When “picky eating” becomes an eating disorder

8th Mar 2020
Ingress Healthcare

By Lize Van Der Merwe, Registered Dietician

Numerous parents report “picky eating” in their young children, especially during the toddler years. Often, this will involve a child refusing certain foods, which leads to stressful mealtimes and parents worrying about their child not eating enough.

Frequently, picky eating can be addressed by changing the eating environment, adjusting parenteral behaviours and adopting a regular mealtime routine.

However, when should you start worrying about your child’s picky eating, and when does it become an eating disorder?

Avoidant Restrictive Food Intake Disorder (ARFID) is a new diagnosis in the DSM-5 for severe restrictive food intake. This disorder is diagnosed in children and adults and can be challenging to deal with in the family context.

There are distinct differences between picky eating and AFRID. ARFID is diagnosed when an eating or feeding disturbance results in:

Significant weight loss

Failure to gain weight and height as expected

Nutrient deficiencies (i.e. vitamins, protein and minerals)

Dependence on nutritional supplements interference with psychosocial functioning

The feeding disturbance may include a lack of interest in eating, avoiding certain foods based on texture, smell or mouth-feel and concern about the consequences of eating, e.g. stomach ache or nausea.

There are similarities between AFRID and anorexia, in that both disorders involve restriction in the food types and the amount consumed. However, AFRID does not include distress about body size or shape.

When assessing a child for AFRID, it is important to rule out other causes of eating disturbances, such as food availability, medical and other mental health disorders and culturally sanctioned practices.

If you are concerned about your child’s picky eating or notice any of the disturbance mentioned above, contact an experienced Dietitian to guide with further management and treatment.

Book a consultation with Lize Van Der Merwe, a registered Dietician and empower yourself with the knowledge to make the correct decisions for yourself and your family.

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