Picky Eating vs. Selective Eating Disorder

It weighs heavy on my mind, the negative comments from those who don’t live with Selective Eating Disorder (SED). One would think that someone who didn’t know anything about the subject might choose to ask questions instead of offering ridiculous suggestions. Unfortunately, logic escapes many who seem to have an uncontrollable urge to wedge their foot firmly into their mouth. Oh, the irony; reading words from someone with a mouthful of shoe about people who can’t eat but only a handful of foods.

A sample of some comments from The Wright Stuff’s Facebook Page

SED is not picky / fussy eating. Picky eating is a temporary childhood phase. SED usually has an underlying cause. There is always a reason that explains why a child refuses food. Despite what the ‘sole’-seeking, armchair critics might like to think, shipping a child or adult with autism or a digestive disorder to a third world country isn’t going to fix their diet any more than it will change the qualities of the food they cannot eat.

Trying to explain that SED is not just picky eating is hard. Not everyone shares the same medical history. Not everyone eats the same foods. Not everyone answers “yes” to all the points on the chart that follows this paragraph. There is, however, a distinct difference between picky eating as a typical phase of childhood development and someone with SED.

sed vs picky

image © Mealtime Hostage, 2012

The shoe chewing crowd could argue that SED is not really an eating disorder, after all, it’s not in the current version of the DSM. I say, “Keep munching away on that sneaker.” I have yet to speak with anyone who has SED that doesn’t struggle with eating socially to some degree. At a restaurant, the garnish (often an offensive pickle) is leaking juice onto their food; a repulsive sauce has contaminated part or all of their meal. Family gatherings are often dreaded for the overwhelming smells, and the food that is expected to be eaten. Adults with SED learn creative ways to bear the relentless teasing, and the remarks about what isn’t on their plate.

Any event that creates a pattern of behavior that significantly impacts social interaction and/or creates distress for the individual experiencing these symptoms meets the criteria for a disorder. Just because it has not been added to current or previous editions of the DSM or any other medical textbook, does not make Selective Eating Disorder any less real. What it does mean, sadly, is that those with this particular eating disorder have a great deal of difficulty finding treatment for it. Parents, like me, depend on advice and suggestions from other parents of kids with SED, and adults who have grown up with it. Many adults with SED never had anyone take their disordered eating seriously. They have just learned to live with it, a strategy that often involves hiding their limited diets from others by avoiding situations that involve eating socially.

For all the quirks that make it so difficult to describe, there is one unifying truth among people with SED. All of them … Every. Last. One… would, if they were able, willingly choose to eat normally.

UPDATE Added July 5, 2013

Selective eating disorder was officially added to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders in May 2013, and renamed Avoidant/Restrictive Food Intake Disorder.

At the time of the original post, the group of parents and adults that collaborated to create the above chart were aggravated and incensed by the lack of available information on selective eating. Parents, like myself, were fed up with being placated and dismissed with “he’ll grow out of it” while Duke University’s adult picky eating study had heard from over 30,000 respondents. This post continues to attract adults who had no idea there are others who also struggle with eating socially, avoid entire food groups, and often live off a diet that often consists of 30 items or less.

This same post has also attracted knowledgeable feeding professionals who have contributed significantly to the conversation about selective eating.

Speech Language Pathologist, Jennifer Hatfield from Therapy and Learning Services in Indiana describes picky eating as a spectrum, rather than a comparison between extremes.

“A selective eater will NOT “eat when they get hungry.” If you implement a technique designed to “wait them out” or “exert your parental control,” if you alter one of their 10-20 foods, you risk having that food drop out of their food list forever. That. Can’t. Happen. because that would mean lower intake which then would translate into weight loss, nutritional concerns etc..and MORE stress for the child and family.”

Ellyn Satter, Registered Dietitian Nutritionist, Family Therapist and internationally recognized authority on eating and feeding describes eating in general as a spectrum. Developing eating competence is a progression of sequentially satisfying one’s food needs at one level before addressing the needs at the next.

