Picky Eating vs Eating Disorders: Does Your Child Need Help

For some parents, every meal can feel like a battle. When a child refuses to eat you may wonder if there is a medical or mental health problem behind the struggle. Understanding the difference between picky eating vs eating disorders can help you decide whether your child needs help developing a healthy and balanced diet.

Is Picky Eating an Eating Disorder?

Most children experience picky eating at some point. Toddlers and children often use food to test boundaries and establish a sense of self. Technically, any irregular eating habits can be considered “disordered eating.” However, for most children this is temporary, and mild to moderate. When selective eating habits continue or become especially severe, they may be caused by an eating disorder that and can negatively affect your child’s physical health.

Eating disorders are mental illnesses most easily identified by the person’s abnormal eating habits. Depending on the type of eating disorder, it will often involve unhealthy preoccupation with food, body weight, appearance, or body image. As children become teenagers, the social pressures can sometimes push otherwise healthy children into disordered eating patterns that, if left unaddressed, can cause serious physical harm. Most eating disorders emerge between the ages of 12 and 25, but some children experience them earlier. Knowing the difference between picky eating and an eating disorder is important for parents to understand how to best help their children.

ARFID is More Than Just Picky Eating

Sometimes, prolonged or extreme “picky eating” is actually an eating disorder called Avoidant/Restrictive Food Intake Disorder (ARFID). People with ARFID severely restrict what and how much food they eat because of:

• Fear of choking, vomiting, or stomach pains
• Previous food-based trauma
• Sensitivity to taste, smell, appearance, or mouthfeel of foods
• Lack of interest in eating
• Social concerns about eating around others
• Worry they have food allergies or intolerances

Children with ARFID may refuse to eat food based on color, texture, or smell of the food offered. They may also claim to be full at mealtimes, or resist trying new foods. Teens and adults may try to supplement their eating with pills, shakes, or other supplements.

ARFID can have severe physical health consequences because children with the disorder do not get enough calories or nutrients. The eating disorder can cause:

• Digestive issues and stomach cramps
• Trouble concentrating
• Weight loss or low body weight
• Dizziness and fainting
• Fatigue
• Constipation
• Dry skin
• Hair loss
• Low blood pressure
• Rapid heartbeat
• Intolerance to cold
• Irregular menstrual cycle in girls

Anorexia and Bulimia: Where Body Image and Eating Issues Intersect

The two most famous eating disorders, Anorexia Nervosa and Bulimia Nervosa operate slightly differently. Unlike picky eating and ARFID, they often have more to do with the way a child or teen sees their physical appearance or the act of eating, than with the food itself. Anorexia limits the intake of food, usually because of a distorted body image and an effort not to gain weight. Bulimia involves binge eating and purging (most often by vomiting) based on shame or guilt around eating or gaining weight.

Both Anorexia and Bulimia can cause serious harm to a child’s body. Anorexia can cause malnutrition and severe weight loss. Bulimia can do the same, as well as cause damage to a child’s digestive system caused by repeated induced vomiting.

How to Help Your Child Overcome Disordered Eating

One of the best ways a parent can tell the difference between picky eating and an eating disorder is to talk to your child about their food choices. Rather than demanding that your child eat new or more food, find out what it is about the food that makes your child unhappy. Are they uncomfortable while eating or after they eat? Do they feel fear about their food? Or are they worried about how the food will make them look? By having non-judgmental discussions about your child’s feelings and preferences, you can get clues about what type of eating disorder your child may be facing.

Next, you should talk to your child’s pediatrician about their eating habits. The most effective treatments of eating disorders involve medical, dietary, and mental health treatment working together. Your child’s doctor may be able to prescribe medicines to address physical discomfort. A dietician can help you develop a balanced diet and shore up nutrient deficiencies. A psychotherapist can help your child understand and address the underlying cause of the disorder, addressing the fears, guilt, shame, and anxiety that is making them more than just a picky eater.

David Stanislaw is a psychotherapist with over 30 years of experience. He helps children, teens and adults with eating disorders and other psychological issues. Contact David Stanislaw to get help today.