ARFID Symptoms in Children

ARFID, or avoidant/restrictive food intake disorder, can be hard to spot because it often looks like picky eating at first. This guide describes the signs clinicians look for. Only a medical or mental health provider can diagnose ARFID, so use this as a guide for deciding when to ask for help.

Signs of limited food intake

• Eating very little overall, or seeming to have no interest in food
• A list of accepted foods that is very short and keeps getting shorter
• Dropping foods and not taking them back
• Needing foods to be prepared in one exact way or from one brand

Signs linked to sensory sensitivity

Some children avoid food because of how it feels, looks, smells, or tastes:

• Strong reactions to certain textures, such as mixed or lumpy foods
• Gagging at the smell or sight of foods
• Refusing foods that touch each other on the plate
• Accepting only certain colors, temperatures, or brands

Signs linked to fear

Some children avoid eating because they are afraid of something happening, often after a choking or vomiting episode:

• Fear of choking, vomiting, or tummy pain
• Refusing solids but accepting liquids or purees
• Becoming anxious or tearful as mealtimes approach
• Eating only foods that feel "safe"

Signs related to appetite

• Forgetting to eat, or not seeming hungry
• Getting full after a few bites
• Eating slowly, or losing interest quickly
• Needing frequent reminders to eat

Effects on health and daily life

Doctors pay particular attention to the impact of the eating pattern. Signs that it may be more than picky eating include:

• Weight loss, or growth that is slower than expected
• Tiredness or low energy
• Needing nutrition supplements or a feeding tube
• Avoiding parties, school lunches, or family meals because of food
• Meals that cause intense stress for the child or family

What is not ARFID

ARFID is not caused by a lack of food and it is not about body image or wanting to lose weight. It is also not the result of parenting, and it is not a phase that children just choose to go through.

What to do if you recognize these signs

1. Write down what your child eats over a typical week, including foods that have dropped off the list.
2. Talk to your pediatrician about growth and health. Ask whether a referral for a diagnosis is needed.
3. Ask for a feeding evaluation. A feeding therapist can look at the skills and sensory needs behind the avoidance and build a plan. You do not need a diagnosis to ask.
4. Reduce pressure at the table. Pressure to eat tends to increase anxiety and avoidance.

If your child is choking, struggling to breathe, or showing signs of dehydration such as very few wet diapers or no urination for many hours, seek urgent medical care.

To learn more, see our page on ARFID in children, the guide to what ARFID is, or how picky eating and ARFID differ.

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