The Difference between ARFID and Picky Eating

What is ARFID?

Avoidant restrictive food intake disorder (ARFID) is extreme picky eating that makes it hard for a person to nourish themselves sufficiently, and to enjoy food. This looks like intense food aversions that can stem from a combination of many different things: sensitivities to certain food textures/smells, fears from actual or imagined experiences of choking or vomiting, and experiences of neurodivergence, loss and trauma.

The avoidance with food usually leads to issues with growth, health, and well-being. People with ARFID often feel slightly out of place in the eating disorder community given that this disorder doesn’t typically center around body image issues. However there are actually huge overlaps among all eating disorders- for instance, an eating disorder is just the tip of the ice burg— it’s an attempt to solve another problem.

Common signs & symptoms

There are definitely signs and symptoms associated with ARFID that can cue us into someone’s struggle with it. It’s important to be aware that many traits of ARFID reflect that of picky eating so it's critical to understand the differences in these two eating patterns to make proper distinction. The main difference between the two is that ARFID results in more extreme health consequences. 

Here are some of the signs that might clarify that someone is struggling with ARFID rather than just picky eating:

  • Weight changes or falling off a growth curve for children

  • Withdrawal from family and friends

  • Heightened anxiety around mealtimes

  • No longer eating foods previously enjoyed or eaten

  • Late onset of puberty/irregular menstrual cycles

  • A lack of interest or refusal of food

  • Lack of energy or dizziness

  • Fear-based food restriction

  • Nutritional deficiencies 

  • Abdominal pain

The signs and symptoms listed above are fairly general implications that someone may be dealing with an eating disorder, including ARFID. Let's dive into some more specific signs and symptoms particular to that of ARFID:

  • Distress when trying new foods or listening/watching other people eat

  • Eating only “white” or “beige” foods such as bread, chips, boiled rice, chicken nuggets and crackers

  • Sensory sensitivities to food textures, colors, tastes and/or smells

  • Eating limited foods prepared in a particular way

  • Fear of vomiting,  choking, nausea, or an allergic reaction to food

  • Only eating food of a specific brand or from a specific food outlet

As time progresses, food aversions may intensify, and thus identifying these issues early on can help mitigate future issues. Parents- don’t fret, there’s plenty to do to help your kid heal and enjoy food again, and we have resources at the end of this blog.

What age does arfid start

ARFID can definitely present in early childhood, but technically there’s not an exact age or age range that ARFID starts. Kids go through so many phases with food, and rejecting foods, liking a food one day and then not the next are actually really normal parts of healthy development. Know that really it is the repeated experience of avoiding foods, eating less and less variety or amounts, and losing the fun with food that are going to cue you into a bigger issue. It is not unusual for ARFID to persist into adulthood— we see it all the time! In fact, sometimes people show up to our clinic looking to get help with their chronic anemia or fatigue, and then we find it’s really ARFID that needs support.

What’s the Difference Between ARFID and Picky Eating?

To tell the difference between ARFID and picky eating, remember there are a few specific distinctions. Although picky eating may be frustrating it is not an eating disorder and it will not necessarily interfere with a child's health and development the same way ARFID does. For starters it is important to remember that picky eating is a normal and common trait in young children—unlike picky eating, ARFID is a chronic eating disorder and time alone will not resolve these issues. If an individual's food choices or food aversions worsen over time and you see your child really struggling to enjoy and have fun with food, it may indicate the presence of ARFID as opposed to that of picky eating. 

Another significant difference between typical picky eating and ARFID is the struggle to grow properly. With picky eating, individuals may avoid specific foods but can generally acquire sufficient nutrition and energy to support healthy growth trajectories. On the other hand, someone dealing with ARFID might need to rely on nutritional supplements and specific nutrition therapy as they get back to giving their body what it needs to grow.

Sensory issues are another clue that a person might be struggling with ARFID as opposed to picky eating. Picky eaters usually avoid foods based on appearance or smell while an individual with ARFID exhibits heightened sensitivities with increased anxiety concerning texture, taste, smell, and visual presentation. In the case of ARFID, this anxiety may be driven by a fear or choking or vomiting, or can be a consequence to past trauma. This person is not trying to be challenging or particular— their body and brain is just so overwhelmed when presented with food!

This discussion around anxiety brings us to our final key distinguisher of ARFID and picky eating. Individuals with ARFID may isolate or withdraw themselves from social settings, particularly those involving food. In contrast, a picky eater can participate in a social event without significant distress about the available food. The intense anxiety those with ARFID may face in these settings limits their ability to engage with others and leads to isolation. Adding in mental health therapy alongside nutrition support can really help someone navigate this part.

The difference between ARFID and picky eating comes down to impacts on health, relationships and enjoyment, and sensory and emotional difficulties. It can be treated!

What happens if arfid is left untreated?

Left untreated, health consequences occur, but relationships typically get stressed too. Parents may notice that eating with their child is just plain hard— either resulting in food power struggles, or too many “special” meals are needed to get your child to eat. For those with a highly selective diet where several food categories are limited, significant nutrient deficiencies may come up affecting growth and mental health.  As a result of this other issues can pop us like: anemia, low bone disease, low blood pressure, loss of period, fatigue, and increased anxiety and depression.

If you or someone you know might be struggling with ARFID, be sure to get them assessed! Parents can use our course “I think my child might have an eating disorder” as a starting place.

ARFID is treatable, so reach out for support and know there are many other resources available to you:

National Eating Disorders Association: Call or text the helpline at (800) 931-2237, or visit the website to chat online / or click here for local treatment options. 

211: Call 211 to speak to someone who can give you a referral for help. Visit the website to learn more.

National Suicide Prevention Lifeline: Dial 988 or 800-273-8255 to connect to someone who can help if you're in a crisis.
F.E.A.S.T provides support and education resources to parents and caregivers of loved ones impacted by eating disorders.

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Grace Lautman, MS, CN, LMHC
Grace Lautman, MS, CN, LMHC

Grace Lautman is a licensed mental health counselor and a certified nutritionist in the state of Washington. She is the owner of Honor Nutrition & Counseling and an expert in the treatment of eating disorders and trauma.

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