ARFID – “Picky Eating” Signs & Symptoms

Young black girl thinking about weight obsession

Everyone knows the trope of a child that is a “picky eater.” What is less known is that these seemingly harmless and age-appropriate behaviors can, at times, interfere with nourishments and daily life to the point that it becomes a disordered eating behavior called ARFID.

The Fifth Edition of the Diagnostic and Statistical Manual of Mental Illnesses specifies these concerning behaviors under the diagnosis of Avoidant and Restrictive Food Intake Disorder, otherwise known as ARFID.

What is ARFID?

Previously referred to as “Selective Eating Disorder,” ARFID is considered similar to Anorexia Nervosa in some of its symptoms and the way ARFID presents itself. Both disorders involve rigid limitations regarding the amount/types of food consumed. However, ARFID does not involve the distorted beliefs and fears about body shape, weight, size, or appearance.

As far as diagnostic criteria, ARFID is characterized as “an eating or feeding disturbance… manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:

  • Significant weight loss (or failure to achieve expected weight gain or faltering growth in children).
  • Significant nutritional deficiency.
  • Dependence on enteral feeding or oral nutritional supplements.
  • Marked interference with psychosocial functioning [1].”

Individuals that experience ARFID often do not gain enough nutrients to grow and develop properly.

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Who is at Risk?

While ARFID was only added in the most recent iteration of the DSM-5, research has been conducted to learn about what might put a person at risk.

Although seen in various stages of life, it is more common in children and young adolescence [2].

Research also shows that diagnoses such as Autism Spectrum Disorder, Obsessive-Compulsive Disorder, ADHD, anxiety disorders, and intellectual disabilities show an increased risk of developing ARFID [1].

Further, of the estimated 5% of children impacted by ARFID, the majority are boys [3].

Signs & Symptoms of ARFID

Girl in park thinking about ARFIDI can hear you wondering aloud about how a parent can differentiate between “picky eating” and the more serious symptoms of ARFID.

An important distinction is that children with ARFID do not “grow out of it” and the malnourishment caused by these behaviors can continue, or worsen, if not taken seriously and addressed.

Warning signs that your child may be engaging in ARFID symptoms include stalled weight gain and vertical growth, dramatic weight loss, persistent complaints of gastrointestinal issues or stomach aches around mealtimes, restriction in types/amount of food eaten, will only eat certain textures of food, lack of appetite or interest in food, and limited range of “preferred” foods that continues to become more limited over time [1].

Specific treatment successes have yet to be researched or ARFID, however, studies have found that “patients with ARFID recovered at a rate similar to patients with AN, although 38% of the sample continued to struggle in some meaningful way 1 year after initial diagnosis [3].”

The main takeaway is that if you are concerned that your child’s eating habits are harmful, it is best to consult with a pediatrician, nutritionist, or eating disorder specialist.


Resources:

[1] Unknown (2019). Avoidant and restrictive food intake disorder (ARFID). National Eating Disorders Association. Retrieved from https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid.

[2] Unknown (2018). Avoidant and restrictive food intake disorder (ARFID) Facts. The Eating Recovery Center, retrieved from https://www.eatingrecoverycenter.com/conditions/arfid/facts-statistics.

[3] Norris, M. L., Spettigue, W., & Katzman, D. K. (2016). Update on eating disorders: current perspectives on avoidant/restrictive food intake disorder in children and youth. Neuropsychiatric Disease and Treatment, 12, 213-218.


About Our Sponsor:

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Fairhaven Treatment Center is a leading eating disorder treatment center that provides treatment for adult women and adolescent girls struggling with Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder and Other Specified Feeding or Eating Disorder (OSFED).

Fairhaven specializes in working with eating disorders with co-occurring post-traumatic stress disorder (PTSD), trauma and attachment disorder, and a history of addiction and substance use disorder.


About the Author:

Image of Margot Rittenhouse.Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.


The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a 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 November 6, 2019, on EatingDisorderHope.com
Reviewed & Approved on November 6, 2019, by Jacquelyn Ekern MS, LPC

About Baxter Ekern

Baxter is the Vice President of Ekern Enterprises, Inc. He is responsible for the operations of Eating Disorder Hope and ensuring that the website is functioning smoothly.