ARFID: What It Is, and How to Approach It From Every Angle

If your child (or maybe even you) will only eat a handful of foods and becomes deeply distressed when offered anything outside that “safe list,” you might be dealing with something beyond “picky eating.”

That “something” could be ARFID — Avoidant/Restrictive Food Intake Disorder.

Unlike a phase of selective eating in toddlers, ARFID is a recognized eating disorder that can occur in both children and adults. It’s not about weight loss or body image, like anorexia or bulimia. Instead, it’s about avoiding certain foods due to sensory sensitivities, fear of negative consequences (like choking or vomiting), or just a complete lack of interest in eating.

In recent years, ARFID has become more common (although still rare) and has recently received its own diagnostic (ICD-10 code). While I have my theories as to why we are seeing more and more of this disorder, prevention is the best medicine. 

ARFID is defined as a psychological disorder, but we cannot forget how important our gut health is and toxic build up can be to our psychological health. Read to the end, because I will share with you the strategies that I have found useful is supporting kiddos and families with ARFID. 

How ARFID Shows Up

People with ARFID may:

• Eat an extremely limited variety of foods (often fewer than 10–15 total).
  
  
• Avoid foods based on texture, smell, or appearance.
  
  
• Refuse entire categories of foods (like anything green or anything crunchy).
  
  
• Show anxiety or distress when presented with unfamiliar foods.
  
  
• Experience nutritional deficiencies, poor growth, or social limitations due to eating patterns.
  
  

Why ARFID Happens

ARFID can have multiple root causes:

1. Sensory Processing Differences
   Hypersensitivity to textures, smells, or flavors makes new foods feel overwhelming or even threatening.
   
   
2. Past Negative Experiences
   Choking, gagging, or vomiting incidents can create lasting fear-based avoidance.
   
   
3. Neurodiversity
   It’s more common in individuals with autism spectrum disorder (ASD), ADHD, and anxiety disorders.
   
   
4. Underlying Medical or Gut Issues
   Reflux, constipation, food intolerances, or gut dysbiosis can make eating uncomfortable, reinforcing avoidance.
   
   

Conventional Approaches

These are typically the go-to methods in the medical or behavioral health world:

• Feeding Therapy / Occupational Therapy
  Trained feeding therapists use gradual exposure, play-based techniques, and desensitization to help clients expand their food repertoire.
  
  
• Speech Therapy
  Especially if oral-motor skills, chewing, or swallowing mechanics are part of the problem.
  
  
• Cognitive Behavioral Therapy (CBT) & Exposure Therapy
  Helps individuals work through anxiety associated with certain foods.
  
  
• Nutritional Supplementation
  To address deficiencies when the diet is severely limited.
  
  

While these approaches can be effective, they often focus on behavior modification without always addressing the root causes that make eating so hard in the first place.

Holistic Approaches

Here’s where we zoom out and look at the whole person, not just the plate:

1. Address Sensory Needs Outside Mealtimes
   Sometimes the nervous system needs more “sensory regulation” in daily life before it can handle food challenges. Activities like swinging, deep pressure, or playing with fidget tools before a meal can help.
   
   
2. Heal the Gut
   
   
• Rule out constipation, reflux, SIBO, candida overgrowth, or food intolerances. When I run stool tests on kiddos with ARFID, there is always some sort of dysbiosis and poor digestion happening.
  
  
• Support digestion with probiotics, fiber (as tolerated), and gut-healing foods.
  
  
3. Lower Anxiety Through Lifestyle
   
   
• Consistent routines, sleep hygiene, and stress-reducing activities like yoga, walking, or mindfulness.
  
  
• For kids, predictable mealtime structures (hello, Division of Responsibility!) reduce pressure and battles.
  
  
4. Nutrient-Dense “Bridge Foods”
   Upgrade safe foods slightly before introducing totally new ones. Example: if only white bread is safe, try one with a cleaner ingredient list before moving to whole grain.
   
   
5. Functional Nutrition Support
   Identify micronutrient deficiencies and replenish them in ways that won’t overwhelm the individual (sometimes smoothies or hidden veggie muffins work wonders). Most picky eaters, including kids with ARFID are deficient in zinc and iron. These can help with appetite, energy, mood, and sleep, all things that are important for addressing restrictive eating.
   
   
6. Family-Based Involvement
   Meals should be pressure-free, social, and enjoyable. Even if the child isn’t eating the new food, let them see others enjoying it. The framework I teach parents helps kids feel safe and relaxed at the table. This goes a long way to reducing overall anxiety about new and different foods.
   
   

Why Both Matter

For some families, ARFID can feel urgent and stressful — you want your child nourished now. Conventional therapies can help open the door to new foods. But if we stop there, the problem can resurface because the root causes — whether sensory dysregulation, anxiety, or gut discomfort — haven’t been addressed.

That’s why a combined approach works best: use the skill-building and desensitization tools from conventional therapy, while also improving the body’s ability to receive and enjoy food.

The Bottom Line

ARFID isn’t “just picky eating.” It’s a complex, multi-layered condition that benefits from a team approach. Think of it like untangling a knot: you need to loosen it from multiple angles. The goal isn’t just “more foods” — it’s helping the person feel safe, comfortable, and confident around eating for life.

If your child (or you) is struggling with a limited diet, know this: it’s not your fault, and you do have options. The best plan blends tools from both worlds — conventional and holistic — to support the nervous system, the gut, and the emotional experience of food.