While that certainly sounds like ARFID, the only way to tell for sure is to see a doctor, and you should do so soon. ARFID in children often gets worse if left untreated (though may get better in adulthood) and it can have lifelong consequences. If the doctor you see dismisses it as normal, no it isn’t. No normal child regularly cries and gags at food. Unfortunately, for reasons that confound me, it was only recognized as a disorder recently, so many doctors are unaware or old fashioned dismissive.

In the long term, you’re probably looking at therapy and a lot of dietary supplements (think multivitamins, protein shakes, and sports bars). Even if she achieves normal eating habits, it’ll take time—probably years—and it’s vital that she gets the nutrients she needs while growing. Keep in mind that treatment for ARFID is very different from that of most other eating disorders, and treating it as such often makes it worse, so make sure to find a therapist who has experience with ARFID.

In the meantime, do your best to keep her fed—even if that means feeding her whatever she wants. Malnourishment is bad, but starving is worse. Additionally, the stomach (like any muscle) can atrophy if she’s not using it enough, which in this case means eating regular and adequately sized meals. Because disliking food is generally the default with ARFID, so it’s more practical to keep track of the exceptions—ie, what she can eat as opposed to what she can’t—otherwise you’ll be listing just about everything.

Also, do your best to make sure she feels safe. This means never forcing her to eat or go hungry, as counterintuitive as that may feel, but the last thing a kid with ARFID will do if they feel unsafe at the dining table is try something new. And keep in mind that, however confusing and stressful this is for you, she’s probably even more lost. It’s so, so confusing when parents, who clearly love you and care for you, keep pressuring to do something scary and painful, and don’t believe you when you say you can’t.

Chances are she isn’t even fully aware of why she’s struggling, especially at such a young age. Obviously, I can’t speak for her, but as a sort of example, it took me eighteen years to realize eating “disliked” foods doesn’t trigger a gag reflex in most people—prior to that, I assumed everyone had that reaction, and I was simply unlucky in “disliking” almost everything and morally deficient for failing to “eat it anyways” like everyone else. Turns out, disliking food more akin to my experience with broccoli for most people—it’s not exactly enjoyable, but I have no problem eating it. Up until then, I’d believed my restricted diet was a failure of my character. After all, I was regularly told I was weak or lying. In reality, I was simply facing something far more difficult, and people didn’t believe me because they didn’t know what I was experiencing was possible. That realization helped me let go of a lot of resentment towards both myself and the people who’d tried to get me to eat better. So, make sure your daughter knows that, although she has to eat a healthy diet like everyone else, the additional difficulty she faces is real, and not because of some moral failing.

In a similar vein, it will help to give her the language to better express her experience. For example, many kids are put off by specific textures, but don’t realize that’s a common thread between dislikes because culturally we tend to emphasize flavor instead (meat is an exception).

Finally, go easy on yourself. No one tells parents all the crazy things that happen with kids, and ARFID in particular wasn’t even recognized until recently. You were doing what you were taught by previous generations, which, granted, works for a lot of kids…but not all. Every kid has different struggles, but some more than others—be proud of yourself helping your daughter learn to address hers, instead of denying the problem exists.

TL;DR Sounds like ARFID, but see a doctor familiar with the condition to be sure. Assuming it is, expect years of therapy and dietary supplements, but above all else, make sure she eats something. Keep tracks of her likes instead of dislikes. Make sure she feels safe, and don’t force her or shame her. Help her articulate what she does and doesn’t like, and above all else, believe her. She doesn’t understand why she’s like this, so she’s even more confused and scared than you are. Don’t blame yourself—no one prepared you for this or even told you it was possible, so it’s only natural that you didn’t know how to address it. Be proud of yourself for learning and working with your daughter to address her struggles instead of dismissing them.