There is average picky eating … and then there are the more extreme cases.
Our guest today, Jessica Bodie, PhD, is a psychologist who works with these kids – including her own.
ARFID is Avoidant/Restrictive Food Intake Disorder, and its treatment goes way beyond what I discuss in The Picky Eater Playbook and the No More Picky Eating Challenge. I’m so glad Jessica was able to come and share more about treatment for ARFID with us.
We chatted about:
- the reason doctors might look at a growth chart and ignore a parent’s concerns about eating
- what Jessica has done with her own son when it comes to his restrictive eating
- how ARFID is different than normal picky eating
- the strategies I would suggest AGAINST for average picky eaters that Jessica uses
- how being uncomfortable might have to be part of becoming more comfortable with food
Listen in now, and check out part 2 when it releases on Thursday!
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Key Takeaways about Exposure Therapy for ARFID
- Extreme picky eating can affect nutrition, family routines, and a child’s social life. ARFID (avoidant/restrictive food intake disorder) goes beyond ordinary food preferences.
- A normal growth chart doesn’t rule out ARFID. Children may eat enough calories while struggling with variety, nutritional needs, or eating away from home.
- Fear of choking, vomiting, or gagging; sensitivity to textures and tastes; and discomfort while eating can all contribute to food avoidance.
A good growth chart doesn’t tell the whole story of how hard it is to feed your child. – Dr. Jessica Bodie
- A food list that keeps shrinking, increasing demands for specific brands, and stressful meals are reasons to seek an evaluation.
- Dr. Bodie uses gradual exposure to help children practice eating unfamiliar foods, starting with easier challenges and building toward harder ones.
- Her approach includes rewards and required practice bites. (This differs from Katie’s advice for average picky eaters.) Treatment for extreme eating difficulties may involve different strategies.
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If you’ve done the No More Picky Eating Challenge and want to have all my strategies at your fingertips, it’s the perfect resource! Or if you’re just beginning to tackle dinnertime struggles at your house, it will walk you through my whole system for eliminating picky eating.
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Learn More about The Picky Eater PlaybookAction Steps from This Episode
- Notice whether your child’s food choices are expanding, staying steady, or steadily disappearing.
- Write down how eating affects everyday life, including school lunches, restaurants, parties, and family meals.
- If you’re concerned, bring those examples to your pediatrician. Ask about an ARFID evaluation rather than relying only on weight or growth.
We say, ‘I know you don’t love this. That’s why it’s a challenge food.’ – Dr. Jessica Bodie
- Ask whether a dietitian could help assess nutritional gaps in your child’s usual foods.
- Acknowledge your child’s experience: “This food feels unfamiliar, and I understand that trying it can be hard.”
- If your child needs treatment, work with a qualified clinician on a gradual plan. Use this interview to ask questions about exposure, rewards, and practice bites rather than copying the protocol on your own.
Resources We Mention for ARFID in Children
- If you register for the No More Picky Eating Challenge, there is a questionnaire to help you figure out if you have an extreme picky eater!
- Why feeding therapy can backfire with extreme picky eaters
- I always suggest finding a therapist versed in the SOS Approach to Feeding if you have an extreme picky eater
- Grab your copy of The Picky Eater Playbook now!
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Jessica Bodie, Ph.D., is a licensed clinical psychologist and Director of Child Services at the Center for the Treatment and Study of Anxiety (CTSA) in the Perelman School of Medicine at the University of Pennsylvania. Dr. Bodie specializes in the treatment of OCD, PTSD, social anxiety, panic disorder, specific phobias, generalized anxiety, and picky eating/ARFID. She is a certified clinician, consultant, and supervisor in Prolonged Exposure (PE) for PTSD and Exposure and Response (Ritual) Prevention (EX/RP) for OCD.
Dr. Bodie has conducted research on and clinically treats extremely picky eating (also called Avoidant/Restrictive Food Intake Disorder, ARFID), emetophobia (vomit phobia), and choking phobia.
Dr. Bodie is active in the field and participates in teaching, writing, supervision, and consultation activities to disseminate evidence-based treatments for anxiety and related disorders.
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