ARFID can have 3 main components:
- Lack of appetite
- Fear of food (often due to food-related trauma)
- Sensory problems
There can also be physical issues eg difficulty swallowing or overactive gag reflex.
You can have one, two or three of these issues.
ARFID usually means that there is an effect on health, and there may be a dependency on nutritional supplements in order to stay healthy.
Both my children have undiagnosed ARFID. Both are ND. One has a couple of foods he can reliably eat and maybe 10 safe-ish foods ie he can eat some of them some of the time. When his stress levels were very high, he had months and months where he only reliably ate 1 food. It was white Belgian chocolate ice cream for months, then bacon for months, and that formed 90% of his diet. The other 10% of foods were completely unstable. At another point his main carbs were meringue nests and Haribo goldears. My other child's safe foods chsnge every few days/few weeks so he rarely has a predictable repertoire and every day we are scrabbling around to find anything he can eat.
We were an exclusively nutritious homecooked wholefoods household for years and years until we started allowing more 'junk' after DC2 just stopped eating (the second time this had happened. Both seemed to be triggered by a V&D bug). But DC2 had ARFID right from the word go, and DC1 started dropping foods after antibiotics at 13 months. Every lot of antibiotics caused refusal of more foods until age 3 he only ate 5 things, which included no protein, no veg and 1 fruit only occasionally
Nutritional deficiencies are common in ARFID and can also make ARFID worse. Low zinc and iron can cause low appetite and poor digestion. For example, if you become zinc deficient enough, your body breaks down your digestive enzymes to get at the zinc within them - which then means you lose full digestive function, so you become more zinc deficient etc. Low zinc commonly causes low appetite, so if you say "just wait till the child's hungry and then they'll eat", you can end up in big trouble.
We've had lots of improvements with nutritional supplements but not enough not to have ARFID. There are no services locally for ARFID support so our GP advised us not to seek a diagnosis.