Satter hierarchy of food needs

The foundation of Satter’s Hierarchy of Food Needs rest on getting enough food to eat (extreme poverty), followed by having access to acceptable food (unspoiled food, food you are not allergic to). Only after achieving reliable access to food (able to acquire a food stash, and plan for subsequent meals) can people start to consider food selection in terms of taste and appearance.

How does this work with adult picky eating? Consider popular parenting techniques of the 1960s, 70s and 80s and how a parent would be advised, even encouraged to respond to a picky eater. A child who is repeatedly sent to bed hungry for not touching anything on their plate, declining the vegetable, or gagging on the chicken is not learning that there is a constant and reliable access to food. Despite the full pantry, this particular child is growing up with food acceptance skills at the very bottom on the food needs hierarchy. As a result, the need to satisfy hunger is commonly met with energy dense, low nutrient carbohydrates.

Once people learn they can readily access enough, acceptable, reliable, and good-tasting food, only then are they able to comfortably consider novel food and finally, choosing what to eat for instrumental purposes (calories, specialty diets, etc).

It’s common for the adult picky eater to refer to eating as “a chore.” Adult PEs at the lowest levels of food acceptance tend to see food in terms of “edible” and “repulsive”, often wishing all their caloric and nutritional requirements could be met with a supplement to avoid eating all together. With this in mind, adult picky eating is less about being stubborn and hard-to-please and more about living in a food-focused society with under-developed food acceptance skills.

In terms of helping the adult picky eater embrace or expand what they can eat, Satter offers:

“To help yourself, begin by addressing your attitudes about eating. You are entitled to like what you like and to feel good about eating what you eat. Once you learn to be kind to yourself about eating, work on protecting yourself from food pressure. Be matter-of-fact and unapologetic about saying ”yes, please,” and ”no thank you.” Don’t complain and don’t explain.”

What anyone eats is nobody else’s business. If someone else is offended by what is or isn’t on your plate, that is their problem, not yours. It is, and always has been, the eater’s responsibility to choose how much to eat, and that includes the right to say “no thanks” to offerings of anything you don’t want, especially when it’s served with judgement, ridicule, stress, pressure and guilt.

Please continue to add to the conversation.

256 thoughts on “Picky Eating vs. Selective Eating Disorder

    • “Healthy” is a subjective term. What’s considered healthy changes from decade to decade, from food guide to food guide, and from nation to nation.

      What matters is how you feel about eating, not so much what you eat. If you approach food with shame about what you eat, the stress experienced is far more unhealthy than anything you do or don’t eat.

      If dietary change is what you hope for, start by accepting that you are doing the best you can with what you enjoy eating right now, and focus on enjoying the act of eating. Progress looks like being able to be calm in the presence of unfamiliar food, then being able to take some without tasting it, to taste a little bit without eating it, to eat a small piece and not like it (or maybe you do!) – throughout this process, you always have the right to say ‘No’.

      Even the most reprehensible meal is still better than not eating at all.

  1. How do I defiantly know I have this because I’m 16 and I’m always told that I’m just being fussy with my food?? Xx

    • Rachel, SED (now known as Avoidant Restrictive Food Intake Disorder ARFID) is an avoidance of certain food or food groups based on their sensory qualities (sight, smell, texture). While that would apply to everybody on the planet, the disorder component applies if this causes you significant discomfort so as to impair your quality of life. For example, finding eating in the presence of others so uncomfortable, that you actively seek to avoid social eating occasions.

      A diagnosis may help you feel validated, but what to do about it and how to help you come to terms with what you do eat have yet to be embraced by the mainstream medical community.

      If you’re on Facebook, join the Picky Eating Adults group and the Mealtime Hostage parent support group. You can also get in touch with me using the Contact form on the blog for more personal coaching.

  2. Thank you! I recognise myself in this. Being labelled as a ‘fussy eater’ all my life has been so so unhelpful in making positive changes. Only when I moved out when I was 18 and started being completely in control of my own diet (no one around to criticise, no one telling me to eat more or eat less, stop playing with my food, don’t be so ridiculous, just eat it it doesn’t matter) was I able to address these issues (and some still persist).

