Trigger warning: This article discusses ARFID (Avoidant/Restrictive Food Intake Disorder), including restrictive eating behaviours and the impact on families. Please read with care and seek support if you need it.

You can also explore our wider Understanding Eating Disorders hub for more information about related conditions.

Avoidant/Restrictive Food Intake Disorder, often known as ARFID, is a recognised eating disorder that affects children, young people, and adults. It involves a pattern of avoiding or restricting food intake that goes far beyond what is commonly thought of as “picky eating”. ARFID can lead to nutritional deficiencies, problems with growth, and significantly impact daily life.

What makes ARFID different from other eating disorders is its cause; conditions such as anorexia nervosa or bulimia nervosa are usually linked to concerns about body weight, shape, or appearance. ARFID, however, is not motivated by body image, and instead is rooted in sensory sensitivities, fear of negative consequences such as choking or vomiting, or a general lack of interest in eating. This difference does not make ARFID less serious. Its effects on health, wellbeing, and family life can be profound, and parents are often the first to notice that something more than ‘fussy eating’ is taking place.

What ARFID Looks Like

At first glance, ARFID can appear similar to a child being selective about what they eat. Many children go through phases of rejecting foods, favouring plain meals, or refusing vegetables. These phases usually pass, and children eventually expand their diets. With ARFID, the avoidance persists and intensifies: a child may only accept a very narrow group of foods such as plain bread, pasta, or chicken nuggets, and show strong distress when faced with something unfamiliar.

Unlike ordinary picky eating, which is often temporary and does not affect health, ARFID can lead to serious nutritional gaps or delayed growth. Parents may notice that mealtimes become a source of conflict or anxiety, and what once seemed like a normal childhood phase develops into a pattern that disrupts everyday life including during school lunches and family gatherings.

Common Features of ARFID

Although ARFID presents differently in each person, some themes often emerge. Many children have strong reactions to the sensory aspects of food. Texture, smell, taste, and even colour can feel overwhelming, leading to avoidance of entire food groups. Others may develop ARFID after a frightening incident such as choking or being sick, which creates ongoing fear about eating. For some, the difficulty stems from a lack of interest in food altogether. They may not recognise hunger signals in the same way as others, or simply find eating unenjoyable.

The impact of ARFID goes beyond nutrition and children may become anxious in social settings where food is involved, potentially avoiding birthday parties or meals with friends because of the fear or discomfort surrounding food. Parents often describe the strain of preparing multiple meals, managing conflict at the table, or worrying constantly about their child’s health and growth.

How ARFID Affects Families

Living with ARFID places considerable pressure on families, too. Parents may feel caught between the need to ensure adequate nutrition and the desire to avoid triggering distress. This often leads to time-consuming meal preparation and ongoing tension at the dinner table. Siblings may feel frustrated or overlooked as much of the family’s energy goes into supporting the child with ARFID.

It is not uncommon for parents to experience guilt, frustration, or worry about being judged by others. Well-meaning friends or relatives might dismiss the behaviour as fussiness, which can leave families feeling isolated. Recognising ARFID as a legitimate eating disorder can help shift perspectives and allow families to approach mealtimes with greater understanding and patience.

ARFID in Schools

Schools are an important environment where ARFID becomes especially noticeable. Lunchtimes can be challenging, as children with ARFID may refuse most or all of the food provided. Some avoid eating altogether during the school day, which can affect concentration and learning. Teachers may observe tiredness, difficulty focusing, or reluctance to join social activities involving food.

Creating awareness in schools is vital. When teachers and peers understand ARFID, they can provide support instead of judgement. Small adjustments, such as allowing a child to bring familiar foods from home or offering quiet eating spaces, can make a significant difference.

You can read more about how First Steps ED works with schools through our Support in Schools services.

The Emotional Impact

The emotional toll of ARFID should not be underestimated. For the individual, eating can become a source of anxiety rather than pleasure. The pressure to eat certain foods may lead to distress or conflict with parents, while constant awareness of being “different” can cause feelings of shame or isolation.

For families, the emotional strain is equally significant. Parents often feel torn between supporting their child’s needs and worrying about nutrition. Siblings may feel resentful about different rules at mealtimes or about the attention directed towards their brother or sister. Over time, the stress of ARFID can affect family relationships as well as the individual child.

Recognising the Signs

Parents are often the first to suspect that their child’s eating habits are not typical. A consistent reliance on only a few foods, visible distress when trying something new, avoidance of social situations, and signs of poor nutrition or slow growth may all suggest ARFID. Unlike ordinary fussy eating, which tends to come and go, ARFID remains consistent and begins to affect multiple areas of life.

Recognising these patterns early makes it easier to access appropriate support. Even if the child appears to be growing normally, limited food variety can have hidden consequences for health and wellbeing.

Diagnosis and Assessment

A diagnosis of ARFID is usually made by a GP or specialist eating disorder service. It involves taking a detailed history of the child’s eating habits, assessing their growth and nutrition, and ruling out other medical causes. Parents play a crucial role in this process by sharing detailed observations, since the patterns of ARFID may not be clear in a short appointment.

Because ARFID does not involve body image concerns, it is sometimes overlooked by professionals who associate eating disorders with weight loss. Persistence and advocacy from parents and carers are often needed to ensure the right diagnosis is made.

Treatment and Support

Treatment for ARFID varies depending on the underlying causes and the needs of the individual. Nutritional support is often a first priority, helping to ensure that children receive the vitamins and minerals they need for healthy growth. Therapy may also play a role, particularly Cognitive Behavioural Therapy (CBT) and exposure-based approaches that gently reduce anxiety around food. Family-based interventions can help parents develop strategies to support their child at mealtimes, while occupational therapy may be useful in managing sensory sensitivities.

Parents are central to the recovery process, by creating calm, pressure-free mealtimes and respecting safe foods while gradually introducing new ones, and working closely with professionals all help a child move forward. Support for parents themselves is equally important, as ARFID can be exhausting and emotionally demanding.

First Steps ED offers a range of services designed to support families, including Parent and Carer Support and One-to-One Support.

Living with ARFID

Life with ARFID can feel limiting, but with the right support, children and young people can make progress. Recovery does not always mean eating every type of food, but it can mean expanding safe foods, reducing distress, and feeling more comfortable in social situations. Over time, families often find that daily life becomes less dominated by food and mealtimes become less stressful.

It is important for parents to recognise that progress may be slow and non-linear. Small steps, such as trying a new food without panic, can represent meaningful change. With patience and persistence, improvement is possible, and many children go on to have healthier and more balanced diets.