Picky eaters vs. Restrictive eaters...

Ever wonder if your child’s picky eating is more than just picky eating?

While the majority of toddlers and young children experience some type of picky eating as a normal part of their childhood development, there is a line where normal picky eating can become dangerous.

For many parents, having young children means plenty of negotiating to get them to eat their vegetables, taste new foods or finish what’s on their plate.

There are different types of restrictive eating behaviors that vary in severity.

• These range from general picky eating to more extreme eating disorders, such as avoidant restrictive food intake disorder (ARFID). There are several key differences when considering ARFID vs. picky eating

Picky Eaters

Picky eating is quite common during childhood. Picky eating involves avoidance of certain types of foods (often vegetables) as well as having very clear preferences for certain foods and generally avoiding new foods.

Signs of a picky eater might include:

• Lower weight than non-picky eaters

• Behavior problems

• Refusal to accept or try a wide range of foods

• Eating only very specific foods

• Eating very slowly

Although these signs and symptoms can be very frustrating for parents, they do not necessarily mean that a child has an eating disorder. In fact, there are several key points that are unique to picky eating:

• Children will likely outgrow this phase

• Picky eaters can function normally in social situations involving food

• Picky eaters do not allow fears to drive their eating choices

• Picky eaters are interested in eating the foods they enjoy

Individuals with ARFID

In the Diagnostic and Statistical Manual of Mental Disorders version 5 (DSM-5), criteria for an eating disorder for ARFID includes significantly low weight, reliance on supplementation for nutritional needs and significant impact on normal functioning.

Some of the main signs and symptoms that could indicate ARFID are:

• Failure to maintain a healthy weight

• The need for feeding tubes or supplements to receive appropriate nutrition

• Experience anxiety leading up to or during social events that serve food

• Avoidance of food based on sensory aspects or fear of negative consequences (taste, choking, etc.)

• Lack of interest in food

These ARFID symptoms can have a significant impact on how a child behaves and whether they are able to live normally. This can also be very distressing for parents, as these symptoms can impact their child’s development and, in severe cases, have long-lasting effects. Addressing ARFID symptoms can improve nutrition status and long-term health.

Treatment for ARFID

Because picky eating is quite common in children, parents may feel like their concerns and frustrations are not heard or not taken seriously. This can make it difficult to get treatment for children with ARFID.

However, there are several ARFID treatment options available that can address some of the fears or anxieties related to food, target behaviors surrounding food and focus on re-nourishment and weight gain. One of the focus's is on establishing a clear idea of how to achieve adequate nutritional status. This is often done by a paediatric Dietitian. However, treatment for ARFID must address the underlying anxiety or fear that is causing food avoidance or restriction.

Some of the possible treatment options for ARFID include:

• Family therapy

• Cognitive-behavioral therapy

• Treatment of anxiety

• Weight gain and re-nourishment strategies

The best treatment strategies for parents and children dealing with ARFID depend on the individual as well as the severity of the condition. We recommend booking an initial consultation with our expert paediatric dietitian in which she can do a nutritional assessment, and provide practical solutions to increase your child's food variety. She may also prescribe an appropriate oral nutrition supplement to start taking.

Click HERE to download our FREE children's nutrition guide.

We are always happy to help, The Nutrition and Co team.