WHAT IS ARFID (Avoidant/Restrictive Food Intake Disorder)?

Avoidant/Restrictive Food Intake Disorder, also known as ARFID is an eating disorder that occurs when a child or adolescent has a persistent inability to meet their energy or nutritional needs through their diet. Children and adolescents with this disorder eat very little and/or avoid certain foods that can result in a substantial weight loss or failure to gain weight. Children with this disorder may not grow as expected. Nutritional deficiencies such as iron deficiency anemia can occur. These children may depend on nutritional supplements or tube feeding to gain weight or to grow and develop normally. Because of the problems with eating, these young people may have difficulty participating in normal social activities, such as eating with friends and family members, and maintaining relationships with others. ARFID typically begins during childhood but can occur in individuals of all ages. Unlike anorexia nervosa or bulimia nervosa, individuals with ARFID do not have body image concerns or fears about gaining weight.

ARFID can cause significant medical problems that require medical attention. Parents should take their child to see their doctor if their child exhibits any of the following signs or symptoms:

o No growth or poor growth in height

o Fear of choking or vomiting resulting in food refusal

o Eats very slowly and/or is unable to finish what is provided

Your doctor should assess your child for a physical disorder that can cause such problems. Such physical disorders include digestive tract disorders that impair food absorption, hormonal problems like diabetes, and other serious problems such as cancer. Doctors should also consider other mental health disorders that can cause weight loss like depression, anxiety, schizophrenia and other eating disorders like anorexia nervosa or bulimia nervosa.

Parents know their child best. If you think that your child has a problem, then arrange for your child to see their doctor. Early intervention is the best possible way to recovery.

If your child is diagnosed with ARFID, work closely with your treatment team. Your team will work with you on a treatment plan that will include meal planning, meal support and the introduction of new foods to ensure that your child is receiving adequate and appropriate nutrition.

Every meal may feel like a battle. As a result, there can be a lot of stress experienced by families who have a child with ARFID. Serious limitations may be placed on families due to a child’s inability to try new foods. The child may display problematic behaviour such as difficulty swallowing or gagging, and behavioural tantrums that contribute to a high degree of conflict around meals. Remember that the treatment for ARFID is a process that takes time and patience. Children and adolescents with ARFID do recover.

Written by Dr. Melissa Lieberman and Dr. Debbie Katzman (HSC)

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Toronto, ON M6C 2C6

Dr. Melissa Lieberman

Child and Youth Psychology

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