Review of ‘Not Just a Picky Eater’: A closer look at ARFID

Feb 4

Written By Allie

In 2023, Eric Pascarelli released a documentary called Not Just a Picky Eater. As a recent learner of an eating disorder called ARFID, my curiosity was properly piqued by the title of this film.

I’ve lightly covered this lesser-known eating disorder as part of the ED Deep Dives section of Recovery Writes, but I wanted more information from someone who was actually living with ARFID, or Avoidant Restrictive Food Intake Disorder.

Keep reading for insights from this documentary and to learn more about an eating disorder that is much more common than we think.

Read my Deep Dive post about ARFID.

The film opens with a series of interviews of people, all of whom are asked how many items they would feel comfortable and/or enjoy ordering from The Cheesecake Factory’s notoriously colossal menu. Interview subjects scanned the pages and picked dozens of appetizers, mains, and desserts they would order if they were dining at this major American chain restaurant.

The same question was asked to Eric Piscarelli, the director and subject of this documentary.

“I could probably get away with eating five of these things,” he replied when asked how many of the hundreds of menu items he could eat.

Piscarelli said for the majority of his life, he only allowed himself to eat a very limited selection of food, but he never quite knew the reason for it.

Throughout the documentary, Piscarelli is interviewed by an overzealous podcast host who I couldn’t help but find incredibly obnoxious. She asked him what he typically eats in a day. When he replied with his list of very basic foods, she shot him with looks that screamed, “You’re weird.”

Now, I do not have a history with ARFID, but my experience with disordered eating makes me ultrasensitive to people’s opinions about what’s on my plate and whether it’s any of their business. (It’s not.)

As Piscarelli ran through a list of foods he would not be OK with eating (e.g., salads, vegetables, fruit), the podcast host would ask him probing and insensitive questions like, “How do you know you won’t like a certain food if you never try it?”

If only it were that simple.

What is ARFID?

ARFID—Avoidant Restrictive Food Intake Disorder—is an eating disorder in which people limit themselves to eating only certain foods, foods that they may consider to be “safe.”

ARFID was added to the DSM-5 in 2013, making it one of the newer eating disorders to be recognized by the American Psychiatric Association.

According to Dr. Jennifer Thomas—Co-Director of the Eating Disorder Clinical and Research Program at Massachusetts General Hospital and Associate Professor of Psychiatry at Harvard Medical School—people with ARFID tend to prefer foods that are made up of mostly carbohydrates and/or dairy, and tend to avoid protein, fruits, and vegetables.

Piscarelli explains that his aversion to certain foods isn’t just about taste—it can also be about texture, sight, and smell. The aversion may even have roots in physical, mental, or emotional trauma.

For example, someone with ARFID may have become severely ill after eating a specific food, which then prevents them from wanting to eat that food and/or try new foods in the future.

What are the symptoms of ARFID?*

An individual who presents with ARFID might limit their food intake to specific food groups or food types that they consider to be “safe” while avoiding all other food types. They may avoid specific foods for the following reasons:

Sensory sensitivity—A strong, negative reaction to texture, taste, smell, or other food characteristics
Fear of consequences—Fear that they will choke or develop an illness after eating certain foods
Lack of interest—Seeing eating as a chore; having a poor appetite

Dr. Thomas notes that all of the above can occur together or individually.

*This is by no means an exhaustive list of symptoms. To learn more about ARFID symptoms, click here.

What are the causes of ARFID?

What causes people to have strong aversions to common foods?

Dr. Thomas cites a few possible causes:

Neurobiological—Individuals who have had negative experiences or trauma around certain foods may choose to stick to one particular food group that they know is easy to digest/that has not caused problems for them in the past, while avoiding the rest.

Cultural—Individuals may choose to eat foods they know are more likely to be readily available in their immediate environment (e.g., bread, rice, depending on the region of the world).

What does ARFID treatment look like?

In the documentary, Dr. Thomas says treatment can involve a multitude of approaches, such as:

Therapy sessions using cognitive-behavioral therapy (CBT) techniques
An exploration of previous trauma with certain foods and how and why fears of eating specific foods came about
Eating new foods with a therapist to work through the in-the-moment emotions that arise around these foods

By eliminating entire food groups like fruits and vegetables, people with ARFID are at risk of nutritional deficiencies. Therefore, consultations and follow-ups with a physician or a nutritionist who specializes in eating disorders (preferably ARFID) are an important aspect of recovery.

ARFID is more common than we think

Dr. Thomas noted that ARFID is likely much more common than we think—she believes it’s just as common as other well-known eating disorders like anorexia nervosa and bulimia nervosa.

The documentary mentions tools people can use to self-report symptoms (e.g., PARDI) but adds that an official diagnosis can only be given by a professional.

Advice for people with ARFID

As someone who has dealt with ARFID his entire life, Piscarelli had some advice for others who share his eating behaviors:

“Don’t let people’s opinions or perspectives—or your fear of other people’s opinions or perspectives—change the course of the things you want to do.”

‘We don’t choose to be this way’: Advice for loved ones of people with ARFID

If you know or suspect someone may struggle with symptoms of ARFID, here are a few ways you can support them:

Don’t force them to try new food.
Be flexible when choosing restaurants and/or planning menus.
If you do plan to eat at a restaurant, share the menu in advance.
Know that, “we don’t choose to be this way,” Piscarelli said.