Understanding ARFID and Its Link to ADHD

Many children are picky eaters, but for some, the struggle with food goes beyond preference. If your child avoids eating certain foods, eats only a very limited variety, or shows anxiety around mealtimes, you might be dealing with something deeper than just pickiness. A condition known as Avoidant Restrictive Food Intake Disorder (ARFID) could be the reason—and recent research shows a growing link between ARFID and Attention-Deficit/Hyperactivity Disorder (ADHD).

In this article, we’ll break down what ARFID is, how it’s different from other eating disorders, why it’s connected to ADHD, and how parents and caregivers can offer support.

What Is ARFID?

Avoidant Restrictive Food Intake Disorder (ARFID) is a relatively new diagnosis in the world of mental health and nutrition. It was officially recognized in the DSM-5 in 2013. Unlike other eating disorders, ARFID isn’t about body image. Instead, it’s characterized by an extreme avoidance or restriction of food that leads to:

Significant weight loss (or failure to gain weight in kids)
Nutritional deficiencies
Dependence on supplements or feeding tubes
Interference with daily life and social relationships

Children (and adults) with ARFID may:

Be hypersensitive to the texture, smell, or appearance of food
Have a strong fear of choking or vomiting
Feel a lack of interest in eating altogether

The Surprising Link Between ARFID and ADHD

Recent studies have begun exploring the overlap between ARFID and ADHD, and the findings are eye-opening. Children with ADHD are more likely to experience feeding difficulties, and many show signs of ARFID. Here’s why that may be:

1. Sensory Sensitivities

Many kids with ADHD also have sensory processing challenges. This means they might find certain textures (like mushy bananas or crunchy carrots) overwhelming or even unbearable. This sensitivity can make eating a stressful experience—leading to food refusal or strong preferences for “safe” foods.

2. Executive Functioning Struggles

ADHD affects executive functioning, the part of the brain that helps with planning, attention, and regulation. Mealtimes often require transitions, patience, and staying focused—skills that can be tough for someone with ADHD. If eating feels like a chore, it’s easy to avoid it.

3. Emotional Regulation

Children with ADHD may also struggle with managing big emotions. If they had a negative experience with a certain food (like gagging or choking), they may develop a lasting fear. This fear can spiral into a phobia of eating, which is one of the hallmarks of ARFID.

Signs to Watch For

If your child has ADHD and you’re noticing feeding difficulties, keep an eye out for these red flags that could point to ARFID:

Extremely limited food choices (less than 20 accepted foods)
Tantrums, anxiety, or distress during meals
Slow weight gain or weight loss
Avoiding entire food groups (like all fruits or proteins)
Gagging, vomiting, or crying at the sight or smell of certain foods
Preferring liquid meals or snack foods to real meals

Diagnosis and Treatment

Diagnosing ARFID requires a team approach. Pediatricians, dietitians, psychologists, and occupational therapists may all be involved. If ARFID is suspected, a healthcare provider will assess growth charts, dietary intake, medical history, and behavioral patterns.

Treatment Approaches

There’s no one-size-fits-all treatment for ARFID, but some proven approaches include:

Cognitive Behavioral Therapy (CBT-AR): A modified form of CBT that addresses the fear-based or sensory aspects of food avoidance.
Occupational Therapy (OT): Helps children gradually get used to different textures and temperatures through playful exposure.
Family-Based Therapy: Parents are empowered to guide meals and support their child’s eating in a structured, encouraging way.
Nutrition Counseling: A registered dietitian can help balance the child’s nutritional needs while working within their comfort zone.

When ADHD is part of the picture, therapy may also include strategies to improve focus, structure, and self-regulation during meals.

How Parents Can Help at Home

Even without a formal diagnosis, parents can create a supportive environment that reduces stress around food and gently encourages progress.

Here are some tips:

Stick to a routine: Predictability can reduce anxiety. Try to offer meals and snacks at the same times each day.
Serve preferred and new foods: Always include one “safe” food your child likes at each meal, but add a small portion of a new or non-preferred food nearby—no pressure to eat it.
Model calm eating behavior: Your child will learn from you. Keep your own reactions neutral, and avoid pleading or bribing.
Celebrate tiny wins: If your child touches, smells, or licks a new food—cheer them on! Desensitization is a slow but powerful process.
Avoid pressure or punishment: This can backfire and make mealtime even more stressful.

When to Seek Help

If your child is losing weight, missing growth milestones, or struggling emotionally because of food, it’s time to seek professional guidance. A pediatrician can help rule out medical causes and refer you to specialists in feeding therapy and ADHD.

Final Thoughts

ARFID and ADHD often go hand-in-hand in subtle but meaningful ways. Understanding this connection can help you better support your child’s eating habits with compassion and clarity. With early intervention, a supportive environment, and the right treatment plan, children with ARFID and ADHD can build a healthier relationship with food—and with themselves.