Are you confused between what is “just picky eating” and what is Avoidant Restrictive Food Intake Disorder (ARFID)? It can sometimes be challenging to differentiate between the two because they are on the same spectrum, yet different in key ways. As an individual with eating concerns, a loved one or even a treatment provider, having a way to look at the different aspects of ARFID in a quick, easy format can at least give you a start in exploring and discussing what is truly going on.
This blog will provide information on ARFID and a quick, easy tool for looking at ARFID Eating Disorder: Is it Picky Eating or ARFID. While “picky eating” is a descriptor for behavior around not liking or wanting certain foods, ARFID is an eating disorder first described in the Diagnostic and Statistical Manual-Fifth Edition in 2013 (updated in 2020).
ARFID and Weight
Are you or a loved one struggling with malnutrition, weight loss or weight gain? Not all individuals with ARFID look or act the same or have exactly the same concerns when it comes to food. While the first two criteria for the diagnosis address underweight and growth concerns (significant weight loss, failure to grow as expected in children), the others refer to nutritional deficiency, dependence on nutritional support (supplements), and/or marked disturbance of psychosocial functioning (interfering with your social life).
Individuals who are at or above average weight are not always recognized as having ARFID. However, they can be equally as nutrient deficient as individuals at a lower weight, have very few foods they are able to eat, and can struggle to be in social settings where they have no access to their safe foods. Because some individuals eat from mainly one food group, often grains, they may overeat these particular foods in attempts to feel satisfied, and risk weight gain due to the imbalance of their meals/snacks.
For others, weight loss is a concern due to lack of interest in food, choking or gagging, change in taste, or packaging, of food that causes fear or disgust around eating “newer” versions of a “safe” food.
ARFID and Lack of Interest in Food
Do you or someone you know tend to forget to eat, not want to go to the table when called or not have an interest in seeking food, even when it is readily accessible? Does eating feel like a job or a chore, and you’d much rather be doing something else? You or your loved one could have ARFID.
Individuals with ARFID may or may not have a lack of interest in food, but for those who do, it is certainly a challenging concern. Those individuals struggle with:
Lack of hunger/fullness cues such that there is no mental trigger to cause them to think about and seek food; these individuals will likely need external support including alarms, reminders, and friend/family support to establish eating routines
Lack of recognition of hunger/fullness cues if they occur; hunger cues are there in some way but are not identified as such. Hunger cues can be more than stomach growling, they can be reflected in mood, energy level, and physical symptoms like dizziness and headache. Chapter 7 in the Bridge the Food Gap: An ARFID Recovery Workbook helps individuals create their own hunger/fullness scale.
Ignoring hunger/fullness cues meaning that an individual experiences hunger but still does not seek food.
ARFID, Impact on spending time with friends and family
Do you or a loved one avoid social interactions due to fears that you will be asked to stay for a snack or meal? Do you hang out with friends and not eat anything while you are with them, even if they eat? Do you have trouble traveling to new places out of fear that there won’t be anything you can eat?
ARFID can greatly impact our willingness to socialize, as well as our ability to keep ourselves nourished in social settings. Parents and loved ones struggle with the stress of making sure that safe foods will be available.
ARFID, Anxiety and Disgust
When distinguishing between picky eating and ARFID, another key feature is the intensity of the experience of anxiety and/or disgust when thinking about, looking at, smelling or otherwise experiencing new foods. Picky eaters will push away or choose not to eat certain foods, but the intensity of emotional reactions are much more severe in ARFID. Individuals with ARFID will have strong reactions to food based on the foods’ taste, texture and smell, including completely avoiding the foods, spitting them out, or gagging/vomiting foods that they find aversive.
In conclusion, picky eating and ARFID can be considered to be on a spectrum when we look at the severity of the reaction to things like anxiety, disgust, interest in food, and impact on social life. In other ways, ARFID stands out as separate from picky eating in its health concerns and fears of choking, gagging, disinterest in food, and how severe the reactions are to taste, texture and smell.
ARFID Eating Disorder Quiz
Check out the ARFID Eating Disorder Quiz. This free tool will assess picky eating vs ARFID. Please remember this is just a quick way to see how much you or your loved ones picky eating is affecting them. Take this quiz to your medical provider, therapists, or dietitian for further evaluation. Please refer to our references and resources page for more information and support.
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