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Many young children are very selective about which foods they will eat. Although picky eating is common, especially for preschool-age children, strong preferences for a narrow range of foods can look similar to certain eating disorders.
There are a number of factors that might help indicate whether someone’s picky behavior is potentially problematic.
Generally, being a picky eater describes having strong preferences or aversions to certain foods, and it can manifest in several forms.
Picky eating can look like someone only eating certain types of foods or refusing to eat new foods. Picky eaters will also sometimes turn down certain types or groups of food entirely, such as all crunchy foods. They might even suddenly start refusing to eat foods they once enjoyed.
Pickiness is a common occurrence, especially among young children. In fact, anywhere from 14-50% of parents have identified their preschool-aged children as picky eaters.1 (The gap is mostly due to different definitions of “picky eating” being used across various surveys.)
In a majority of these cases, the picky eating patterns subside after a few years. However, some instances of extremely selective eating continue into adulthood.
There are a number of reasons why picky eating is such a widespread phenomenon. But perhaps the biggest reason behind it is biology.
Children’s rate of growth is highest right after they’re born, typically peaking around age two, then slowing down between ages two and five.1 During this period of change, a child’s appetite also changes, typically decreasing overall and becoming more inconsistent. This can lead to many common picky eating behaviors.
Refusing to try unfamiliar foods is one of the most common expressions of picky eating behavior, and once again, biology is likely behind this. Some research suggests that rejecting new foods may have developed as an evolutionarily protective trait to help young kids avoid eating something potentially poisonous.1
These behaviors also tend to set in during the same time period when children first discover and start testing out their autonomy.
Biology isn’t the only culprit behind picky eating, however. Food preferences, even as early as childhood, can be a learned behavior.
In many instances, parents will—intentionally or not—model eating patterns their child's diet. And children can be further influenced by their parents’ “feeding style.”1
Some parents take more of a prominent role in what and how much their children eat, prodding their children to eat more or using food as a reward. In these cases, it’s not uncommon for that feeding style to lead to a power struggle, with children digging their feet in about their picky eating habits.1
While picky eating describes strong—and often changing— food preferences, disordered eating is a more general term, referring to any type of irregular, problematic, or dangerous eating behavior.
Eating disorders are prolonged patterns of disordered eating behaviors which meet specific criteria and thresholds set in the DSM. There is no hard line between disordered eating and eating disorders, and generally, someone is considered to have an eating disorder when their disordered behaviors are significantly distressing and disruptive to their life. Eating disorders also frequently involve obsessive and all-consuming thoughts about food and/or body image concerns.2
Picky eating may often be mistaken for diagnosed eating disorders.
The eating disorder that most often gets mistaken for picky eating is avoidant/restrictive food intake disorder (ARFID).
First officially identified in 2013, ARFID is not always directly related to body shape or size. People struggling with this disorder tend to restrict food overall or eat a very limited number of foods because they’re either generally uninterested in food, particularly sensitive to certain aspects of food, or fearful of certain foods.
In addition, people with ARFID often have body image issues and may also have other eating disorders, such as anorexia nervosa (AN) or orthorexia.3
Because they don’t necessarily fixate on weight, people with ARFID are frequently confused for picky eaters. However, the behaviors associated with ARFID tend to be much more extreme or disruptive.
People with ARFID may have strong reactions to foods with certain colors, smells, textures, or even brand names. Behind this aversion is often an intense fear of physical consequences, including vomiting, choking, allergic reactions, or getting a stomach ache. Other times, the sensory aspects of food are themselves highly aversive. Some people with ARFID simply do not like food very much and are therefore not very motivated to eat. The resulting food restrictions can be so severe that they result in nutritional deficiencies or, with children, stunted growth. It’s important to note that people of all body sizes and ages can struggle with ARFID.
Anorexia nervosa can also be mistaken for picky eating. The disorder is often displayed through restrictive eating, only eating certain foods, or through ritualistic eating behaviors. While some people can have both anorexia nervosa and ARFID, fear of food and restriction of specific foods in AN tend to be motivated by the energy or nutritional content of food as well as by body image concerns.
For example, someone with AN may be obsessed with having a healthy diet and therefore be picky about what they eat.
In some cases, it may be difficult to distinguish between picky eating and eating disorders.
One of the common differences between picky eating and eating disorders is the age of onset and how long the symptoms persist.
Generally, picky eating starts between ages two and five and will subside by late childhood. Meanwhile, eating disorders commonly develop between the age of 12-25, long after most picky eating behaviors have been resolved.1 If a child refuses certain foods at two years old, you generally don't need to seek help. They may enjoy the same food once they reach a later age. However, eating disorders do occur in young children, and it’s possible for eating disorders to develop earlier or later on. Some people continue to have a very limited palate for different foods into adulthood but do not experience distress or medical problems as a result of this.
If you are trying to support someone with very restrictive choices, it may help to first talk to them about what’s driving their preferences. Something seemingly more arbitrary and generalized, e.g., “Green food is yucky,” is typically a less concerning response. Something more specific, e.g., “Green foods will make your stomach hurt” or “Green foods make you skinny,” may be an indication that something more distressing is going on.
If you’re concerned with their answers, the behaviors continue at a highly disruptive rate, or the person starts showing other indications of a more severe situation, such as further reducing the foods they will eat or developing nutritional deficiencies, you may want to consult a dietician or doctor. These experts—especially those with training on ARFID —can help determine whether the behavior is derived from picky eating or represents another form of disordered eating or an eating disorder.
Picky eating can be a normal part of many children’s development, especially when it's new food. But extreme, persistent, and strongly fear-based restrictions or limitations around food can be a sign of something more severe.
If you or someone you know are experiencing symptoms of ARFID or another eating disorder, help is available from professionals who have experience treating these conditions.
Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.
Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.
