Picky Eating or Something More // The wisdom to know the difference

By Sheva White

“Elisheva was a bright and happy child,” recalls her mother, Shelly. “She played and ran around and was like any other typical two-year-old, until it came to mealtimes. Then she would clamp her mouth shut and refuse to eat, shaking her head stubbornly at any food we offered her—if she agreed to come to the table at all.

“My friends and family were full of helpful suggestions. The mothers in the park told me that she was just a picky eater. Why, I was making a mountain out of a molehill! All I had to do was keep offering her our regular fare and refuse to give in to her demands. My cousin laughed it off with a breezy wave of her hand, saying, ‘You’re such a first-time mom! It’s only a phase. Don’t worry so much.’ An older, more experienced neighbor told me to make her stay in her high chair until she’d finished her mashed potatoes. Then she proceeded to lament today’s ‘snowflake generation.’

“We were at our wits’ end, trying any and every suggestion. But nothing worked. Elisheva kept refusing food, and mealtimes became a nightmare.”

Lots of kids are picky eaters, but some kids take it to an extreme. Some will refuse to eat anything green or anything that isn’t a certain shape or texture. Others won’t eat anything hot, slimy or mushy. While many parents and caregivers chalk this up to a temporary stage or stubbornness, it may be a sign of something more serious—avoidant/restrictive food intake disorder, known as ARFID.

ARFID is a relatively new diagnosis that was added to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, in 2013. It is an eating disorder in which a child or adult has a limited or highly selective diet, avoiding certain foods or entire categories such as fruits, vegetables or proteins. This can result in significant weight loss and nutritional deficiencies, and it can interfere with daily life. It’s different from other eating disorders such as anorexia or bulimia because the primary motivation isn’t a fear of gaining weight or a body image issue. Rather, ARFID involves an aversion to specific foods, consistencies, colors or smells, or a lack of interest in eating altogether.

ARFID can be challenging for both the child and the parents. Parents often feel frustrated and helpless, and they worry about their child’s health. It can be especially difficult when the child’s eating habits interfere with the ability to socialize or participate in activities that involve food, such as going out to eat or attending a party. This is particularly problematic in frum circles when it comes to Yomim Tovim, Shabbos meals and simchos.

Another mother named Chaya shared her experience with her son’s ARFID. “My son had always been a picky eater, but it wasn’t until he started losing weight and avoiding more and more foods that we became concerned. It was a struggle to get him to eat anything other than plain pasta, chicken nuggets and bread. We tried everything from bribing him with dessert to forcing him to eat vegetables, but nothing worked. It was a relief when we finally got a diagnosis of ARFID, but it was also scary to learn about the potential health consequences.”

Sarah, whose daughter was diagnosed with ARFID, described how the condition affected their family life. “We couldn’t go out to eat as a family because my daughter would refuse to eat anything on the menu. Nor would she attend sleepovers or birthday parties because she didn’t want to be around foods she didn’t like. It was isolating for all of us, and we felt like we were walking on eggshells around mealtime.”

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