Picky Eating, or Something Else? (When It Feels Like Much More Than “Just a Phase”)

Written by Dr. Colleen Reichmann, psychologist and director of Wildflower Therapy

If you’re reading this, there’s a good chance you’re exhausted. Not the usual “parent tired,” but the deep, gnawing kind that comes from living every day with a child whose eating is so selective, so rigid, so emotionally charged that meals feel like battlegrounds. Maybe you’ve been reassured again and again that “kids are picky,” that “they’ll grow out of it,” that “as long as they’re on the growth curve, it’s fine.” Maybe you smile politely when you hear this every time, but inside you’re thinking:

But this doesn’t feel fine….This feels like our life is shrinking. This feels like my child is suffering. This feels like I’m failing him.

If that’s you, take a breath. This space is for you.

I want you to know something right from the start: you are not failing. And your child is not broken. What you’re experiencing is far more common and far more complex than most people realize. And there is help.

At Wildflower Therapy in Philadelphia, we specialize in the full spectrum of adult and pediatric eating concerns, including extreme selective eating/ ARFID (Avoidant/Restrictive Food Intake Disorder).

The Loneliness of Parenting an Extremely Selective Eater

Most people don’t understand what this is like. They think “picky eating” means preferring pasta over broccoli or liking plain food. They picture the kind of picky that’s inconvenient but manageable.

But you know the other side of picky eating-the side that turns family life upside-down.

You might be:

Making separate meals every night

Packing the same exact lunch for school because anything else will be left untouched

Canceling playdates because you’re worried about food situations

Living with meltdowns, panic, or total shutdown when new foods appear

Trying out what the intuitive eating dietitians on social media say to do- and then panicking as you watch your child exist solely on goldfish for 8 days straight.

Pivoting to “holding the boundary” with other expert-approved phrases like “the kitchen is closed” or “what’s on your plate is what’s for dinner,” then panicking as you watch your child go to bed hungry (and still refuse breakfast the next morning).

Watching your child cry at the table

Watching yourself cry after they’ve gone to bed

Parents describe it as a “full-time job.” A constant calculation. They carry anxiety not just about nutrition, but about the future. Will they ever eat at a friend’s house? What about summer camp? Are they getting enough nouishment? How will they ever learn to nourish themselves as adults? How come the pediatrician doens’t seem to care that they are only eating like 5 foods? Why will they only accept pre-packaged foods??

These thoughts feel dramatic until you live with extreme picky eating-and then they feel painfully realistic.

“My Pediatrician Said It’s Normal… But This Doesn’t Feel Normal.”

Let’s talk openly about something parents rarely say out loud:

Many pediatricians are thoughtful, caring, and well-intentioned… and also not trained to recognize the early signs of ARFID or clinically significant feeding disorders.

Most pediatric training teaches that kids go through picky phases, and that growth curves matter more than variety. They tend to learn that almost all kids eventually expand their diets. Most will suggest that parents should “keep offering and they will eat it eventually.”

For many families, that advice works beautifully. But for others (maybe for you), it leads to years of unnecessary stress. Because here’s the truth: Some children do not “grow out of it.”Some children don’t start eating a wider variety with repeated exposure. Some children will absolutely skip meals, refuse food for hours, or go to bed hungry rather than tolerate certain textures, smells, or colors. Some children have anxiety so intense around food that asking them to “just try a bite” triggers panic, overwhelm, or meltdown. Some children desperately want to eat more foods, but genuinely can’t yet. And many of these children actually meet criteria for Avoidant/Restrictive Food Intake Disorder (ARFID), a pediatric eating disorder that is not about weight concerns, and is very different from typical selective eating. These kids are often unintentionally overlooked by pediatricians because they’re:

Growing “well enough”

Not losing weight

Not talking about body image

Not visually malnourished

Not causing concern from a medical standpoint

But you, the parent, feel something deeper: This isn’t typical. This is impacting everything.

When Traditional “Feeding Specialist” Advice Makes ThingsWorse

Many families are told to start with a basic pediatric feeding specialist. Sometimes this helps. But sometimes, for kids with more severe sensory, anxiety, or neurological differences, it backfires. You may have heard advice about how important repeated exposures are, and how important it is to also make food fun. Often times, feeding specialists (sometimes these are occupational therapists) will suggest different ways of playing with food, and getting kids to take bites. Parents will often report that their children will play and take bites during the sessions, but that none of it translates to meaningful change outside of the session.

And this is because children with ARFID need a more specialized approach that simple play or exposures. These children often experience fears or sensory overwhelm that is bigger than their hunger, and bigger than any urges to please parents. Trying to force bites can trigger meltdowns and power struggles. Mealtimes become battlefields. Food refusal can start to escalate. Children may become more rigid, more anxious, and more distressed. And most parents, in turn, start to feel overwhelmed and, at some point, unsure how to parent at all when it comes to food.

