Both ARFID (Avoidant/restrictive food intake disorder) and picky eating may involve a loss of appetite, weight loss, and strong food preferences, they may differ in terms of nutritional deficiency.
These behaviors are commonly seen in children and may be helped by dietitians, developmental pediatricians, and psychologists.
The DSM-5 defines ARFID as a feeding or eating disturbance characterized by avoidance or restriction of food intake and clinically significant failure to meet requirements for nutrition through oral food intake.
On the other hand, common behaviors in early childhood are categorized as part of a spectrum of feeding difficulties.
Picky eaters have strong food preferences and will only eat foods that they are familiar with and are unwilling to try new foods. The following discussions further delve into their differences.
ARFID -Avoidant/Restrictive Food Intake Disorder
ARFID is a feeding or eating disturbance characterized by avoidance or restriction of food intake. This can cause clinically significant failure to meet requirements for nutrition through oral food intake.
Individuals with this disorder experience severe weight loss, lack vital nutrients, and require either dietary supplements or tube-feeding. Furthermore, their condition significantly impacts their ability to function psychologically.
People who are suffering from anorexia may dress in layers to hide their weight loss, report consistent but vague excuses around mealtimes, and have a limited range of preferred food.
It’s important to remember that the eating disorder is not caused by a lack of food, cultural reasons, anorexia or bulimia nervosa, or another medical condition.
ARFID is not the same as things like picky eating in kids or reduced food intake in adults that are considered normal.
Some people may be extremely sensitive to certain qualities or sensory characteristics of food, such as color, smell, texture, taste, or temperature.
The feeling of disgust may also be a negative response that has been conditioned by experiences such as choking and vomiting. ARFID usually begins during infancy or early childhood, and sometimes continues into adulthood.
Picky eating is also known as “choosy eating”, “faddy eating”, or “fussy eating”. Feeding difficulties are a common behavior in early childhood. There is no single widely accepted definition of feeding difficulties, but it is usually categorized as part of a spectrum of feeding difficulties.
People who are picky eaters tend to have strong opinions about the food they eat and are unwilling to try new things or even eat familiar foods. This can lead to health problems later on.
The causes of fussy eating habits include early feeding difficulties and the late introduction of lumpy foods. This behavior may stem from a power struggle between the parent and child, or be an expression of fear or other negative emotions.
There are some things you can do to reduce picky eating, such as being a good role model for your child, exposing them to new foods often, and making mealtime a positive experience.
Some other things you can do to get your picky eater to try new foods are to change what you’re serving, give them some options to choose from, let them help make the meal, and don’t try to address any behavior problems at the same time.
Health Surgeon’s Ideal Weight Calculator: This ideal weight calculator was specially formulated for kids under the age of 18. It is important for children to maintain an ideal weight as it assures they are getting enough nutrition as they grow and that they are not putting extra stress on developing joints.
Picky Eating and Disordered Eating
The line between picky eating and an eating disorder can be difficult for parents to distinguish. While there are some similarities between the two, picky eating is usually not as severe as an eating disorder. The line between being picky eater vs. having an eating disorder often depends on a few different things:
- Whether there is an underlying fear related to eating
- The extent of restriction
- How much it impacts health.
Picky eating can be a problem for parents, but it is even more serious when it turns into a disordered eating habits. Extreme and persistent stress can impede healthy growth and development.
If someone is avoiding or refusing to eat, it may be an eating disorder, but the diagnosis depends on specific criteria.
If someone is not eating due to a lack of available food, cultural practices, or another health condition, they may be misdiagnosed with ARFID.
If a child refuses to eat or only eats a limited variety of foods based on their likes and dislikes, they may be misdiagnosed with ARFID.
ARFID is a disorder that is characterized by a fear or anxiety of eating. This can manifest as avoidance of certain foods or refusal to eat altogether. If people avoid food due to anxiety or another behavioral disorder, they may be misdiagnosed with ARFID.
Difference Between ARFID and Picky Eating
ARFID is a condition in which someone has an aversion to food or is unable to eat enough to meet their nutritional needs.
Picky eating is a common behavior in early childhood which is usually categorized as part of a spectrum of feeding difficulties. Picky eaters avoid trying new foods or even eating familiar ones that they do not like.
ARFID was previously referred to as Selective Eating Disorder, while picky eating is also known as “choosy eating”, “faddy eating”, or “fussy eating”.
Since both ARFID and picky eating share similar characteristics, it can be difficult to distinguish between the two conditions. Picky eating is fairly common in children, but most children will ultimately eat the foods they prefer.
ARFID is a condition where people have a lack of interest in food which can then lead to nutritional deficiencies.
Picky eaters are more likely to eat a variety of foods when they are hungry, whereas people with avoidant restrictive food intake disorder are more likely to restrict their intake to only a few foods even when they are hungry.
Picky eaters are also more likely to eat new foods when they are offered by someone else, whereas people with avoidant restrictive food intake disorder are more likely to avoid new foods.
People with ARFID may require nutritional supplements or feeding tubes in order to have sufficient nutrition. Picky eaters don’t need to take extra supplements to get enough calories and grow normally.
