Understanding ARFID in Children and Adolescents

Child struggling with an eating disorder and picky eating

Contributor: By Rachael Clauson, MAAT, Eating Disorder Specialist, Timberline Knolls Residential Treatment Center

Many preconceived ideas and stereotypes define the struggles of eating disordered individuals and overgeneralize the signs, symptoms, and causes of these illnesses. This is problematic in that this overgeneralizes individuals’ needs and support as well as eating and feeding disorders as a whole.

For example, Avoidant Restrictive Food Intake Disorder (ARFID) is an eating and feeding disorder and a new addition to the DSM-V that varies from other eating and feeding disorders.

What Makes ARFID Unique

The diagnostic criterion for ARFID includes disrupted eating patterns such as avoidant or restrictive behaviors around food. Since ARFID is primarily diagnosed during childhood and adolescence (though it can be diagnosed among adults), it is important to separate the usual “picky eaters” from those with ARFID.

As children develop and grow, it is common for them to show hesitance around new foods, due to tastes, textures, smells, and appearance. For a person with ARFID, picky eating is intensified and the behaviors and aversion to certain types of foods is exacerbated.

This can be very challenging for a guardian or family member since this can make every interaction with food feel like a battle. However, it’s important to recognize that these behaviors need attention and support like any other disorder or mental illness.

Causal Factors

ARFID does not have one root cause; instead, researchers and clinicians have explored a variety of potential contributing factors, such as biological, psychosocial and environmental influences.

A child who is already predisposed to ARFID due to biological or genetic makeup may be triggered by environmental or psychosocial situations such as a traumatic event.

An example might be choking on solid food at a young age and then developing a fear to solid foods.

Another example could be experiencing sexual trauma and developing an aversion to food with similar sensory components to that trauma.

Comorbidity is also important to consider in addition to ARFID’s diagnostic criterion since disrupted eating patterns coexist among other mental illnesses that struggle with the sensory experience with food.

Other mental disorders such as anxiety disorders, developmental disabilities and autism may exacerbate ARFID symptoms. In autism and many developmental disabilities, an individual’s relationship to their body and senses are already very heightened.

The sensory experience associated with food may create additional sensitivity and chaos for the individual.

Although anxiety is common, rarely does it extend to the fear of weight gain. Instead, anxieties are related to certain foods/food groups, trying new foods, or eating in social situations.

Collaboration and Compassion in Treatment and Recovery

When considering treatment options and interventions for kids and adolescents, it is important to have a holistic and collaborative approach. On the family’s side, modeling is the best form of teaching.

Kids sitting on the ground

If the family can model a healthy relationship with food, the child may follow. Exposure is also critical in treatment as the intention is to break down the aversion and rebuild the relationship with food.

This might look like eating together as a family and encouraging one more bite, or this might look like a facilitated treatment intervention with licensed mental health professionals.

Contacting a holistic treatment team that specializes in eating/feeding disorders can also help to develop coping skills to assist in the treatment and intervention that comes with healing from ARFID.

Reaching out to a variety of perspectives such as a psychiatrist, dietician, pediatrician, psychotherapist, and occupational therapist can add to the collaboration that is significant in treatment.

The ARFID diagnosis may be challenging and overwhelming to deal with, but like all eating disorders, the signs and symptoms warrant professional attention and support. The individuals who suffer from ARFID also deserve validation and compassion in treatment and the family system.

Rachel Clauson Image - 2-17-16About the Author: Rachael Clauson, MAAT, is and Eating Disorder Specialist at Timberline Knolls Residential Treatment Center.

Her primary responsibilities consist of facilitating group therapy, creating individualized support plans, and providing support and awareness for resident’s continued success in recovery.

She received a Bachelor of Science Degree in Drawing and Painting from Northern Michigan University. She also received her Master of Arts in Art Therapy from The School of The Art Institute of Chicago.


[1]: https://www.eatingdisorderhope.com/blog/causes-arfid-pediatric-patient
[2]: https://www.eatingdisorderhope.com/blog/support-child-recovery-arfid
[3]: http://www.aboutkidshealth.ca/En/HealthAZ/ConditionsandDiseases/BehaviouralandEmotionalProblems/Pages/arfid-how-to-help-child.aspx

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on October 1, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on October 1, 2017.
Published on EatingDisorderHope.com