Avoidant/Restrictive Food Intake Disorder (ARFID) Program

We are a multidisciplinary outpatient program caring for patients with avoidant restrictive food intake disorder (ARFID) at risk for malnutrition and/or micronutrient deficiencies. If your child is between the ages of 6 and 18 years old and has challenges with feeding or eating, our multidisciplinary team may be able to help.

Patients 6 to 18 years old with a diagnosis of ARFID and one or more of the following criteria for severe malnutrition:

• no weight gain for six months or longer in a growing child
• body mass index (BMI) for age Z-score </= -2.0
• weight loss of >/=5 percent of body weight in the past three months.
• dietary intake assessed to be severely restrictive (e.g., consisting </=5 foods or diet devoid of key food groups)

In addition, patients must: 

• not be diagnosed with another restrictive eating disorder (e.g., anorexia nervosa).
• reside within New England (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont) during the time of treatment

If your child or teen meets the above criteria, please contact our team at ARFID-FEED@childrens.harvard.edu or by phone at 617-355-6341 so we can initiate the screening process that is required for our program.

Please be prepared to provide your child’s full name, date of birth, preferred email address, preferred phone number, and previous medical records including full growth chart history and prior relevant medical notes.

What if my child has ARFID but does not meet these criteria?

If you are concerned about your child or teen’s challenges with feeding or eating but your child does not have severe malnutrition (as noted in the above criteria) then we recommend you talk with your pediatrician to see if any of the following steps may be appropriate for your child:

• a referral to our Division of Gastroenterology, Hepatology and Nutrition to rule out any underlying conditions and assess GI-related symptoms
• a referral to a psychologist to address generalized anxiety, anxiety around food, and other mental health concerns
• schedule an appointment with one of our clinical nutrition specialists to conduct a comprehensive nutrition assessment and develop an individualized care plan
• a referral to our Feeding and Swallowing Program for a clinical feeding evaluation to evaluate your child’s feeding behaviors, skills, and difficulties.
  • For ongoing community-based feeding therapy support, check out our guide to local ARFID feeding therapy and SLP resources.
• If your child is below 6 years old, a referral to a multidisciplinary program that is specifically designed for younger children, such as Boston Children’s Growth and Nutrition Program, may be appropriate.
• If your child is over 12 years old, a referral to our Division of Adolescent/Young Adult Medicine for adolescent-specific care may be appropriate.

Our team is comprised of specialists in gastroenterology, adolescent medicine, nutrition, and mental health services. Together, we can evaluate your child and develop a comprehensive care plan. This plan is aimed at improving your child’s nutritional intake to achieve healthy growth and address nutritional deficiencies. We provide education and support to help kids and teens eat balanced and nutritious meals without discomfort. Our team of behavioral medicine specialists helps provide psychosocial support to assist our families in navigating the social challenges associated with ARFID.

Our team values collaboration and will work hand in hand with your pediatrician and/or established community treatment providers whenever possible. When appropriate, we may additionally make referrals to providers with expertise in your community.

Families and providers can access additional family resources here.

Books

• The Picky Eater's Recovery Book: Overcoming Avoidant/Restrictive Food Intake Disorder, by Dr. Jennifer Thomas
• Off the C.U.F.F.: A Parent Skills Book for the Management of Disordered Eating, By Dr. Nancy Zucker
• ARFID Avoidant Restrictive Food Intake Disorder: A Guide for Parents and Carers, by Dr. Rachel Bryant-Waugh

Websites

• The Multiservice Eating Disorders Association is an eating disorders support network and resource for clients, loved ones, clinicians, educators, and the general public, and is dedicated to the prevention and treatment of eating disorders.
• The National Eating Disorders Association is the largest not-for-profit organization in the United States providing information, newsletters, and treatment referrals to people suffering from a variety of eating disorders.