ARFID: When Picky Eating Gets Your Kid Off Track

Picky Eating is very common (and developmentally appropriate) behavior that most parents experience with their little ones. In fact, picky eating is expected for the majority of children up until the age of 7 years old. This post is not about developmentally appropriate picky eating. Instead, we’re going to share some info and tips for parents when their child’s picky eating gets way off track.

When Picky Eating Becomes Serious

Picky eating can occur on a spectrum - starting from disliking certain vegetables all the way to avoiding entire food groups. When children consistently avoid certain food groups or categories, it often leads to malnourishment, nutritional deficiencies, and negative impacts on growth (e.g., height, weight, muscle mass). When picky eating gets to the extreme end of the spectrum, it can also be an indicator that the child is experiencing a feeding/eating disorder called ARFID.

What in the World is ARFID?

ARFID stands for Avoidant Restrictive Food Intake Disorder - it is a relatively new diagnosis to describe selective eating that is negatively impacting the individual’s ability to meet their nutritional needs or grow as expected. Interestingly, ARFID does not discriminate - kids, teens, and adults of every race, ethnicity, gender identity, sexual orientation, and background can struggle with ARFID or ARFID-like symptoms.

The avoidance of food seen with ARFID is due to one (or multiple) of three reasons: fear of adverse consequences, sensory sensitivities, or a complete lack of interest. Fear of adverse consequences can include fears of choking, vomiting, or stomach aches. Sensitivity sensitivities can include aversion to certain flavors, smells, textures, or even colors. A lack of interest can show up as eating feeling like a chore or a non-preferred activity. The one thing that makes ARFID different from other feeding/eating disorders is that it does not involve any distress surrounding body image or active attempts to lose weight.

Maybe my Kid has ARFID - What Now?

If you have concerns that your child’s picky eating is so extreme that it is impairing their physical development, social functioning, or mental health, there are professionals who can help. Providers most familiar with ARFID often include pediatricians, GI specialists, and mental health professionals. If you feel that your child may have ARFID, talk to a licensed therapist or psychologist who specializes in treating children with eating disorders (and specifically ARFID). Also feel free to advocate to your pediatrician about your child’s eating being a significant impairment in their daily life.

In addition to seeking professional help, there are several take-home techniques parents can use to help their kiddos struggling with extreme picky eating. Because of the overall lack of food intake associated with ARFID, the first step is to ensure the child is getting enough nutrients. A great place to start is with nutritional shakes or drinks - think Ensure, Boost Kid Essentials, or Kate Farms. Caregivers may keep nutritional shakes around the house and use them in between meals as a nutrient dense snack option. Shakes are great options because of their nutrients and ability to pack along to any soccer game or day at school. They can also be a fun snack to plan with your child as caregivers can turn nutritional drinks into a sweet treat by adding ice cream or special mix-ins for a yummy milkshake.

Along with packing in nutrition via drinks/shakes, parents can work to set expectations around meal and snack times. For instance, if you want your child to eat half of their mashed potatoes, all of their green beans, and a few bites of chicken, clearly set those expectations before meal time begins. These expectations can be set verbally or even with a reward chart (think sticker charts - because like adults, kids love earning rewards)! When your child meets your expectations, be sure to 1) praise them for their bravery and/or 2) reinforce their hard work with an external reward. Remember - progress takes time and it may feel slow, but taking the time to celebrate the small victories can make all the difference!

Take Home Message

Picky eating is developmentally normal, especially between the ages of 7-8 years. However, if you notice that your child’s eating habits are impacting their development, seek help and do what you can at home to make sure your child is getting the nutrition they need to continue growing!