Most children go through a picky eating phase, and many adults still have a laundry list of foods they refuse to eat. For some individuals, however, picky eating goes far beyond refusing a side of broccoli or needing a sandwich cut just the right way. Avoidant/restrictive food intake disorder, or ARFID, is a serious eating disorder that interferes with a person's mental and physical health. Here are four important differences between picky eating and ARFID.
While a picky eater might gag or throw a tantrum when presented with a disliked food, children and adults with ARFID often have extreme physical symptoms like choking, vomiting, fainting or panic attacks. These physical symptoms make it hard for people with ARFID to even be around the foods they don't like. ARFID also makes it difficult or impossible to try new foods, whereas picky eaters often have no problem with trying something once or twice.
Picky eaters tend to enjoy the few foods they like and are typically normal weight or overweight, but people with ARFID are often underweight and avoid eating because of their intense anxiety around food. Physical health concerns make ARFID more difficult to treat than simple picky eating, and treatment options for eating disorders like inpatient therapy and parenteral nutrition should be considered in severe cases.
One of the most defining features of ARFID is impairment of psychosocial functionating. The anxiety surrounding food makes socializing difficult for people with ARFID, while picky eaters typically don't feel this same anxiety. Picky eaters can usually find something they want to eat at social functions or be content with eating later or bringing their own food.
Parents can help children overcome picky eating at home by exposing them to new foods at each meal and offering rewards and praise, while adult picky eaters can benefit from self-help and cognitive behavioral therapy. ARFID, on the other hand, is more difficult to treat and usually requires eating disorder therapy. Severe cases of ARFID may benefit from an intensive in-patient program.
Are you concerned that you or your child's food restriction may go beyond picky eating? It's important to get an assessment for ARFID as soon as possible to prevent health problems like weight loss, malnutrition, weakened bones, and menstrual abnormalities in women. Starting treatment as early as possible improves outcomes and reduces the risk of complications for ARFID patients.