Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder that can cause children to eat too little or too small a variety of foods to meet their nutrition needs. While ARFID can sometimes look similar to picky eating, it can be more concerning because it usually does not improve on its own as a child gets older.
The good news is that recovery from ARFID is possible.
Progress often happens gradually, and improvements may take time rather than happening overnight. With the right treatment and support, many children can reach full remission of ARFID symptoms and go on to have healthy eating patterns.
Treatment options for ARFID recovery
With a formal evaluation from a health care professional that includes assessing growth charts, blood work, medical history and feeding/eating history, the appropriate treatment option for your child with ARFID can be determined.
ARFID treatment can involve one provider or a team depending on your child’s needs. Common health care professionals that support ARFID treatment include pediatricians, registered dietitians, psychologists, occupational therapists and speech language pathologists.
There are several evidence-based treatment approaches for ARFID. The right option will depend on the severity of your child’s symptoms and should be determined with the guidance of a health care professional. These include:
- Family-based programming (1): First recommended step, focuses on parenting strategies and mealtime practices.
- Cognitive Behavioral Therapy (CBT) (2): Improves coping skills and reduces emotional distress around food and eating.
- Feeding Therapy (1): Step-by-step expansion of diet through small modifications to already enjoyed/safe foods.
- One-on-one therapies: More individualized approach to increase food variety and reduce eating anxiety.
In more extreme cases of ARFID, some children may need to be treated in a hospital or clinic in-patient setting to restore health safely.
In the early stages of ARFID treatment, ensuring your child is eating enough to support healthy growth is important. Supplementing your child’s diet with oral nutrition supplements may be necessary. Please consult with your child’s pediatrician before starting your child on any treatment or supplement.
Learn more about treatment options for ARFID here.
How long does ARFID recovery take?
ARFID recovery time will look different for every child.
There are many factors that can affect progress and recovery time.
- Child’s age.
- Severity of food restrictions.
- Underlying cause of ARFID (sensory issues, fear of something bad happening after eating, low appetite or interest in eating).
- Access to treatment.
- Family support.
Progress may not follow a straight line in ARFID recovery. It can happen in small steps and any progress can be celebrated as a win towards full remission of ARFID symptoms.
What ARFID recovery may look like
While ARFID recovery may look different for every child, recovery involves two phases: physical and psychological. (3,4)
The first priority in ARFID recovery is weight gain or stabilization. (4-7) If a child with ARFID has experienced weight loss or is falling below expected growth charts, weight gain is important to ensure normal growth into puberty.
Weight gain helps restore physical health by filling any nutrition gaps from malnutrition. It is necessary to improve psychological health, including improving mood and reducing anxiety around food. By restoring weight, physical and mental health can be improved and full recovery can be made.
Full remission may not necessarily mean that a child with ARFID will start eating anything and everything. It may just mean that they are open to eating a wider variety of food or eating more food in general.
Some possible signs of improving ARFID symptoms may include:
- Eating enough calories for proper growth.
- Eating a wider variety of foods.
- Less anxiety around meals.
- Ability to try new foods.
- Improved/less stressful family mealtimes.
- Reduced reliance on nutritional supplement.
AFRID recovery is possible with support
Recovery from ARFID may not happen overnight, but it is possible. Many children make progress step by step as they gain comfort with foods and build healthier eating habits over time. While the process can feel slow at times, small changes can add up to meaningful improvements. Getting support early from health care professionals can make a big difference in helping children make a recovery with less likelihood of relapse. With the right guidance and patience, many children with ARFID can go on to expand their diets and meet their needs to grow and support normal development.
References
1. Białek-Dratwa A, Szymańska D, Grajek M, Krupa-Kotara K, Szczepańska E, Kowalski O. ARFID—Strategies for Dietary Management in Children. Nutrients. 2022; 14(9):1739.https://doi.org/10.3390/nu14091739
2. Sikora DM. The treatment of avoidant/restrictive food intake disorder (ARFID) with predominance of anxiety presentation. A proposal of a protocol for therapeutic procedure. Psychoterapia. 2021;198(3):33–47. doi:10.12740/PT/141443.
3. Richmond TK, Woolverton GA, Mammel K, et al. How do you define recovery? A qualitative study of patients with eating disorders, their parents, and clinicians. Int J Eat Disord. 2020;53(8):1209-1218. doi:10.1002/eat.23294
4. Sim, L.A., Whiteside, S., Harbeck-Weber, C. et al. Weight Suppression and Risk for Childhood Psychiatric Disorders. Child Psychiatry Hum Dev 56, 1005–1014 (2025). https://doi.org/10.1007/s10578-023-01617-7
5. Downey AE, Richards A, Tanner AB. Linear growth in young people with restrictive eating disorders: “Inching” toward consensus. Front Psychiatry. 2023;14:1094222. Published 2023 Mar 3. doi:10.3389/fpsyt.2023.1094222
6. Society for Adolescent Health and Medicine. Medical Management of Restrictive Eating Disorders in Adolescents and Young Adults. J Adolesc Health. 2022;71(5):648-654. doi:10.1016/j.jadohealth.2022.08.0067. Tanner, A.B., Richmond, T.K. Assessing growth in children and adolescents with Avoidant/Restrictive Food Intake Disorder. J Eat Disord 12, 82 (2024). https://doi.org/10.1186/s40337-024-01034-8
