Is It Picky Eating or ARFID?

By: Brittany Gage, MS, RDN, LN, CD, Owner of Healthy Bee Dietitian PLLC

Many parents and adults struggle to understand whether eating habits are “normal picky eating,” personal preference, or something more serious like ARFID (Avoidant/Restrictive Food Intake Disorder). Mealtimes can quickly become a daily challenge—especially when a child or adult seems to rely on only a handful of foods. While picky eating can be a normal part of growth and development, ARFID is a clinically recognized eating disorder that can significantly impact nutrition, growth, and overall quality of life. For caregivers, parents, friends, or partners supporting someone with ARFID, understanding the difference between picky eating and ARFID is an essential first step toward getting the right help.

What Is ARFID?

ARFID stands for Avoidant/Restrictive Food Intake Disorder. It is an eating disorder that does not stem from body image concerns. Instead, it is characterized by a significant reduction in the amount or variety of food a person eats. This avoidance is often linked to sensory issues, fear-based reactions, or a low interest in eating.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), ARFID involves one or more of the following ¹:

• Significant weight loss or difficulty gaining weight

• Nutrient deficiencies

• Dependence on supplements or formula for adequate nutrition

• Interference with social functioning

ARFID typically shows up in three main presentations:

• Sensory-Sensitive ARFID: Avoidance due to texture, smell, taste, or appearance ²

• Fear-Based ARFID: Avoidance linked to fears of choking, vomiting, gagging, or a past traumatic experience ²

• Low-Interest ARFID: Low appetite or minimal interest in eating, even when food is available ²

What Is Picky Eating?

Picky eating is a normal—though often frustrating—part of childhood development. Many children go through phases where they prefer familiar foods, resist trying new ones, or insist their foods are prepared a certain way (or served on a certain plate). Adults can also have food preferences, but they are typically more capable of meeting their nutritional needs independently.

Picky eating usually improves with repeated exposure, patience, and a low-pressure environment. Common characteristics of picky eating include:

• Preference for familiar foods, but still accepting a variety

• Hesitancy to try new foods, but warming up with time

• Adequate intake to support healthy growth and weight

• Minimal distress or anxiety around food

• No significant disruption to daily routines or functioning

Key Differences Between ARFID and Picky Eating

1. Motivation Behind the Behavior

ARFID: Avoidance is driven by fear (choking, vomiting), sensory sensitivities, or low appetite.

Picky Eating: Typically driven by taste preference; avoidance is mild and often temporary.

2. Impact on Health

ARFID: May cause weight loss, poor growth, nutrient deficiencies, or medical complications.

Picky Eating: Does not compromise overall health or nutrition.

3. Emotional Response

ARFID: Severe anxiety, panic, or distress when presented with certain foods; may gag or refuse to sit at the table.

Picky Eating: Mild annoyance or resistance, without significant anxiety or fear.

4. Flexibility

ARFID: Rigid food list; new foods feel overwhelming or distressing.

Picky Eating: Gradual flexibility with time and low-pressure exposure.

5. Functional Impairment

ARFID: Avoids social situations, school events, or family meals due to food-related anxiety or limitations.

Picky Eating: May be inconvenient but does not interfere with participation or social functioning.

Red Flags That May Indicate ARFID

If you’re unsure whether eating behaviors go beyond picky eating, the following signs may indicate ARFID:

• Eating fewer than 20 total foods

• Sudden refusal of foods after a choking or vomiting event

• Extreme sensitivity to texture, temperature, or smells

• Gagging or vomiting when trying new foods

• Limited appetite or seeming “never hungry”

• Reliance on supplements or nutritional drinks

• Difficulty meeting growth expectations

• Avoiding restaurants, family meals, or social events involving food

If several of these signs resonate, an evaluation by an eating disorder–trained dietitian or therapist can be extremely helpful.

If you suspect you or your child may be struggling with ARFID, you don’t have to navigate it alone. As a dietitian specializing in eating disorders, I provide evidence-based, weight-inclusive support to help individuals expand their intake, reduce anxiety, and reconnect with their bodies in a safe and nourishing way.

Click here to schedule a consultation or learn more about my services.

Resources:

1. Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 22, DSM-IV to DSM-5 Avoidant/Restrictive Food Intake Disorder Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t18/

2. Thomas JJ, Wons OB, Eddy KT. Cognitive-behavioral treatment of avoidant/restrictive food intake disorder. Curr Opin Psychiatry. 2018 Nov;31(6):425-430. doi: 10.1097/YCO.0000000000000454. PMID: 30102641; PMCID: PMC6235623