Understanding ARFID Beyond Picky Eating: Insights from Recent Research

Jennifer Urich
Oct 9
3 min read

Avoidant/Restrictive Food Intake Disorder (ARFID) is still relatively new on the clinical radar, but recent research is helping us understand it not just as “picky eating gone serious,” but

as a complex biopsychosocial disorder.

When a child refuses foods, eats only a few “safe” meals, or becomes extremely anxious around food, many families are told it’s “just picky eating.”

But for some children and teens, this pattern is actually something more serious — Avoidant/Restrictive Food Intake Disorder, or ARFID.

A new research review by Natasha Fonseca and colleagues published in 2024, “Avoidant restrictive food intake disorder: recent advances in neurobiology and treatment,” is helping us understand ARFID in a whole new way.overlapping features.

The big message?

ARFID is real, complex, and treatable.

ARFID happens when someone eats too little or avoids so many foods that it affects their nutrition, growth, health, or daily life.

Unlike other eating disorders, ARFID is not about body image or weight loss.

Researchers describe three common reasons why someone might have ARFID:

Sensory sensitivities – Some children find the texture, taste, smell, or look of certain foods unbearable.
Low interest in food – Some kids just don’t feel hungry or get full quickly.
Fear of something bad happening – Some children avoid food after a scary experience (like choking or vomiting) and worry it will happen again.

Many kids with ARFID have a mix of these reasons, not just one.

What’s Happening in the Body and Brain?

The research shows that ARFID isn’t “just in someone’s head.”

There can be real differences in how the brain and body process hunger, fullness, and food cues:

Some people with ARFID may have differences in the way their gut and brain communicate (through hormones that signal hunger and fullness).
Brain scans show that some individuals respond to food cues differently — for example, food might not trigger the same sense of reward or motivation to eat.
ARFID is more common in children with other differences like autism or sensory processing challenges.

This means that ARFID is not a choice. It’s a combination of biology, experiences, and sometimes other developmental differences.

How Is ARFID Diagnosed?

There isn’t just one simple test.

Professionals typically look at:

Growth and nutrition (to see if the child is getting enough to eat)
Eating behaviors (what foods are eaten, what’s avoided, how meals feel emotionally)
Medical, sensory, and psychological factors that might be involved

Tools like structured interviews or questionnaires can help, but a full evaluation usually involves a team — pediatrician, therapist, dietitian, occupational or speech therapist.

There’s no single “magic fix,” but many children make real progress with the right support.

1. Meeting nutrition needs first.If a child isn’t eating enough, the top priority is to make sure they get the calories and nutrients their body needs. Sometimes that means special drinks or supplements at first.

2. Gentle, structured exposure to new foods.Many kids with ARFID need slow, step-by-step help to get comfortable with unfamiliar foods. This might involve just looking at, smelling, or touching a food before ever tasting it.

3. Therapy to reduce fear and anxiety.Approaches like CBT-AR (a form of therapy designed for ARFID) and family-based therapy can help reduce food-related anxiety and build confidence at mealtimes.

4. Team support.Many children benefit from a multidisciplinary team, which may include:

Feeding therapist (OT or SLP)
Dietitian
Pediatrician or GI specialist
Mental health therapist

Medication is sometimes used but isn’t the main treatment and should be carefully monitored.

🌱 What This Means for Families

Your child is not being “difficult.” ARFID is real and often rooted in how their brain and body process food.
Early help matters. The sooner ARFID is recognized, the better the chances of improving variety, nutrition, and mealtime stress.
Progress looks different for every child. For some, progress means trying new foods; for others, it’s feeling less scared at the table.

🧡 Final Thoughts

This new research helps shine a light on why ARFID happens and how to help children overcome it with compassion, patience, and the right support.

If your child eats only a few foods, avoids entire food groups, or struggles to grow and thrive, it’s okay to ask for help. A knowledgeable feeding team can help create a plan that works for your child’s unique needs.

📚 Reference:

Fonseca NKO et al. (2024). Avoidant restrictive food intake disorder: recent advances in neurobiology and treatment.Journal of Eating Disorders.