  3. Your article mentions weight-loss as a symptom of SED, but I am more worried about weight-gain: I’ve grown up as a picky eater and I find that I identify with quite a lot of the symptoms except for weight-loss. Sure, in my childhood I was small but I’m 18 now and I fear my metabolism will run out eventually! I eat barely any fruits and vegetables and I hate dairy products; my diet consists of lots of grains and pasta, meat, granola bars, crackers, chips and mainly lots of unhealthy options! I wish it were “just a phase” that I could grow out of so I could start eating healthier, but the texture of fruits and vegetables simply repulse me! What options are there for eating healthier in my case?

    • According the preliminary results of the Duke study, adult picky eaters vary in weight just like the variety eating population. Everyone’s metabolism slows down after adolescence, because the need to fuel growth is complete. The thing to keep in mind, though, is a large percentage of the variety eating population do not eat ‘normally’. The success of the diet industry speaks to the high level of disordered eating in society, and society considers chronic dieting as normal.

      Health is a multi-dimensional construct. What we eat plays a small role compared to activity and exercise, as well as our attitudes toward body satisfaction and how we approach food. Just as an example, in the US about 70% of the population does not meet the recommended daily requirements for fruit and vegetable intake, and despite the widely publicized claims that F&V prevent disease, the CDC reports that heart disease and most cancers have been on the decline for the past 3 decades. Given the negative role stress has on health, worrying about all the healthy stuff you don’t eat will likely do more damage than not eating these foods ever will.

      If variety is what you seek, look at the way you prefer your food – crunchy? Soft? Salty? Sweet? Look for ways to prepare new food in appealing and palatable ways. Potatoes are incredibly under rated as a nutritious vegetable. Dried fruit is still fruit. Smoothies are a texture friendly way to introduce new food and nutrients to your diet. Food is not a punishment to suffer through. Take your time finding foods you enjoy eating, and enjoy eating them.

      • I found that masking the taste of something really helps. I have the same problem I won’t try any new foods but I will try any dessert also I love take out so weight gain has been a problem for me. I eat a lot of veggies now but when I was younger broccoli would make me gag and I won’t have any dips so I’d dip it in yogurt and I got so used to it that I finally could eat the broccoli without the yogurt. Another thing I did was I found healthy things I actually did like like nuts, granola bars, you can always ask your doctor if you can take vitamins for the lack of fruit and veggies I have Vitamin D&C etc for it even though I eat some fruits and veggies I don’t eat them as much as I should. Also sometimes all it takes is portions and exercise when I was trying to lose weight I would have one chicken breast (I only eat chicken) and a tiny bit of roasted potatoes and that’s all I’d eat for dinner so if you eat meat like fish or lean meats you can do the same. I hope this helps a bit :)

  4. OK so my boyfriend basically only eats pizza and fast food and a few other foods. He refuses to eat any cooked vegetables or any thing touching or near them. He will occasionally try new foods but in the 2 years i have been with him i have never gotten him to eat it a second time and he usually wont even finish the first meal with a new food. He often goes to bed with out eating because there is no pizza in the house and i often resort to cooking french fries just to get him to eat something. though he eats hamburgers he refuses lettuce, tomatoes and onions unless they are diced this is the only way he will eat them and he will often refuse a burger with whole onions entirely, there is no removing the onion. He wont eat seafood at all and avoids all food with corn as an ingredient. He will often reject food just by looking at it. I am concerned for his health and i do not know how to get him to eat better/try new foods is it possible he has this disorder?

    • Surprising as it may sound, the majority of adult picky eaters are in excellent health. There appears to be no higher incidence of illness among picky eaters than there is among those who eat a varied diet. I hope that much is at least reassuring.

      Trying to get your boyfriend to try new foods sounds logical, but is actually adding to the already existing anxiety he experiences with eating. “Get” is a control word – you want him to do something he doesn’t want to. The desire to change has to come from within him. In the meantime, his plate is his business.

      If he is content with what he can and cannot eat, the best thing you can do is accept his eating for what it is, and defend him from outside sources of pressure to eat. There are many very informative articles at http://ellynsatterinstitute.org/hte/adultseatingandweightindex.php – and some wonderful peer support on Facebook’s Picky Eating Adults.

