Eight Foods and a Packed Lunch

Little Arjun, seven, from Chennai, ate only a few foods: plain rice, one brand of biscuit and dry toast. New smells made him gag. At school he sat apart and ate almost nothing. He had never worried about his weight. He s…

Little Arjun, seven, from Chennai, ate only a few foods: plain rice, one brand of biscuit and dry toast. New smells made him gag. At school he sat apart and ate almost nothing. He had never worried about his weight. He simply said some foods felt scary and made his mouth feel strange.

His parents tried bribes and then punishments. Mealtimes became battles, and Arjun was losing weight and getting tired. His teacher noticed he was quiet and sensitive to loud noises.

A paediatrician checked his growth, then referred the family to a team. They explained that this was not fussiness and not anorexia: it was a condition called ARFID, where fear or sensory discomfort limits food, and it is common in children on the autism spectrum. The team introduced new foods very slowly with a dietitian and a therapist, and the parents learnt to keep mealtimes calm.

It took many patient months. Arjun first learnt to sit near a new food without eating it, then to touch it, then to lick it. His parents cheered every small step and never pushed. His teacher let him eat with one friend in a quiet corner. By the end of the year he had added a handful of foods, and mealtimes were no longer a battlefield.

How to recognise it

• A very limited range of foods, with strong refusal of new textures, smells or tastes.

• No worry about weight or body shape.

• Weight loss, tiredness or slow growth.

• Gagging, fear of choking or vomiting around food.

• Distress at mealtimes and family conflict.

What this story explains

This story shows ARFID, where food is limited by sensory discomfort or fear, not body image, and why it is common with autism and needs nutritional support, exposure therapy and family involvement.

Probable root causes

• Sensory sensitivity to taste, texture or smell.

• A frightening event such as choking or vomiting.

• Autism or anxiety traits.

• Mealtime pressure that makes fear grow.

What to do

1. Have the child's growth and nutrition checked by a paediatrician.

2. Stop pressure at meals: no force, bribes or battles.

3. Work with a dietitian and a therapist on slow, small steps with new foods.

4. Keep meals calm and predictable, with safe foods always on the table.

5. Share information with the teacher so lunchtimes are kind.

6. Tell the team about any sensory or social difficulties.

Whom to consult

• A paediatrician for growth, nutrition and referral.

• A dietitian for safe and slow widening of food choices.

• A child psychologist for fear and exposure therapy.

• A developmental specialist if autism is possible.

Do and don’t

How to behave and communicate

• Speak softly: "You do not have to eat it. It can just sit on the table."

• Use simple, literal words and a visual plan.

• Notice his signals and stop when he is overwhelmed.

• Praise courage: "You touched it. That was brave."

• Keep a neutral tone at the table.