Picky Eating Vs ARFID
As awareness of Avoidant/Restrictive Food Intake Disorder (ARFID) continues to rise, a common (and problematic) correlation to “picky eating” continues to follow in its path. So when does picky eating become something more serious? What is the difference between picky eating and ARFID?
Not only is there a vast spectrum of feeding difficulties, many people are unsure of how to obtain appropriate support when more is warranted. If you or your loved one is struggling with food, you don’t have to go through it alone.
What is Picky Eating?
While there is no agreed-upon definition of picky eating, it is referred to when an individual presents as more selective or anxious around certain foods or food groups. Picky eating can show up for a variety of reasons and is considered developmentally appropriate in childhood, often decreasing or disappearing over time.
What is ARFID?
ARFID is so much more than picky eating; it is characterized as a limited food intake or avoidance of certain foods, causing significant medical and/or social impairment. Those who have ARFID have a limited food intake due to either lack of interest, sensory sensitivities, fear of adverse consequences such as choking, or a combination of the three. While someone can have ARFID and struggle with negative body image, food intake is not impacted by body image like other eating disorders.
Key Differences
There are a few differences in picky eating and ARFID. While sensory sensitivities may be at play in picky eating, fear of adverse consequences or lack of interest typically are not. If you notice a significant amount of anxiety at dinner time or an indifference to food where food could be forgotten about, you may want to get assessed.
The key difference between picky eating (which remember, can have quite a range) and ARFID is based on the impact of quality of life. ARFID can cause delays in growth, nutrient deficiencies, and impaired social functioning.
When to Get Help
It can be hard to know when to get more support for food concerns. For parents of kids struggling, there can be varying feedback as to how to proceed. Some parents come into my office, telling me that they were told not to worry because their child would “grow out of” the picky eating, only to have matters get worse. Parents—you are the expert of your kid. Trust your instincts and get a second opinion if you feel as if something is needing more attention.
For adults struggling with food, there can be shame in the stigma of being “picky” (this word in and of itself can hold so much judgment) or struggling with food intake. Know that ARFID and related eating difficulties can occur at all ages—you are not alone and you deserve support.
What Does Support Look Like?
Support for ARFID can look different based on needs, but the following clinicians can be helpful:
-A therapist can support in managing the emotional and social components that arise with ARFID. Therapists who treat ARFID may use CBT-AR (Cognitive Behavioral Therapy for ARFID) or ERP (Exposure Response Prevention), but it is important to make sure it is trauma-informed and neuro-affirming.
-A dietitian can support in addressing any nutritional deficiencies in addition to supporting with food exposures, if appropriate.
-A primary care physician can help monitor physical health, such as ordering lab work, or provide medications such as anti-nausea medication.
-An occupational therapist or SLP can help with difficulties related to chewing, swallowing, or food sensitivities.
-A psychiatrist can support with medication management. While there is not a particular medication used to treat ARFID, some people benefit from medication management if there are co-occurring concerns such as anxiety, depression, or ADHD.
Get Support Today
If you would like more information regarding therapy for ARFID, I encourage you to reach out today for a free 15 minute consultation call.