affected by eating disorders. In fact, about 30 million (9% of the population) will be affected by one at some point during their lives. Most are young women, but the number of men who are diagnosed has grown. However, ARFID affects children primarily — although adults can also be diagnosed. 

Most of us associate the term “eating disorder” with conditions like anorexia nervosa (severely restricted eating and the distorted idea that one is overweight, no matter how thin one becomes) and bulimia nervosa (binging and purging by using diuretics and laxatives or making themselves vomit afterward). 

The less frequently talked about ARFID isn’t centered on having a distorted body image or weight loss. Instead, children living with the condition limit their food intake to just a few types. They may develop rituals around their ingestion, such as eating foods in a specific order or preparing food in a very particular way. 

The reason you may not have heard of ARFID yet is that its inclusion in the Diagnostic and Statistical Manual of Mental Disorders (fifth edition)has been relatively recent (2013).

In addition to the symptoms we spoke of earlier, there are others, including the following:

• In addition to weight loss, stunted growth, constipation, abdominal pain, and fatigue
• Food sensory sensitivity (problems with the texture, smell, or appearance of certain foods)
• Fear or anxiety about certain foods that can be attributed to negative past experiences
• Intense fear of trying new foods
• Markedly decreased interest in food and eating, which leads to a lack of hunger
• An inability to enjoy food
• Improper nutrition weakens the immune system, making illness more likely

Put simply, a young person with ARFID no longer considers eating pleasurable. Instead, it’s upsetting and a source of stress. Some of the traumatic roots of ARFID include choking on a certain food in the past, having become ill from eating something, being force-fed at some point, or experiencing food insecurity.

It’s critical to seek treatment for a child with ARFID because it can become life-threatening. In addition to malnutrition and dehydration, those living with the condition can also experience an electrolyte imbalance and delayed onset of puberty. 

Serious health conditions can also develop, including anemia, low blood pressure, and osteoporosis.

Can AARFID be treated successfully?

The good news is that treatment exists for ARFID. 

Cognitive behavioral therapy (CBT) is effective for people coping with ARFID since it can address a patient’s fear and anxiety about food, help them pinpoint and clearly see flawed thoughts and behaviors around food and eating, and assist them with their food-related sensory challenges. 

Other therapeutic tools that may be part of a patient’s treatment plan include:

• Nutritional counseling
• Individual psychotherapy
• Family therapy
• Group therapy
• Prescription medication

Clarity Psychiatric Care also offers an innovative program for young patients with eating disorders — the Together Youth Mentoring Program. It assigns a young person struggling with an eating disorder to a peer who has experienced it and recovered. They can offer unique support during treatment.

ARFID is different from picky eating, and it requires professional treatment. 

Contact our Cherry Hill office at 856-428-1260 to schedule an appointment with us, or you can use our convenient online booking tool.