This page has been reviewed by Dr Marielle Quint, March 2025.
Avoidant/restrictive food intake disorder (ARFID) is an eating disorder where a child or teenager avoids or restricts food for reasons unrelated to body image. This might include sensory sensitivities, fear of choking or vomiting, or a lack of interest in eating. ARFID can lead to nutritional deficiencies, weight loss, or delayed growth, and can have a significant impact on a child’s health, mood, and social life.
ARFID can affect eating behaviour, physical health, and emotional wellbeing. It often appears in early childhood but can develop or continue into adolescence.
1. Limited or restricted eating
Avoiding entire food groups (e.g. no fruits, vegetables, or meats)
Eating only certain textures, colours, or brands of food
Refusing to try new foods or eating extremely small portions
Insisting on very specific preparation methods or routines
2. Nutritional deficiencies and growth issues
Significant weight loss or failure to grow as expected
Fatigue, low energy, or poor immunity due to nutrient deficiencies
Delayed physical development or puberty
Pale skin, brittle nails, or other signs of poor nutrition
3. Fear-based avoidance
Avoiding food after a choking, vomiting, or illness-related incident
Distress or anxiety when presented with unfamiliar foods
Gagging, retching, or spitting out food due to sensory discomfort
4. Dependence on supplements or specific foods
Reliance on nutritional shakes or liquid diets to maintain intake
Only tolerating bland, soft, or highly processed foods
Requiring long mealtimes or very specific settings to eat
5. Social and emotional impact
Refusal to eat at school, restaurants, or social events
Tantrums, distress, or refusal to sit at the table (especially in younger children)
Anxiety around contamination, food preparation, or smells
Feeling embarrassed or ashamed about eating habits
Diagnosis involves a detailed assessment by a healthcare professional and typically includes:
Exploring eating habits, food preferences, and past experiences
Reviewing growth history and nutritional intake
Checking for underlying medical, sensory, or psychological factors
Screening for related challenges such as autism, anxiety, or trauma
ARFID is different from picky eating and requires support when it affects physical health, emotional wellbeing, or family routines.
Treatment is tailored to the underlying cause of the food avoidance and may involve several approaches:
1. Psychological therapies
CBT for ARFID – Helps children challenge unhelpful thoughts around food and reduce fear or anxiety
Exposure therapy – Gradual, supported exposure to feared foods in a safe setting
Family-based therapy (FBT) – Involves parents in meal planning and feeding support, especially for younger children
DBT strategies – Can be helpful for children with strong emotional reactions or sensory-based avoidance
2. Nutritional support
Working with a dietitian to ensure balanced nutrition
Creating food exposure plans to widen variety over time
Addressing deficiencies with supplements when needed
3. Medical support
Monitoring physical health and growth
Checking for deficiencies through blood tests
Coordinating care with GPs or paediatricians if necessary
4. Occupational therapy (if sensory-based)
Supporting children with texture, smell, and consistency sensitivities
Using desensitisation techniques to make eating more comfortable
At Kidswell Health, we have an in-house team of experienced child psychologists, therapists, dietitians, and health professionals who support children and teenagers with ARFID. We offer comprehensive assessments, tailored treatment plans, and ongoing emotional and nutritional care.
If your child is in crisis or at risk due to eating-related issues, seek immediate medical advice.
Book an appointment with one of our experienced professionals today.
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