What to Do When Your Kid Won't Eat

If you’re a parent, you’ve likely spent some time wondering about the eating habits of your kids. Toddlers can seemingly go days with little more than single container of berries. Or suddenly decide that cookies are the only food that matters. The sight of eggs or anything green can cause meltdowns.

Even worse, today’s favorite could become tomorrow’s ‘ick.’

Picky eating is one of those things that’s developmentally appropriate, even when it’s also entirely frustrating. It can even be scary when you wonder if your child is getting the nutrients they need. You may wonder if your child’s picky eating borders on a more concerning condition. 

Avoidant restrictive food intake disorder (ARFID) can cause someone to limit their diet to only a few foods. From the outside, it can look a lot like picky eating. But there’s a world of difference between these two. Trying to treat ARFID as though it’s picky eating can actually make it worse .

Here’s what to know about picky eating, ARFID, and how to tell it apart from other eating disorders.

Picky Eating vs ARFID

To a certain extent, almost everyone’s probably been a bit of a picky eater. Being a little discriminating in what you eat isn’t a bad thing, and having preferences is very normal.

People who are picky eaters generally have a list of favorite foods, a much larger number of unsure foods (foods they’ll eat in some contexts or haven’t had much experience with), and a short list of foods they really cannot stand.

For people with ARFID, the list is much smaller.  This can cause their diet to dwindle to a very short list that doesn’t meet their nutritional needs. Which causes other problems.

Lack of Necessary Nutrients

In some ways, ARFID more closely resembles another eating disorder, anorexia nervosa. But while anorexia is driven by a distorted body image and fear of gaining weight, ARFID is really about the food itself.  

But regardless of motivation, the complications of not eating enough to sustain your body are serious. Eating disorders are acknowledged as having a high risk of severe bodily harm or even death.

Some of the complications of ARFID include:

• Bone fragility
• Malnourishment
• Heart problems
• Anemia
• Weight loss

Types of ARFID

So, if anorexia is primarily about weight and food, what is ARFID primarily centered on? Experts think there are 3 subtypes of ARFID based on what’s driving their food restrictions.

Avoidant

For a foodie, meals are about texture, taste, color, and smell. And people with ARFID experience those things just as viscerally. But negatively. The things they find unappealing (vivid colors, certain textures) might be so broad that there aren’t many foods left.

Aversive

If you’ve ever gotten food poisoning and had to give up a former favorite, you understand fear-based changes in eating. But for people with ARFID, it could be fear of something like choking, which could prevent them from eating any solid food.

It’s important to note that this fear may, or may not, be based on a past event. But what’s important now is that it feels powerful and real. Many have described the feeling of trying to force themselves as being forced to eat poison or food that’s obviously rotten.

Restrictive

Food takes up a lot of our time. Between making meals, cleaning up after meals, going to the grocery store to buy food for more meals, and then structuring social gatherings around it, we spend a lot of our waking lives preoccupied with it. But what if you didn’t feel any compulsion to eat at all?

Many of the people in this group don’t understand their body’s hunger signals.

Mixed Type

Many folks with ARFID fall into more than 1 of these categories. So imagine you don’t feel hungry and all food is sensorily off-putting. It would make it pretty hard to eat as much as you need to.

How Do I Know If My Child’s Picky Eating Is ARFID?

You may not. Especially in young kids, picky eating and ARFID do look a lot alike.

But overtime, it becomes clear that they differ. Children who are picky eaters may be able to push through a disliked food for the promise of desert.

Picky eaters without ARFID might see other kids or family members enjoying a food and be curious. They might smell, lick, or mash food with their hands, exploring it with their senses before eventually determining that it is, or isn’t, worth trying.

And picky eaters can be worn down. Most of the time you’ll need to offer a child a new food somewhere between 5-20 times before they’ll actually try it. (Remember Green Eggs & Ham? Ready to channel your best Sam-I-Am?)

ARFID only becomes more solidified over time.

But whether you’re dealing with extreme picky eating or ARFID, it’s worth bringing up to your pediatrician. And consulting with a dietitian to make sure your child is getting the nutrition they need is worthwhile.

What Is Treatment for ARFID Like?

The causes of ARFID are complex and sometimes layered. Which means that treatment also often requires more than one expert.

Sometimes doctors, mental health professionals, developmental pediatricians, and dietitians all need to come together. In addition to helping the patient, they also have to work with families, so healing can continue at home .

Picky Eating Treatment vs ARFID Treatment

“Let them be hungry” is frequently given advice for picky eating. And, for that purpose, it’s not bad advice. Making sure your child is hungry at mealtimes and learns to develop a cadence around food helps with developing healthy routines.

But for ARFID, that approach is not recommended. Can you imagine telling the parent of a child with an eating disorder to just let their child be hungry? But for families dealing with ARFID, it happens all too frequently. 

Can ARFID Be Avoided?

One thing picky eating and ARFID are absolutely identical in is that parents blame themselves. They think if they’d tried baby led weaning, or didn’t try it, or tried it….but did it differently.. that their child would be a ‘good eater.’

But the reality is that most likely, there’s nothing you did or didn’t do that caused your child to restrict their food intake. With the right support though, you can help them improve their relationship with food.