  5. Where have you been all my life!?

    Growing up, my diet consisted of mostly cold cereal, grilled cheese, and quesadillas. However, I wouldn’t eat cheese on anything else. I could eat some vegetables (potatoes, corn, green beans, broccoli, and raw carrots), chicken or ground beef, rice/pasta sans sauce, and apples. I didn’t even like pizza as a kid! I was often worried about attending sleepovers or birthday parties because I was afraid that I was going to have to eat something I didn’t like. As an adolescent, I was able to eat more entrees, but again, to a limited extent. At this same point in my life though, I developed anorexia, which led to bulimia that I actively battled for ten years. Needless to say, eating and food are a large source of stress and negativity for me.

    Once I got married and had access to/control over an actual kitchen, things improved dramatically because I could cook and prepare food items to my liking, however, I was still the pickiest eater that I knew.

    Even with all my progress over the last five years, I’ve hit a new barrier. As a professional, I feel like I experience so many business lunch/dinners, or because I travel for work, I eat with my colleagues because we are all sharing the same rental car and I don’t get to dictate where I dine. I hate feeling like a burden when the whole group accommodates my needs, or I am extremely embarrassed when picking certain food items out of my meal among a group of adults that can just eat whatever is placed in front of them. I’ve learned to like Caesar salads (though I am getting rather sick of them) because it is a fairly ubiquitous dish among restaurants, and I typically can’t find anything else edible, by my standards. I dread going to oriental or seafood restaurants.

    I’ve recently started seeing a dietician due to GI problems, and I mentioned to her that I would like to have a healthy relationship with food (physiologically, mentally, and emotionally), and that I wanted to try to expand my palate. I am supposed to try something new each week, and I report back to her at my appointments, but I don’t think she understands how hard it is for me. It can cause me some real anxiety, which in turn exacerbates the GI problems she’s supposed to help me resolve. Are there psychiatrists that specialize with this selective eating disorder? I feel like I need to be able to talk to someone about how I walked around the grocery store with an orange in my basket (my new food item I am supposed to try), only to put it back before checking out because it was, quite literally, freaking me out to think about going home and eating it. I just don’t know what kind of professional to seek out, because I was anticipating my interactions with her to be a bit more useful.

    Anyway, I’d appreciate any insight you have. Thank you for your site, I was enlightened, and relieved to know I’m not the only person experiencing this.

    • Eating socially is really difficult when our own relationship with food is dysfunctional.

      “Once I got married and had access to … an actual kitchen, things improved drastically.” This is significant – you always have control over how much to eat – that means you, and no one else, chooses a lot, a little or none of what’s offered. It’s not any one’s business, or place, to critique what’s on your plate.

      Your dietitian doesn’t get it. Please stop torturing yourself with new foods for her amusement. Put the orange down, and walk away.

      Everybody has food they don’t like, and it is absolutely okay to have a list that is longer than others. You’ve been wise enough to listen to your body say “that doesn’t make me feel good” and avoid that food in response. No one really knows why one person loves a food another doesn’t. And why does it matter? Health? There’s more to health than produce.

      Depending on where you are, I may be able to recommend an RD who can help your GI and eating issues as a package. Get in touch through the Contact page if you’d like to talk privately.

  6. Thank you for this site. It sheds some light on things for me. I hadn’t realized until reading this that my girlfriend might have an eating disorder. Satter’s chart makes sense.
    My girlfriend has distress around eating, and it causes a lot of stress in our relationship. She grew up in poverty where sometimes there wasn’t anything to eat. sometimes she would eat toilet paper just to have something in her stomach. She lived in a ghetto so when there was food, there were only some types of foods available, especially fried. When I met her as an adult, she was not eating enough except some greasy foods late at night, which would make her feel ill in the morning and I thought it was because she was struggling financially. But she has a lot of distress from a traumatic childhood. Now she is in a situation that is somewhat financially secure. She will only eat a very limited selection of foods, and she still doesn’t eat enough at the right times of day and it causes extreme mood swings due to blood sugar imbalances. Her typical pattern is to have a heavy dinner (of only certain select foods), then in the morning she doesn’t feel hungry so she doesn’t eat. She might eat a sugary, caffeine-filled protein bar mid-morning, and then by mid-afternoon, her blood sugar has swung so low that she can become very upset easily. Even then, she won’t eat much besides maybe a pretzel or two. Then at dinner, she will only eat out of one or two choices of favorite foods and only if they are cooked exactly how she likes, and not touching or with any juices merging on the plate.

