“I hate spinach.” How many parents have heard and responded to that emphatic statement with “But, you haven’t tried it!” While many kids go through periods of being “picky eaters,” you may have started to sense there may be something more serious going on with your child. You could be on to something – and it’s worth mentioning to your child’s doctor. A condition known as ARFID, an acronym for Avoidant Restrictive Food Intake Disorder, is picky eating taken to the extreme.

ARFID often starts in childhood but doesn’t always have the other symptoms that are commonly associated with eating disorders like binge eating, anorexia, or bulimia nervosa. Researchers estimate that ARFID affects about 1.5% of adolescents, which is nearly the same as the 1.7% diagnosed with anorexia. The condition appears to be more common in boys than girls.

Is it a Passing Phase or Something More?

The child who only wants P&B sandwiches, the pre-teen who only eats a certain color food, or the college student who eats three things: pizza, pasta, and cereal. It can be difficult to tell if these are phases, personality quirks, or something else. How do you decide when to intervene? A few years ago, the DSM-5 introduced ARFID and listed ways to evaluate if picking eating is a serious problem. To receive the diagnosis, a child or adult must:

  • Have a lack of interest in food or eating.
  • Have worries about the negative consequences of eating.
  • Have issues with how food looks, tastes, or feels, and avoid it for those reasons.

An ARFID diagnosis also requires that these food issues interfere with nutritional needs, such as significant weight loss or a child falling behind in her or his normal development. Like other eating disorders, ARFID can also cause problem’s in a child’s social life.

Triggers and Treatment

ARFID doesn’t display typical signs of other eating disorders, as people who struggle with it are usually of normal body weight. Researchers are still trying to figure out what triggers ARFID and are working on better ways to treat it. Right now, they believe there are real underlying biological causes:

  • A hypersensitivity to taste, texture, and smell. For example, your child may say broccoli tastes “bitter.”
  • A previous traumatic experience with food, like choking, which causes anxiety about eating solid foods.
  • A chronic lack of interest in the food itself.

Unlike other eating disorder patients, most kids with ARFID don’t think about their weight or body shape. Specialized care by a treatment team is often necessary for a full assessment and diagnosis. Behavioral and psychological interventions, including cognitive behavioral therapy, offer promising treatment.

Learn More

If you think your “picky eater” exhibits signs of ARFID, or if you want to learn more about the condition, the good news is that the medical community is continually discovering more about the condition and devising treatment methods that can help. No one needs to be alone in their struggle against an eating disorder. Support is available and recovery is possible.