How to tell the difference between picky eating and ARFID (Avoidant Restrictive Food Intake Disorder)
It’s just picky eating, right? Well, that’s what every well-meaning person tells you. But ARFID (Avoidant Restrictive Food Intake Disorder) is not just your run of the mill picky eating that’s relatively common in children.
While those well-meaning people don’t mean any harm when they suggest that your child is just a picky eater, ARFID can be a serious condition. If you suspect your child may have ARFID, we share what you need to know about the difference between ARFID vs picky eating.
People with ARFID will avoid food or restrict their intake of food. This can lead to nutritional deficiencies and affect weight, growth and overall health and wellbeing.
Unlike other eating disorders, such as Anorexia Nervosa or Bulimia Nervosa, avoidance of food for ARFID sufferers isn’t usually associated with body image or weight concerns. Causes of ARFID could include sensory aspects of food, such as smell or texture, as well as past adverse food experiences, such as choking.
ARFID affects psychosocial functioning and negatively impacts an individual’s daily life and their ability to participate in activities, outings or other food related events.
Current research recognises that autism is seen in those with ARFID at higher rates than the general population rate of 1.5%. Estimates of co-occurring ARFID and autism range from 12.5% all the way up to 33.3% (Harris et al., 2019; Inouye 2021).
While most common in children and teenagers, ARFID can also continue into adulthood.
RELATED: WHAT IS ARFID?
The key differences between picky eating and ARFID
Straight up, picky eating and ARFID are not the same thing. Fussy eating is a very normal thing for children to experience. They only like white food or to have their sandwiches cut into certain shapes. They’ll eat a certain food every day for a week and then refuse to eat it again.
So, is picky eating a disorder? No, this type of behaviour is a relatively common part of development as children develop their preferences and establish their independence. As frustrating as it is, it isn’t a disorder.
ARFID is different. It’s not a stage. And it’s not a normal part of development. It’s not even “extreme picky eating”. It’s a diagnosable and treatable eating disorder.
Most people have some type of experience with picky eating, particularly parents. But picky eating is different from ARFID. Picky eating usually improves over time and it doesn’t typically interfere with the child’s health like ARFID does.
If you’re unsure if your loved one has ARFID, some of the signs to look out for include:
- Withdrawal from family and friends
- Heightened anxiety around mealtimes
- Pale appearance
- Late onset of puberty or irregular menstrual cycles
- Lack of energy, dizziness, headaches
- Weight loss
- Fear based food restriction
- Distress when trying new foods or listening/watching other people eat
- A sudden lack of interest or refusal of food
- Only eating food of a specific brand or from a specific food outlet
- Fear of vomiting, choking, nausea or allergic reaction from food
- Sensory sensitivities to food textures, colours, tastes and/or smells
- Eating very slowly and feeling full after only eating a small amount of food
- Insisting on eating only “white” or “beige” foods such as bread, chips, boiled rice, chicken nuggets and crackers
- Only eating very limited foods prepared in a particular way
- Nutritional deficiencies (as identified through blood tests)
- Stomach pains when eating
When you look at those signs, it’s easier to see the differences between picky eating and ARFID. A picky eater usually still develops in the same way as other children. They don’t get upset about eating food and will usually try new and different foods… even if they don’t actually eat them.
RELATED: Sensory Issues Associated with ARFID
How is ARFID diagnosed?
The first port of call if you’re concerned about ARFID is to speak to your GP. They can then make a referral to the appropriate healthcare provider to support you and your loved one.
For someone with ARFID, their care team could include some or all of the following supports; GP, speech therapist, psychologist, dietitian, paediatrician, exercise physiologist, occupational therapist, hypnotherapist.
Diagnosis of ARFID isn’t a simple test. It may involve blood tests or other scans as well as conversations with you and your loved one. Diagnosis is important. This then enables you to pull together an eating disorder treatment team to support your loved one in their recovery.
Recovering from ARFID is generally a long, slow process and requires intensive practical and emotional support through exposure and food chaining* from preferred foods.
*Food chaining works by taking a food that your child is already eating and identifying new foods that they are similar in color, shape, texture, smell, or taste to serve them at meals.
Supporting a loved one with an eating disorder can feel like a very lonely and overwhelming journey. That’s why Eating Disorders Families Australia (EDFA) was founded, to support carers and family members just like you.
Dive into our resources that can help you while you support your loved one.
About Eating Disorders Families Australia
Eating Disorders Families Australia (EDFA) is the only national organisation solely for carers and families of those with an eating disorder. EDFA provides support, EDucation, advocacy, and counselling services. EDFA has a private Facebook forum, providing a safe place for eating disorder carers and family members to share experiences, seek advice and assistance, and find hope.
EDFA is the ONLY organisation that provides monthly support group for carers of those with a diagnosis of ARFID.
For more information about any of our services, please don’t hesitate to contact us.
