The difference between ARFID and ‘picky eating’

This Eating Disorders Awareness Week, we’re shining a spotlight on ARFID (avoidant restrictive food intake disorder). Having only been medically recognised in 2013, there are many myths and misconceptions surrounding ARFID, with individuals mistakenly labelled as ‘picky eaters’. But here is how they differ. 

ARFID, an abbreviation for Avoidant/Restrictive Food Intake Disorder, is an eating disorder distinguished by avoidant or restrictive food preferences, affecting about 1% of children and 5% of adults. 

Despite its prevalence, ARFID remains relatively unknown compared to other eating disorders, and people are often mislabeled as “picky” or “fussy” eaters, when in fact they are dealing with a devastating and highly distressing condition. 

ARFID and “picky eating” share some similarities in terms of selective eating habits, but they are profoundly distinct in their severity, impact, and underlying causes. 

“Picky eating” is a common phase in childhood, characterised by a child’s selective food preferences. Here, children may refuse certain foods based on taste, texture, or appearance, often showing strong reactions such as tantrums or refusal to eat. Despite this, picky eating typically does not result in significant weight loss or nutritional deficiencies, and most children grow out of this phase as they become more adventurous and curious with food. 

ARFID, however, involves severe and persistent restrictions in food intake that lead to significant nutritional deficiencies, impaired growth, and interference with social functioning. 

Unlike picky eating, ARFID is not just a childhood experience and can persist into adulthood if left untreated. Individuals with ARFID may have a limited range of acceptable foods due to sensory sensitivities, fear of choking or vomiting, or other “aversive” experiences related to eating. 

Another key difference between ARFID and picky eating is the level of distress or impairment experienced by the individual. 

While picky eating may cause frustration or inconvenience for parents and caregivers, ARFID often leads to profound anxiety, social isolation, and significantly impacts the quality of someone’s life. ARFID can also co-occur with other conditions such as anxiety disorders, obsessive-compulsive disorder (OCD), or autism spectrum disorder (ASD). 

As a serious eating disorder, ARFID requires a comprehensive, specialist assessment by a qualified healthcare professional. Once assessed, treatment typically involves a multidisciplinary approach, including dietetic sessions, one-to-one psychotherapy sessions, and perhaps psychiatry or occupational therapy – all tailored to address the individual’s specific needs and challenges related to food and eating. 

In summary, whilst both ARFID and picky eating involve selective eating habits, ARFID is characterised by severe and persistent restrictions with food that results in significant physical and psychological consequences. Recognising the differences between these two conditions is essential for early intervention and appropriate treatment to improve someone’s physical and mental health.  

Are you concerned about your relationship to food and eating? Contact our Admissions team to learn more about Orri’s treatment. 

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