From food fear to confidence: What parents should know about ARFID in children

Many families have at least one picky eater. You may even be telling your friends, "My child only eats five foods," or “She belongs to the beige food club,” or "Mealtimes have become a battle in our house."

If these statements sound familiar, you might be interested to know that there could be a reason why some children struggle more intensely with food than others—it’s called avoidant/restrictive food intake disorder (ARFID).

Here’s everything you need to know about ARFID, how it differs from regular picky eating and what you can do to make mealtimes easier for everyone.

Understanding ARFID in children

ARFID—avoidant/restrictive food intake disorder—goes well beyond typical picky eating. While it might sound overly clinical, understanding ARFID in kids can be a turning point for families who've been struggling with extreme picky eating and mealtime anxiety.

While many children go through phases of refusing vegetables or preferring chicken nuggets, ARFID represents a more significant challenge in a child's relationship with food.

Children with ARFID experience intense food anxiety around eating that can stem from several sources:

• Fear of trying new foods (neophobia) that feels overwhelming rather than just preferential. A child might feel genuine panic at the sight of an unfamiliar food on their plate.
• Sensory sensitivities where certain textures, smells, colors or temperatures of food trigger strong aversive reactions. It's not that they won't eat it—their body is telling them they can't.
• Fear of aversive consequences like choking, vomiting or stomach pain. Sometimes a past negative experience with food creates a lasting fear that's difficult to shake.
• Low interest in eating where food just doesn't register as important or appealing, causing a child to forget to eat or find eating to be a chore.

Trying to figure out the key difference between picky eating and ARFID? ARFID in children significantly impacts their nutrition, growth or daily functioning. These aren't just preferences—they're real barriers that affect a child's well-being.

What causes ARFID in children?

The exact causes of ARFID in children aren't fully understood, but research suggests multiple factors contribute:

• Heightened sensory sensitivities in some kids make certain textures, smells or tastes overwhelming.
• Traumatic experiences like choking or severe illness may result in ARFID in children.
• Anxiety disorders, autism spectrum disorder, ADHD and gastrointestinal issues can also increase risk.
• Genetics may play a role too—ARFID sometimes runs in families.

Most often, it's a combination of biological, psychological and environmental factors working together.

5 daily patterns of ARFID in kids

Every child with ARFID is unique, but here are some key patterns:

1. Mealtimes become stressful. Instead of being a time for family connection, meals trigger anxiety for both children and parents. Your child might become visibly upset, cry or refuse to come to the table.
2. A very limited food repertoire. We're talking about eating the same 10-15 foods (or fewer) consistently, with extreme distress when those "safe" foods aren't available or are prepared differently than usual.
3. Physical symptoms of anxiety. Your child might experience stomachaches, nausea or gagging when faced with nonpreferred foods. These aren't manipulative behaviors; they're genuine physical responses to anxiety.
4. Social impacts. Birthday parties, school lunches, sleepovers and family gatherings become sources of stress because food is involved. Children may avoid social situations entirely to escape food-related anxiety.
5. Nutritional or growth concerns. While not always present, some children with ARFID may have vitamin deficiencies, low energy or growth patterns that concern their healthcare provider.

So, is my child just stubborn?

Here's what parents need to understand: ARFID in kids is rooted in genuine anxiety and sensory experiences, not defiance or manipulation. When your child refuses to try a new food, they're not trying to make your life difficult. Their nervous system is genuinely responding as if there's a threat.

If someone asked you to eat something that looked completely unappetizing or even frightening to you, you'd feel anxious too. For children with ARFID, that's what many everyday foods feel like.

This anxiety can create a cycle. The more pressure a child feels around food, the more anxious they become. The more anxious they are, the more restricted their eating becomes, sometimes paving the way for eating disorders.

Breaking this cycle requires patience, understanding and a shift in approach. But parents, take heart—overcoming ARFID is possible.

Strategies to support kids with ARFID

The good news? There are compassionate, effective ways to support a child with ARFID. Here are some recommended strategies:

Don’t forget to take care of yourself, too. Parenting a child with ARFID can be exhausting at times. It's okay to feel frustrated, worried or overwhelmed. Seek support from other parents, join online communities or talk with a therapist who understands feeding challenges.

When to talk with your doctor about ARFID in children

While these strategies can help, some children need additional support. Consider reaching out to a healthcare provider if:

• Your child's limited eating is affecting their growth or development
• Mealtime anxiety is severe or worsening
• Your child is avoiding social situations because of food
• You're concerned about nutritional deficiencies
• Your family is experiencing significant stress around feeding

A multidisciplinary team—including pediatricians, feeding therapists, dietitians and mental health professionals—can create a comprehensive plan tailored to your child's needs. Pediatric mental health specialists work with families to address the anxiety and emotional components of ARFID, helping children develop a healthier relationship with food.

Moving forward with hope

If your child is living with ARFID, please know this: with understanding and the right support, children can make meaningful progress. Your child's food anxiety doesn't define them, and it doesn't reflect your parenting.

What matters most is approaching mealtimes with compassion—for your child and for yourself. Small steps forward are still forward movement. Some days will be harder than others, and that's OK.

You're doing important work by seeking to understand your child's experience with food, and that understanding is the foundation for positive change. Keep showing up, keep offering support and know that you don't have to navigate this journey alone.

If you have concerns about your child's eating patterns or food-related anxiety, reach out to your pediatrician or find one near you