Mealtimes do not have to be a constant struggle with a child who has Avoidant/Restrictive Food Intake Disorder (ARFID). By understanding the disorder and learning new ways to respond, you can help support your child in building a healthier relationship with food. The tips in this blog can help you support your child at home, though some children will need additional professional support to make progress. Either way, understanding ARFID and learning new ways to respond is an important first step.
What is ARFID?
ARFID is an eating disorder characterized by the restriction or avoidance of food volume or variety that leads to significant nutritional, medical, or psychosocial impairment. Unlike other eating disorders, ARFID is not driven by body image concerns. Instead, it can stem from several different causes. Some young people with ARFID may have heightened sensitivity to the sensory characteristics of food, such as texture, taste, smell, or appearance, which can make eating certain foods feel overwhelming or intolerable. Others may have a general lack of interest in eating that is driven by a low awareness of hunger or lack of motivation to eat. A third presentation involves fear of aversive consequences. For example, a child may be scared of choking, having an allergic reaction, or throwing up and begin avoiding specific foods or similar items to prevent those things from happening.
The Cycle of Continuous Food Avoidance
When someone develops food avoidance, unhelpful patterns can become difficult to break. Avoidance provides temporary relief, but it keeps the brain from learning that these foods are safe, allowing the disorder to persist. Over time, chronic avoidance can have a range of short- and long-term impacts on health and development:
- Physical changes: When a child eats very little over a long period of time, the stomach adjusts to receiving smaller amounts. As a result, it becomes less able to stretch and make room for food and may empty more slowly than usual. This means your child may feel uncomfortably full after just a small amount, even when they haven’t eaten enough.
- Loss of hunger cues:For some children with ARFID, particularly those with low interest in eating, reduced awareness of hunger may be part of the disorder itself. Across all presentations, a persistent lack of regular eating can make this harder over time, as the body gets fewer opportunities to recognize and respond to hunger signals. This can make it genuinely difficult for your child to know when they are actually hungry. For young people in the “low interest” group, we often use “mechanical eating” which means eating by the clock rather than waiting for hunger cues to help jumpstart the body’s internal signals.
- Decreased motivation: A general disinterest in food can limit the motivation to try new things.
- Emotional and social impact: ARFID can lead to low mood, anxiety, difficulty concentrating, and social isolation from food-related events.
Supporting a Child with ARFID
Treatment focuses on both increasing nutritional intake and gradually reducing avoidance. Here are ways your family can support this process:
- Validate their feelings: Acknowledge and validate your child’s anxiety and/or overwhelm related to food. Let them know you understand that eating feels hard for them right now. Validating their experience helps lower their overall distress and builds the trust necessary to try something new.
- Externalize the disorder: Frame ARFID as a separate entity, an external challenge rather than a personality trait or a choice your child is making. By “externalizing” the disorder, you can avoid arguing, shaming, or punishing your child for not eating, and avoid comparisons to siblings. These reactions can increase distress and make avoidance stronger. Instead, align with your child to face ARFID together as a team, working side by side to overcome the disorder.
- Use neutral, non-judgmental language: Try to keep your descriptions of food neutral rather than overly positive. Avoid overselling the taste of a food to convince your child to try it as this can set unrealistic expectations and increase pressure. Instead, use neutral language to describe the food and its function (i.e., “This food provides energy to play soccer later”). Instead of calling a food ‘yummy,’ describe it as ‘crunchy,’ ‘salty,’ or ‘orange.’ This helps the child process the sensory data without the pressure of an emotional judgment.
- Model positive eating behaviors and provide consistency: Your child watches how and what you eat. Modeling balanced meals helps provide a roadmap for them. Schedule regular meals and snacks to create structure and predictability.
- Understand and address the fear: Work with your child to identify specific “scary foods” and help your child to identify exactly what is scary about a food. Is it the texture, smell, or the way it looks? Once you understand the fear, you can help your child approach these foods in small, manageable steps, starting with what feels easiest and gradually building up over time.
- Focus on trying, not liking: The goal is a willingness to try new foods, not for them to immediately love them. While weight restoration is often a key priority, treatment also focuses on building “food flexibility” to increase the variety of what a child eats and improving social functioning so they can engage more comfortably in social events involving food. Encourage brave behaviors by starting with small steps like looking, touching, or smelling, and gradually working up to tasting and eating.
- Embrace repetition: Repetition is key. But the goal isn’t just getting used to a food over time. With ARFID, the brain has learned to treat certain foods as threatening. To effectively “rewire” this response, practice should be frequent and consistent. Each interaction with a food is an opportunity for your child’s brain to learn something new: that the food is safe, even if it still feels scary, and that the feared outcome either doesn’t happen or can be handled. Over time, these learning experiences stack up and gradually reduce the fear response.
- Seek professional help: These tips are a helpful starting point, but professional support is often needed, especially if your child is experiencing significant weight loss, medical issues, impairment in their functioning at school or at home, or distress. Evidence-based treatments for ARFID have shown promising results
The journey to overcoming ARFID is paved with small, brave moments. Growth takes time, but with patience and the right evidence-based strategies, your child can expand their world one food at a time. Whether you are just starting this process or looking for more structured support, remember that progress is possible.
