Avoidant restrictive food intake disorder (ARFID) involves ongoing feeding or eating issues that can cause tamariki to avoid food. It is more than just ‘picky eating’, which is common among tamariki. Tamariki with ARFID eat only a small range or amount of food. They often have an extreme dislike of certain foods or are generally not interested in food or eating.
Tamariki with ARFID might restrict their food intake for a few different reasons. ARFID can look very different from one child to another. There can be more than one reason for avoiding food.
Some tamariki are very sensitive to how food feels, smells, tastes or looks. This is more extreme than just disliking certain foods. Their deep dislike of the sensation of food causes them to avoid eating.
Some tamariki may avoid eating because they are worried about what will happen when they do. This could be a fear of things like vomiting, choking or pain. They might deal with this by avoiding certain foods and only eating foods they think are ‘safe’.
Some tamariki don’t feel as hungry as others, or they have a ‘low appetite’. These tamariki may see eating as a chore. This can lead to them not eating enough food to stay well.
Yes, ARFID is an eating disorder and a serious mental health condition. But, unlike other eating disorders, tamariki with ARFID don’t restrict their food intake because of concerns about their body weight or shape.
ARFID can look similar to anorexia nervosa, as some tamariki with ARFID significantly limit their food intake. Not eating the right quantity or variety of food can lead to medical problems. Other tamariki with ARFID may eat enough to maintain their body weight. But, eating a small range of foods may lead to low levels of important vitamins and nutrients.
See the KidsHealth's page on eating disorders for more information on different types [1]
There is not one single cause for ARFID. Experts are still trying to understand what makes some people more likely to develop ARFID.
ARFID may happen due to a mixture of reasons such as environment, upbringing, health and genetics. Some tamariki may have a medical condition that puts them at risk of ARFID. This can sometimes occur with medical conditions that affect the digestive system or require special diets.
ARFID may also happen after a child has a bad experience with food. This could be something that happened to them or something they saw, such as choking, gagging or vomiting.
ARFID is common in tamariki and also occurs in rangatahi. ARFID occurs in both girls and boys but is more common in boys. ARFID most often develops in early childhood and can last into adulthood.
Picky eating is common in tamariki, but it is very different to ARFID. ARFID is more than just fussy or picky eating. Tamariki with ARFID will deeply dislike certain foods or generally lack interest in food or eating. The behaviours in ARFID are ongoing and can cause serious medical problems.
It is common for tamariki to dislike certain foods, but most tamariki will gradually eat and explore new foods as they get older. Tamariki with ARFID need a lot of support to try new foods and to eat the right quantity and variety of food to stay healthy.
See the KidsHealth page on fussy eating in children for more information [2]
It is important to look for certain signs if you are worried about your child’s eating. Tamariki with ARFID may show some of the following signs.
When tamariki restrict their food intake, it can lead to complications that can affect their health, wellbeing and daily life.
Some tamariki who restrict their food intake can lose a lot of weight. Or, they may not grow or gain weight as expected.
If a child isn’t eating enough or is limited in what they eat, they may not be getting the nutrients they need for their body to function.
ARFID can have a big effect on a child's daily life.
Functioning at school and home can be challenging due to:
ARFID can affect your child’s mental health. They may experience low mood and anxiety around food and eating. They can also experience social anxiety and social withdrawal when they feel unable to eat around others.
See your doctor as soon as you can if you notice the following in your child:
If you think your child has ARFID, visit your family doctor. Ask for a referral to a paediatrician (child health doctor) or eating disorder specialist service. The earlier you seek help, the closer your child is to recovery.
See the KidsHealth page on getting help for a young person with an eating disorder [3]
There is no single test to check for ARFID. Your doctor will talk with you and your child about their eating behaviour, habits and thoughts.
Your child may also need the following tests:
Your child’s doctor will not diagnose ARFID if another eating disorder explains your child’s symptoms better. The doctor will also make sure that the eating behaviours, weight loss or failure to grow are not due to another medical condition such as coeliac disease.
Your child’s doctor may refer your child to:
These healthcare providers can confirm whether or not your child has ARFID. They can also recommend the appropriate treatment.
ARFID is quite a new diagnosis, and experts are still researching which treatments work best. For all eating disorders, early diagnosis and treatment are likely to lead to better outcomes.
If your child has ARFID, they might need psychological therapy. This can include whānau and family therapy or one-on-one sessions with your child.
Cognitive-behavioural therapy (CBT)
CBT is a good treatment for people with ARFID. Treatment may involve gradually exposing your child to foods they fear alongside relaxation training.
Responsive feeding therapy (RFT)
Responsive feeding therapy aims to:
When tamariki don’t eat enough food, they can have medical problems. Tamariki with ARFID will need to have regular appointments with their healthcare provider to monitor their physical health.
Medicine
There is no medicine that can treat ARFID. Some tamariki with ARFID may also have depression or anxiety; sometimes, medicines may help with these conditions. Your child may need some nutritional supplements if tests show they have low levels of certain vitamins and nutrients.
Hospital stay
If a child with ARFID is very unwell, they may need to stay in hospital. Health professionals will monitor them until they are safe and well enough to go home.
Having a child with ARFID can feel overwhelming. It is important to reach out for support when you need it. Eating Disorders Association of New Zealand (EDANZ) offers a support service for carers. [4]
With the right team and support, your child can recover from ARFID. Recovery is possible even if your child has had ARFID for many years. Tamariki with ARFID need a lot of love and support to get better and maintain healthy eating habits. They can sometimes develop ARFID symptoms again. If you notice your child is showing signs of ARFID again, contact your doctor as soon as possible.
See the KidsHealth's section on emotional and mental wellbeing [5]
This page last reviewed 27 June 2023.
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Links
[1] https://kidshealth.org.nz/eating-disorders-concerns-about-your-young-person%E2%80%99s-eating?language=ton
[2] https://kidshealth.org.nz/fussy-eating-children?language=ton
[3] https://kidshealth.org.nz/eating-disorders-getting-help-your-young-person?language=ton
[4] https://www.ed.org.nz/
[5] https://kidshealth.org.nz/tags/emotional-mental-wellbeing?language=ton
[6] https://kidshealth.org.nz/contact?from=http%3A%2F%2Fkidshealth.org.nz%2Fprint%2F2810%3Flanguage%3Drar