ARFID: Because Middle School Isn’t Hard Enough Already

Everyone knows a picky eater—maybe even an extremely picky eater—but few are familiar with the term ARFID, even as it gains recognition in the medical and psychiatric communities.

The picky eater I knew was my own nephew, now a twenty-five-year-old adult.

His picky eating had been relatively manageable when he was very young, but after he entered middle school, his eating habits started to complicate many aspects of his life. As a gregarious kid who loved theater and baseball, his world was expanding to include all sorts of new opportunities to socialize away from home. And as we all know, socializing generally involves food.

I hate to admit it, but even with master’s degrees in developmental psychology and social work, I had never heard of ARFID, and I sometimes felt less than sympathetic toward his situation.

But a little research turned me around.

In 2013, ARFID (Avoidant/Restrictive Food Intake Disorder) was added to The Diagnostic and Statistical Manual of Mental Disorders and is defined as a disturbed eating pattern characterized by extreme anxiety in eating situations and aversions to specific smells, tastes, temperature, textures, colors, categories, or brands of food. Children and adults who are affected often are limited to a small number of “safe foods” they are able to eat. Some experts estimate that approximately three percent of children are living with ARFID (Kurz et al.,2015)*.

I began to understand that my nephew’s diet was not restricted to a handful of favorite foods he liked to eat—these were the only foods he could eat, even if he was starving. Once I was more familiar with ARFID, I came to admire the courage it took him to face the types of eating-focused social gatherings we all participate in almost every day. Whether he was noticeably not eating what everyone else was, or he was eating one of the few things he always ate, my nephew couldn’t protect himself from unwanted attention from his peers and adults. And at eleven years old, he wasn’t prepared to defend himself from their scrutiny and harassment.

Although ARFID was (and still is) a newer diagnosis, I managed to find valuable resources that provided information and support for parents. Books, websites, and Facebook groups offered a community where a parent could finally find a name and explanation for their child’s struggles. But what I wasn’t finding were resources created and designed specifically for the kids living with ARFID.

During this time, I became involved in the children’s book-writing community and began to work on a middle grade novel. In 2014, a grassroots organization called We Need Diverse Books was established to advocate for changes in the publishing industry that would produce and promote literature to reflect and honor the lives of all young people. When kids see themselves in the pages of a book, they learn that their experiences matter. Additionally, reading can create compassion and awareness for experiences outside of our own.

The We Need Diverse Books movement has played an integral part in the rise of children’s books featuring characters of diverse racial backgrounds, cultural heritages, religious beliefs, disabilities, and illnesses including mental illness such as eating disorders.

I began to consider the value of a book featuring a middle-school-aged character with ARFID. Although ARFID is a relatively rare condition, the types of challenges it presents are universal in the world of middle graders as they confront the never-ending question of How do I fit in? I intended to write a story in which kids living with ARFID would finally see themselves on the page, and kids unfamiliar with ARFID could relate to a character struggling to accept himself and be accepted by his peers. Ultimately, I hope Food Fight encourages people to react to extreme picky eating and ARFID with empathy rather than judgment.

*Kurz, S.; Van Dyck, Z; Dremmel, D; Munsch, S; Hilbert, A. Early-onset restrictive eating disturbances in primary school boys and girls. Eur. Child Adolesc. Psychiatry 2015, 24,779-785.

Linda B. Davis holds master’s degrees in social work and developmental psychology. As a social worker in a community mental health setting, Linda became passionate about the need for accurate and accessible mental health information in children’s literature. Her middle grade novel, Food Fight, is the story of an overnight class trip that becomes a survival mission for an eleven-year-old boy with ARFID. Food Fight will be released by Regal House Publishing on June 27, 2023.