ARFID stands for ‘avoidant restrictive food intake disorder’. This is an eating disorder where someone limits their overall food intake, avoids certain foods, or both. Children with eating disorders often control their food to help them manage difficult feelings and situations. However, whilst many eating disorders are related to worries about weight, body shape and self-esteem, ARFID is generally related to a child’s anxiety about food and eating.
There are three subtypes of ARFID depending on the underlying reasons a child is restricting or limiting their food, but children often experience a combination of these factors:
- Sensory differences which are triggered by certain foods, textures, tastes, smells or temperatures
- Not recognising when they are hungry, not enjoying eating or finding it an effort to eat
- Anxiety around eating, possibly caused by traumatic experiences such as being sick or nearly choking
How do I know if my child has ARFID?
Every young person’s experience is different, and children can experience ARFID at any age and weight. It can develop gradually into a chronic issue, or suddenly, for example, if a child has a traumatic experience with food.
Sometimes children who only eat certain foods are thought of as ‘fussy’ eaters, but if a child is struggling with ARFID this can mask a more serious underlying issue.
If a child is experiencing ARFID, you may notice the following behaviours:
- Only eating a small range of foods, which might be similar in texture or colour
- Eating less food than they need to stay healthy or not putting on enough weight
- Not recognising if they are hungry or feeling full quickly
- Avoiding mealtimes or social events where they can’t access safe foods
- Showing signs of anxiety when eating, or eating and drinking very slowly
How does ARFID affect children?
If a child restricts or limits their food over a long period, you might notice they are losing weight or growing more slowly than their peers. However, children can still develop ARFID anywhere on the weight spectrum, so it’s important not to make assumptions based on their weight alone.
Children can develop serious nutritional deficiencies if they aren’t eating a varied enough diet, which can have an impact on their physical and mental health. This might not always be obvious straight away, and so it’s important to contact a child’s GP if you’re concerned.
ARFID can also have a big impact on children’s social life and ability to make friends. If children only feel safe eating certain foods this can make it difficult to eat at school or out the house. Many social situations and special occasions revolve around food, and children with ARFID might feel they have to make excuses about why they can’t join in if it becomes too stressful.
Are neurodivergent children more likely to have ARFID?
Any child can develop ARFID at any point in their lives, but it’s thought that autistic children might be more vulnerable to ARFID and other eating disorders. Autistic children are already likely to experience sensory differences and heightened anxiety, and this might mean that certain flavours, textures or smells can be difficult to tolerate.
Neurodivergent children can also find it harder to pick up on sensory cues, such as realising when they are hungry. They might also find it harder to engage with activities they aren’t interested in or be motivated by the social expectations and rituals around food. This means there can be a lot of overlap with the eating patterns associated with ARFID.
How to help children with ARFID
Eating disorders can have a serious impact on children’s physical and mental health, so it’s important to get help as soon as possible. Whilst it can be very worrying if a child is having difficulty eating, it’s not a good idea to try and coerce children into eating foods that don’t feel safe, as this can increase their anxiety and reduce trust.
If you suspect your child is struggling with ARFID, their GP can help to assess any nutritional deficiencies or make a referral. There are a range of professionals who might be involved in supporting children with ARFID, including Children’s Mental Health Services, Dieticians, Speech and Language Therapists and Specialist Eating Disorder Services.
As a relatively new diagnosis, there is a need for more research into how to support children with ARFID. This might include a combination of anxiety management, nutrition, exposure therapy, and help with sensory differences. There’s no one-size-fits-all approach to finding out what helps, but with the right support, many children will make a full recovery.