ARFID is a mental disorder that makes social situations difficult for sufferers because they worry about the food that will be available. People with anorexia may often say that they are not hungry and may forget to eat.
Picky eaters may often feel hungry, as they tend to be interested in only certain types of food. What this means is that people with social anxiety are not so shy that they would feel anxious about social events.
A large portion of children are picky eaters, with estimates putting the number at somewhere between 8% and 50% of all children.
Picky eating often involves a child refusing to eat certain types of foods, such as vegetables. Additionally, picky eaters usually have very clear preferences for certain foods and are unwilling to try new foods. Some parents may prepare a separate meal for a child who is a picky eater to ensure that the child is getting the nutrition they need.
Signs of a picky eater might include:
- Lower weight than non-picky eaters
- Behavior problems
- Refusal to accept or try a wide range of foods
- Eating only very specific foods
- Eating very slowly
The following signs and symptoms, while frustrating for parents, do not necessarily mean that a child has an eating disorder. In fact, there are several key points that are unique to picky eating:
- Children will likely outgrow this phase: Over half (58%) of picky eaters will recover after two years
- Picky eaters can function normally in social situations involving food: Picky eaters will often be able to find a food that they enjoy, and they will not normally experience anxiety leading up to or during the event
- Picky eaters do not allow fears to drive their eating choices: Food choices among picky eaters are usually driven by preference, rather than fear
- Picky eaters are interested in eating the foods they enjoy: Children who are picky eaters will often happily eat foods that they do like (even if the variety may be limited)
Although picky eating may be upsetting, it does not necessarily mean that there is an underlying eating disorder.
Individuals with ARFID
ARFID is a more serious disorder than picky eating and its symptoms are more severe and impairing.
An eating disorder is defined in the Diagnostic and Statistical Manual of Mental Disorders, version 5 (DSM-5), as when a person’s weight falls significantly below what is considered normal, they rely on supplements to meet their nutritional needs, and their normal functioning is significantly impacted.
Some of the main signs and symptoms that could indicate ARFID are:
- Failure to maintain a healthy weight
- The need for feeding tubes or supplements to receive appropriate nutrition
- Experience anxiety leading up to or during social events that serve food
- Avoidance of food based on sensory aspects or fear of negative consequences (taste, choking, etc.)
- Lack of interest in food
The symptoms of ARFID can greatly affect a child’s behavior and ability to live a normal life.
This can also be very distressing for parents, as these symptoms can impact their child’s development and, in severe cases, have long-lasting effects. Treating the symptoms of ARFID can improve your overall nutrition and health in the long term.
Treatment Options For ARFID and Picky Eating
ARFID is a more serious condition than other eating disorders because it is characterized by marked nutritional deficiency, dependence on oral nutritional supplements or enteral feeding, or significant interference with psychosocial functioning.
There are various treatments available for those suffering from eating disorders which include therapies that involve the whole family, medication, and professional help from healthcare professionals such as registered dietitian nutritionists, occupational therapists, developmental pediatricians, gastroenterologists, psychologists, psychiatrists, and adolescent health physicians.
Some ways to reduce picky eating habits or to prevent them from developing include setting a positive example for children, frequently exposing them to new foods, and ensuring that mealtimes are enjoyable social experiences.
Other tips for getting picky eaters to try new foods include changing up the menu, giving options, involving the kids in the meal preparation, and separating behavior issues from picky eating.
Parents may feel that their concerns about their child’s picky eating habits are not being heard or taken seriously. It can be hard to get treatment for children with ARFID because of this.
There are a few different ways to treat ARFID that can help with things like fear around food or bad habits with food, and also help you gain weight back.
Relatively little is known about how to specifically treat ARFID, as it is a relatively new category of eating disorder. Treatment for ARFID must address the underlying anxiety or fear that is causing the person to avoid or restrict food.
Some of the possible treatment options for ARFID include:
- Family therapy
- Cognitive-behavioral therapy
- Treatment of anxiety
- Weight gain and re-nourishment strategies
The best way to deal with ARFID depends on the person and how severe the condition is.
What parents should know about extreme picky eating:
Picky eating is common in childhood and is usually nothing to worry about. Being extremely picky with food can lead to malnourishment, cause behavioral problems, or be a sign of an eating disorder.
If you are concerned about your child’s eating behavior, there are several signs you can look for. Parents should take note if their child experiences severe anxiety or fear surrounding food, rather than just a dislike or preference.
Picky eating is most common during the preschool years, but it usually goes away after a few years or in later childhood. If a person is excessively picky about the food they eat, it may be a sign of an eating disorder that needs to be addressed by a professional.
If a person is extremely picky about what they eat and it leads to weight loss or nutritional deficiencies, this can have negative effects later in life and should be addressed and/or treated.
ARFID is a feeding or eating disturbance characterized by avoidance or restriction of food intake and clinically significant failure to meet requirements for nutrition through oral food intake.
Picky eating is a common behavior in early childhood, and it is usually categorized as part of a spectrum of feeding difficulties.
Unlike picky eating, ARFID requires a more intensive approach due to the marked nutritional deficiency, dependence on oral nutritional supplements or enteral feeding, or significant interference with psychosocial functioning.