Selective Eating Disorder vs. Picky Eating
Is it Selective Eating Disorder or Picky Eating?
Eating disorders vary in severity from general picky eating to a much more severe form of eating disorder such as Selective Eating Disorder. While all eating disorders are concerning, let’s look at the differences between Selective Eating Disorder and Picky Eating.
Selective Eating Disorder (SED) (now known as Avoidant Restrictive Food Intake Disorder (ARFID) on the new DSM-5) has sometimes been referred to as Picky Eating. Although there are similarities between the conditions and both generally consist of an individual limiting their food options to usually less than 20 foods, we’ll look into the key differences in more detail.
Selective Eating Disorder or ARFID differs from other disorders such as anorexia since it is not a choice that the individual is making, rather the idea of trying new foods is considered “unsafe” and the actual thought of doing so is typically quite traumatic.
Picky eating is quite common during childhood and affects between 8% to 50% of children and 58% of those affected will recover within two years. Picky eating can be defined as a toddler, child or adult who limits their amount and variety of food often eating only a specific set of foods, severely narrowing their choice of vegetables or avoiding them completely, is unwilling to try new foods, and has strong and strict food preferences. This frequently leads to the individual having a separate meal from the rest of the family. The longer picky eating lasts, the more likely nutritional imbalances occur.
There is evidence that picky eaters in childhood likely will weigh less than non-picky eaters as a result of reduced caloric intake, and later in childhood experience behavioral problems and often go on to experience anorexia nervosa in adolescence.
Differences between Selective Eating Disorder and Picky Eating
There is not a one-size-fits-all symptom and experience for those that receive this diagnosis. Each person is unique and the how and why they have gotten to the place of this condition is also unique. The following is not an all-inclusive list as there are many signs and symptoms which vary by individual.
Selective Eating Disorder/Avoidant Restrictive Food Intake Disorder |
Picky Eaters |
| Avoids food due to previous traumatic experience, sensory issues, fear of choking, fear of taste | Refuse to try new foods or a variety of foods by preference and not fear |
| Unable to maintain a healthy weight and often diagnosed with “failure to thrive” | Weighs typically less than non-picky eaters |
| Lacks interest in foods and/or eating – repulsed by thought of new food introductions | Typically will eat foods they enjoy |
| Experiences anxiety around food leading up to and during social situations | Most often will not have social anxiety when in a group and will find a food they enjoy |
| Behavioral problems may result with nutrition imbalances | Behavioral problems |
| Often results in a need for feeding tubes and supplementation for essential nutrients | Eats more slowly |
| Absence of concern over body image or weight gain | Foods cannot be combined or touching other foods |
Since ARFID, SED and also picky eating affects the person’s nutritional and metabolic health due to the inability to meet basic essential nutritional needs, it is very important to receive help as early as possible. Multiple mental and physical symptoms may also be appearing in ARFID, SED and in picky eaters. This list is not all-inclusive. Long-term picky eating may lead to Avoidant Restrictive Food Intake Disorder a/k/a Selective Eating Disorder. Therefore, the longer picky eating continues, the more mental and physical symptoms may appear. Symptoms to watch for:
- sleep disturbances
- hair loss, thinning of hair
- dry/brittle nails
- dry skin
- lack of concentration
- fainting/syncope
- muscle weakness
- poor wound healing
- gastrointestinal issues (stomach cramps due to constipation, acid reflux, abdominal pain)
- cold hands, feet
- lower body temperature
- slower heart rate
- lower immunity to colds, viruses
Persons may feel the inability to cope well with general everyday living since nutrient depletion is typically severe by the time of ARFID/SED diagnosis. Various behavioral symptoms may also be experienced.
Who Does ARFID or Selective Eating Disorder Affect?
Avoidant Restrictive Food Intake Disorder (ARFID) and Selective Eating Disorder (SED) can affect both children and adults. As mentioned earlier, this condition often begins as picky eating and progresses in time to become ARFID/SED.
Although reasons vary for who may experience ARFID, people on the autism spectrum, those with ADHD and those with intellectual disabilities are more likely to develop this condition.
What Can I Do for Selective Eating Disorder and Picky Eating?
New data released by the CDC on February 17, 2023 analyzed from the 2021 National Survey of Children’s Health (NSCH) of 18,386 children aged 1-5 showed eye-opening results. According to parent reporting, “during the preceding week, approximately one in three (32.1%) children did not eat a daily fruit, nearly one half (49.1%) did not eat a daily vegetable, and more than one half (57.1%) drank a sugar-sweetened beverage at least once”. (italics are my emphasis)
Researchers have looked into the eating habits of those aged 4-9 and found that children who were picky eaters early on tended to stay picky eaters. It’s important to introduce a variety of healthy foods and avoid the processed foods and sugary drinks early on with your children to help avoid these tendencies. If your picky eater has emotional dysregulation, there may be something more that needs to be addressed. The point is: don’t wait. Look for the signs and address them as needed. The earlier the intervention occurs the better the outcome.
As with all forms of eating disorders, it often takes a team of professionals to help with these conditions. Some options to look into are:
- Cognitive behavioral therapy (CBT)
- Family therapy
- Individual therapy
- Nutrition professional
Better with Nutrition’s Selective Eating Disorder, Avoidant Restrictive Food Intake Disorder, Apprehensive Eater, and Picky Eaters Dietary Program
As a nutrition professional, Better with Nutrition has created a complete dietary program specifically to help those with the eating disorders SED, ARFID, the apprehensive and picky eater. The Selective Eating Disorder and Picky Eaters program has been designed to be used by individuals of all ages, families and even therapists in an in-home setting. This program is designed to be self-guided or if you prefer to arrange an appointment with me, ongoing support consultations are an available option to help you succeed. Email info@betterwithnutrition.com or call 920-940-8262 if you’d like to create an individualized plan to guide you in your health journey. The dietary program may be used alone or along with other support professionals depending upon your personal journey.
What does the program include?
Better with Nutrition’s Selective Eating Disorder, ARFID, apprehensive eater and picky eaters dietary program was created to be as all encompassing from a nutritional perspective as possible. This program consists of:
- providing safe foods
- methods to introduce new foods
- extra slow introductions of new foods for the extreme SED/ARFID/apprehensive/picky eater
- food combination suggestions
- nutritional guidelines and suggestions
- inflammatory foods
- superfoods
- working with allergies/food intolerances
- numerous helpful charts
- shopping guide of foods to avoid and safe foods
- grocery shopping list of healthy foods
- menu planner
- recipe ideas
- and much more…
This program is available in both PDF download format or interactive printed copy. The interactive printed copy contains laminated dietary palates and Velcro food icons in each food group to allow the individual to build their own palates. The interactive printed copy of this program is best suited for those that are visual learners or the young so they can physically take part in building their palates (plates).
It is important to self-empower the individual with choices and this program (both PDF download or interactive printed copy to be mailed to you) fully supports self-empowerment.