Avoidant/Restrictive Food Intake Disorder in a Pediatric Obese Patient.

Avoidant/restrictive food intake disorder (ARFID) can present with limited food variety, intake, or aversions. The symptoms can manifest at any age and typically appear in the first few years of life. The prevalence of ARFID varies widely among clinical and non-clinical populations, and its diagnosis requires trained health professionals to ensure early detection and prevention of poor outcomes.  A four-year-old boy developed an aversion to solid foods after a choking incident with chicken nuggets, fearing a recurrence. Pre-existing phobias and developmental delays compounded his selective eating. Despite a BMI percentile over the 99 percentile for his age (20.34 kg/m), ARFID was diagnosed after a psychiatric referral, highlighting the intricate psychological aspect of pediatric feeding disorders. Patients with ARFID may exhibit unexpected weight variations, and nutritional deficiencies do not always appear with low body weight. Child obesity is a pressing US public health issue, affecting 19.7%, potentially leading to psychiatric comorbidities such as depression or anxiety. Health professionals require training to detect and prevent adverse outcomes. Understanding the mechanisms perpetuating ARFID and addressing mental health in this population are crucial aspects of daily practice.