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What Is The Difference Between “Normal Picky Eating” and Extreme Picky Eating/ARFID?

By Debra Kissen

Picky eating is a common phase in childhood, a rite of passage for many parents who find themselves negotiating over vegetables and trying inventive ways to make food appealing. However, there is a significant distinction between what we call “normal picky eating” and a more severe issue known as Avoidant/Restrictive Food Intake Disorder (ARFID).

Understanding Normal Picky Eating

Normal picky eating typically emerges in toddlers and young children as they develop their food preferences. This stage is marked by behaviors such as:

  • Refusing to try new foods
  • Eating only a limited variety of foods
  • Strong preferences for certain textures or colors

While frustrating, normal picky eating generally does not impact a child’s overall growth, development, or health. Over time, with patience and exposure, most children outgrow these habits.

When Picky Eating Becomes Concerning: ARFID

On the other hand, ARFID is an extreme form of picky eating that extends beyond typical developmental phases. It is characterized by:

  • Severe restriction in the variety or quantity of food consumed
  • Intense fear of trying new foods or aversion to foods based on texture, smell, or appearance
  • Significant nutritional deficiencies or weight loss
  • Interference with social functioning due to eating habits

Individuals with ARFID often experience a profound impact on their physical health and emotional well-being, making it essential to recognize and address the condition early.

How Light On Anxiety Approaches ARFID

At Light On Anxiety, we understand the complexities of ARFID and the challenges it presents for both individuals and their families. Our approach is comprehensive and evidence-based, focusing on Cognitive Behavioral Therapy (CBT) to address the underlying anxiety and behavioral patterns associated with ARFID.

Our treatment approach includes:

  1. Individualized Assessment: We begin with a thorough assessment to understand the unique factors contributing to each client’s eating behaviors and anxiety.
  2. Exposure Therapy: Gradual exposure to feared foods helps desensitize the individual to anxiety-provoking stimuli. This step-by-step process is carefully tailored to ensure comfort and progress.
  3. Cognitive Restructuring: We work on identifying and challenging negative thoughts and beliefs related to food, eating, and body image.
  4. Parental Involvement: Involving family members is crucial for success. We provide parents with strategies to support their child’s progress and create a positive eating environment at home.
  5. Nutritional Guidance: Collaboration with nutritionists ensures that clients receive balanced, nutritious meals that meet their dietary needs while respecting their preferences and limitations.
  6. Mindfulness and Relaxation Techniques: Teaching relaxation methods helps manage anxiety related to eating and promotes a calmer approach to meals.

Our goal is to empower individuals with ARFID to expand their food choices, improve their nutritional intake, and enhance their overall quality of life. By addressing both the psychological and physical aspects of ARFID, we strive to foster lasting change and resilience.

Recognizing the difference between normal picky eating and ARFID is the first step in seeking appropriate help. If you or a loved one is struggling with severe picky eating, know that you are not alone. At Light On Anxiety, we are here to provide the support and tools needed to navigate this journey towards healthier eating habits and improved well-being.

Role Play Of What To Expect When Engaging In ARFID/Picky Eating Exposure Exercise

Take This ARFID/Picky Eating Screener to Assess If You or Your Child May Meet Diagnostic Criteria For This Condition

The PARDI ARFID Questionnaire: a self-report multi-informant measure of the key features of avoidant restrictive food intake disorder, can be used to predict a likely diagnosis of ARFID and measures the severity of impact of self-reported ARFID symptoms and ratings of common ARFID features (sensory-based avoidance; lack of interest in eating or food; and concern about aversive consequences of

The PARDI-AR-Q does not include evaluation of the exclusion criteria for an ARFID diagnosis,
which include the presence of other possible disorders that may account for the feeding and
eating difficulty (e.g. anorexia nervosa, bulimia nervosa, or another concurrent medical
condition or mental disorder that may account for the eating disturbance).

Source: Bryant‐Waugh, R., Micali, N., Cooke, L., Lawson, E. A., Eddy, K. T., &
Thomas, J. J. (2019). Development of the Pica, ARFID, and Rumination Disorder Interview, a
multi‐informant, semi‐structured interview of feeding disorders across the lifespan: A pilot
study for ages 10–22. International Journal of Eating Disorders. 52(4):378-387)
The PARDI-AR-Q (Bryant‐Waugh, R., Eddy, K. T., Micali, N., Cooke, L., & Thomas, J. J. (2019).

Dr. Debra Kissen is CEO of Light On Anxiety CBT Treatment Center. Dr. Kissen specializes in Cognitive Behavioral Therapy (CBT)...

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