Avoidant Restrictive Food Intake Disorder in Children (ARFID)

Avoidant Restrictive Food Intake Disorder in Children (ARFID)

Avoidant restrictive food intake disorder in Children is a mental disorder that makes it difficult to eat certain foods, or to eat any foods at all. This disorder can affect people of any age, but it is seen most often in infants and children.

ARFID can lead to weight loss, lack of energy, and poor nutrition. Unlike people who have eating disorders such as anorexia or bulimia, people with ARFID do not wish to change their body weight or shape.

What are the causes?

The cause of this condition is not known.

What increases the risk?

The following factors make ARFID more likely to develop:

  • Experiencing a very negative or traumatic event, especially one that involves food.
  • History of stomach problems.
  • Having a fear of choking, swallowing, or vomiting.
  • Mental health conditions such as anxiety, obsessive-compulsive disorder (OCD), or autism spectrum disorder.
  • Abuse or neglect.

Infants are more likely to develop ARFID if:

  • They have developmental issues or are regularly irritable during feedings.
  • Parents have eating disorders or challenges with bonding with the infant.

What are the signs or symptoms?

Symptoms of this condition include:

  • Picky eating or lack of interest in food.
  • Fear of food.
  • High sensitivity to the texture, taste, look, or temperature of foods.
  • Irritation or lack of interest (apathy) during eating or feeding.
  • Avoiding activities that involve eating.
  • Unusual rituals involving food, such as:
    • Taking tiny bites.
    • Eating the same foods every day.
    • Cutting food into tiny pieces and moving it around the plate.
  • Weight loss or being underweight.
  • Not having enough nutrients in the body (malnourishment).

How is this diagnosed?

This condition is diagnosed based on your child’s eating history, medical history, and symptoms. Your child’s health care provider may ask what types of food your child eats and how much your child eats. If your child has symptoms such as weight loss, lack of energy, or malnourishment, your child’s health care provider will try to determine if these symptoms are caused by ARFID or another health problem.

How is this treated?

This condition may be treated:

  • With methods used to maintain weight and nutrition. These may include:
    • Feedings through a tube.
    • Nutritional supplements by mouth.
  • With mental health treatment, such as:
    • Counseling.
    • Behavioral therapy that slowly trains your child to get comfortable with eating, or to overcome fears about foods.
    • Relaxation training.

Follow these instructions at home:

  • Give over-the-counter and prescription medicines only as told by your child’s health care provider or therapist.
  • Follow your child’s treatment plan as directed. Make sure your child is eating the amount that your child’s health care provider recommends.
  • Write down your child’s eating habits and any foods that your child does not like. This information may help your child’s health care provider or therapist make a treatment plan.
  • Make sure loved ones know about your child’s condition. They may be able to support your child at home and help your child with treatment.

Keep all follow-up visits as told by your child’s health care provider or therapist. This is important.

Contact a health care provider if:

  • Your child is losing weight.
  • Your child is weak or tired.
  • Your child is thirsty, has dry lips, and has a slightly dry mouth (is dehydrated).

Get help right away if:

  • Your child is extremely weak.
  • Your child is severely dehydrated. Symptoms of severe dehydration include:
    • Extreme thirst.
    • No tear production.
    • Urinating only a small amount of very dark urine in 6–8 hours.
    • Not urinating in 6–8 hours.
    • Confusion or extreme sleepiness.
    • Dizziness.
    • Irritability.
    • Skin that does not quickly return to normal after being lightly pinched and released (poor skin turgor).

Summary

  • Avoidant-restrictive food intake disorder (ARFID) is a mental disorder that makes it hard for someone to eat, or to eat certain foods.
  • This disorder can affect someone at any age, and can lead to weight loss, lack of energy, and poor nutrition.
  • Treatment may include talk therapy, behavioral therapy, relaxation training, other methods of getting nutrition, or a combination of these.
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