As some parents can attest, “picky eating” is extremely common among children of all ages. Some kids may love green vegetables, others won’t. Some may despise the soft texture of oatmeal. Others might only eat bread if there’s peanut butter on it. And some might only prefer a diet confined to mac and cheese or chicken nuggets. In the end, every child has their own set unique practices and preferences.

Most children will naturally begin to expand their dietary repertoire as they grow. For others, though, picky eating might not just be a phase – it may actually represent symptoms of a more serious problem. Avoidant Restrictive Food Intake Disorder (ARFID) is a condition when eating habits or patterns become too extreme, leading to significant nutritional deficiencies, energy loss or delays in weight gains.

Before you go perusing the Internet thinking your child might have ARFID, here are some key distinguishers of ARFID versus picky eating:

  1. Avoidance of food for sensory reasons. Children exceptionally sensitive to temperature, taste, smell, sight and texture are more prone to more serious feeding or eating disorders. Children with ARFID will often refuse to eat food because of its smell, appearance or texture. This commonly includes foods with a more pronounced texture or smell, such as sulfurous vegetables or grapes that are “too soft,” for instance.
  2. Fear of perceived negative consequences of eating.” Individuals with feeding or eating disorders will avoid numerous foods or entire food groups based on perceived negative consequences. These fears range from bloating to vomiting, choking, stomach pain and/or GI distress.
  3. Little interest in food or eating. In cases of ARFID, the lack of interest or desire to eat in is independent of any concerns related to weight or appearance, or attributable to other medical conditions. Food and/or eating is often simply deemed as unenjoyable. .
  4. Nutritional deficits. While few children will eat anything and everything, most children are properly nourished. Children with ARFID often present with nutritional deficits such as weight loss or failure to gain weight expected for height, anemia, bone loss or stunted growth.
  5. Problems with friends/school/relationships. ARFID can also result in social deficiencies. One may avoid gatherings involving food, isolate from friends, demonstrate poor concentration or exhibit greater anxiety than peers. .

Again, picky eating is quite common and most cases likely don’t require any medical intervention. But cases can involve a more serious, underlying illness, such as ARFID. Understanding the distinction between normal “picky eating” and ARFID is essential for early intervention and treatment.

If you’re still unsure – or looking for treatment options – Walden is here to help you. We offer one of New England’s only dedicated pediatric program specific to children with ARFID and other feeding disorders.


Laura Roias is director at Walden’s Worcester clinic providing clinical, administrative and fiscal oversight and development for the clinic. Formerly, she was assistant director of Walden’s partial hospitalization and intensive outpatient programs where she obtained extensive experience conducting individual, group and family therapy. Ms. Roias employs a strengths-based perspective and uses a wide range of therapeutic modalities including cognitive behavioral, dialectical behavioral and interpersonal therapy. She received her master’s from the University of North Carolina.