Picky Eating or ARFID? The Differences

Parents often ask whether their child is simply a picky eater or whether something more is going on. The two can look similar at first, so here is how they usually differ.

What picky eating usually looks like

Picky eating is common in young children. Typically, a picky eater:

• Accepts a reasonable range of foods, even if it is narrower than you would like
• Is growing and developing along their own expected path
• Might refuse new foods, but can usually be around them without intense distress
• May accept a food one day and refuse it the next
• Can often eat with the family, even if the plate looks different from everyone else's

What ARFID is

ARFID stands for avoidant/restrictive food intake disorder. It is a diagnosed condition in which a person eats so little, or such a narrow range of food, that it affects their health or daily life. It is not about wanting to be thin or about body image.

Clinicians usually look for eating that leads to one or more of these:

• Significant weight loss, or poor growth or weight gain in a child
• A significant nutritional deficiency
• Reliance on a feeding tube or nutrition supplements
• Marked interference with daily life, such as school, social events, or family meals

Read more on our page about ARFID in children, or in what ARFID is.

Key differences

Range of foods. Picky eaters have a limited list; children with ARFID often have a very restricted and shrinking list.

Reaction. A picky eater may say "yuck." A child with ARFID may become very distressed, gag, cry, or refuse completely, sometimes because of fear of choking or vomiting.

Health effects. Picky eating usually does not affect growth. ARFID can lead to growth, nutrition, or energy problems.

Impact on life. With ARFID, mealtimes, outings, and social events can become very difficult.

Response to usual strategies. Common approaches like repeated exposure to foods tend not to work for ARFID on their own.

Who can diagnose ARFID?

ARFID is diagnosed by a medical or mental health provider, such as a pediatrician or a psychologist. A feeding therapist cannot diagnose it, but can evaluate the feeding problems behind it and treat them. If you are worried, start by talking to your pediatrician and describing exactly what your child does and does not eat.

When to get help

Do not wait for a label. If any of these is true, it is time to ask for an evaluation:

• Your child's list of accepted foods is short and getting shorter
• Growth, energy, or health are affected
• Meals cause real distress for your child
• Gagging or vomiting is frequent

Both picky eating and ARFID can be helped with the right support, and the first step is the same: a careful look at what is happening. Our article on signs your child may need feeding therapy can help you decide, and our quick check is a short place to start.

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