You might feel like you’ve tried everything-gentle parenting, firm parenting, rewards, ignoring, modeling, pressure, no pressure- and nothing changes. Please know that this does not mean your child is defiant. It likely means that their struggles with selective eating are simply bigger than an OT can address, and more nuanced that a typical pediatrician might recognize. It means they probably need a different approach.

Extreme Picky Eating Has Real Impacts on Daily Life

Society often seems to downplay the toll this takes. There are constant jokes about picky children, after all. But you deserve validation here. Extreme picky eating can impact:

Family routines (“Will they eat anything at this restaurant?”)

Vacations and holidays (the stress of unfamiliar food environments)

School (anxiety around lunch or snack time)

Mental health (both your child’s and your own)

Self-esteem (“Why can’t I just eat like other kids?”)

Parent identity (“What am I doing wrong?”)

And maybe the deepest pain of all: the way mealtimes become a reminder that something feels out of sync, something that you thought would come more naturally in time, but that stays confusing and hard.

If this is your reality, you’re not imagining the severity. You’re not dramatic. You’re simply raising a child whose nervous system responds differently to food.

What’s Actually Going On: A Different Kind of Eating Difficulty

Extreme picky eating and ARFID can be driven by multiple variables. Some fo the most common are sensory sensitivities, gagging or fear of choking, past traumatic food experiences, underlying anxiety and stomach pain, rigid thought patterns, or avoidance that is triggered by overwhelm. It is also highly correlated with neurodivergence (ADHD or autism)- so much so that if a child presents with ARFID, you better believe that we, as eating disorder therapists, are also automatically assessing for neurodivergence.

But please hear me when I say: ARFID is not a behavioral issue. It is often linked to a neurobiological pattern that requires a nuanced, skilled, gentle-and-firm therapeutic approach (not forcing, shaming, or high-pressure feeding methods). ARFID-informed therapy with an eating disorder specialist who has experience with children can be transformative in this respect

What to Do if Your Child Is an Extremely Selective Eater

If you’ve found yourself googling “what to do for my extremely picky eater,” here are steps that can guide you toward clarity and relief.

1. Look beyond the growth chart

Growth charts tell us one thing: the size of the body. They do not tell us how much stress mealtimes cause, how limited the food variety is, whether your child is socially impacted, or if eating is a source of fear. A healthy growth curve does not rule out a clinically significant feeding disorder.

2. Trust your instincts

You live with your child. You see the patterns others miss. You know when something is interfering with life. Parents almost always know before anyone else. Even if you’ve been dismissed

3. Seek a specialist early

The earlier we intervene, the better the outcomes. Kids CAN learn to expand their diets with the right support. And no-you do not need extreme weight loss in order to seek help. You deserve support before burnout for either you or your child takes root.

4. Identify an eating disorder specialist in your area and request an evaluation for ARFID.

How Therapy Helps Kids with ARFID and Extreme Selective Eating

At Wildflower Therapy in Philadelphia, we work with kids, teens, adults, and families struggling with severe selective eating and ARFID. Our approach is gentle, relational, neurodivergent-affirming, and deeply attuned to nervous system safety.

Therapy may include:

• Exposure therapy at a child’s pace (Building comfort, curiosity, and connection with food.)

• Creating a list of which foods to tackle while taking sensory preferences into account (there is a shared understanding that needs to be established around not expecting perfection or extremely advenurous eating at any point.)

• Sensory-based work (Helping kids feel safer exploring new textures, smells, and temperatures.)

• Anxiety-reduction and emotional regulation (Easing the fear that sits underneath food refusal.)

• Parent coaching (So you know exactly what to do at home)

• Coordination with pediatricians, dietitians, or OT’s (To create a cohesive, supportive care team.)

• A shame-free approach (Because your child already feels different enough. They deserve a space where they are understood, not punished.)

Our goal is not to make mealtimes perfect, it’s to make them possible, peaceful, and sustainable.

Children with ARFID can find more peaceful and exploratory ways to interact with food. They can feel safe with food again-and your family can breathe again.

To the Parent Who Feels Like They're Failing

I want you to hear something clearly: You are a good parent. You’re not imagining the severity. You’re not being dramatic. You’re not the reason your child struggles. You are the reason they have hope. You are the one seeking answers. You are the one refusing to settle for “they’ll grow out of it.” You are the one protecting your child’s well-being. You are the one showing up day after day, exhausted and brave. And if you’ve read this far, you’ve already taken a new, powerful step.

When You’re Ready, You Don’t Have to Do This Alone

If you are looking for validation, and nuanced, effective help for your child who is struggling with extreme selective eating, Wildflower Therapy is here. Our team understands ARFID, and we understand how important it is to also include parents in this work. We would be honored to walk this path with your family. Your child’s eating journey does not have to stay stuck.

There is a way forward. And we’re here to help you find it. Please reach out today for your free consultation call. We specialize in eating disorder and body image therapy for all ages in Philadelphia (or virtually across Pennsylvania, New Jersey, Delaware, Florida, South Carolina, Vermont, Virginia, Ohio, and Massechusetts) and help individuals rebuild a peaceful relationship with food and body.