    She asks me to help her to eat more healthy, and more regularly, but when I suggest things they are most often refused. I try to keep the kitchen stocked with convenient foods that she has accepted. Yesterday was an especially difficult day emotionally, due to blood sugar swings, and after dinner she said that she wanted to eat regular meals today. It’s a holiday so it’s easy for me to be available to cook her anything she wants. But she wouldn’t eat in the morning and the meltdown happened this afternoon, and here I am finding this site because I am looking for help. I can take her to the store and give her her choice, and she’ll only walk out with chips and water, and when we get home, complain that there isn’t anything to eat. She asks for help but I don’t know how to help her if she’s unwilling to help herself. I feel like maybe I should go to Alanon or something. (she’s also a recovered alcoholic, and has an ulcer, which the fried foods are hard on)

    I myself am a recovering bulimic (binge/purge) so I do understand about having distress around food. I’m mostly functional, and I haven’t purged or binged to any extremes for many years now. But when things are hard for her, they are hard for the relationship, and I find myself grabbing the bag of chips and secretly binging to cope. I’m scared to suggest to her that she might have an eating disorder.

    I love her so much. I need help figuring out how to support her in her healing and yet keep myself from being on the rollercoaster with her. I don’t want to be on the rollercoaster.

    • Roller Coaster,

      In addition to Satter’s work on eating competence – http://ellynsatterinstitute.org/hte/adultseatingandweightindex.php – I also recommend investing some time studying Intuitive Eating from a Health At Every Size approach. Both are compatible with each other. This article – http://lindabacon.org/pdf/BaconMatz_Diabetes_EnjoyingFood.pdf – written for a different audience than the scenario you describe, is generous with recommendations that will help.

      Very important for someone with a history of food scarcity is being secure in the ability to find enough to eat, and in your girlfriend’s case, enough to eat that includes foods she enjoys. Structure, not nutrition, is where all the attention needs to be.

      During all this, make sure you don’t neglect your own needs.
      Is it possible we can speak over email? Please get in touch with me through the Contact page.

  7. “Food is not a punishment to suffer through.”

    i’m tearing up after reading this. i’ve never encountered this attitude before – this attitude that what i eat is my business, and that food should be enjoyable.

    i’ve always been a bit of a picky eater, but it started to become a problem with the onset of puberty. i grew vertically, but i didn’t put on much weight to compensate for the growth. i’ve stayed in the 90 – 105 lb range since i was twelve; i’m definitely underweight, and am cold much of the time.

    for many years i have dreaded going to a friend’s house for a sleepover because it means being rude and declining foods i can’t eat.

    for a few months early this year, i was at an all time high of 115 lb, because after getting my wisdom teeth removed my parents forced me to drink protein drinks (even though i literally gagged and spit them up). however, since i got out of high school, i have lost ten pounds. today in particular is a Bad Food Day. i’ve eaten saltines, a couple of taquitos, and a few bites of salisbury steak tv dinners.

    what causes me the most anxiety is the way my parents treat it and the way they don’t buy enough food that i CAN eat. even though multiple doctors have told them that they just need to make sure i eat at all, when i put things on the grocery list half of it is never bought, or they buy the wrong brand or type. and then they have the nerve to get mad at me for not eating.

    maybe once i’m out on my own and have a job and can choose what food to buy, i’ll be able to have a healthy relationship with food. but until then i’m in distress.

    • My heart breaks for your situation. I highly recommend both you and your parents visit

      http://www.ellynsatterinstitute.org/

      Ellyn Satter is a family therapist and registered dietitian, and the website has plenty of evidence-based research and guidance to support your journey toward competent eating.

      I suspect your relationship with food will be just fine once the responsibility to feed yourself is in your own hands. I hope your parents can learn to be more supportive of your needs until then.

      Are you able to cook? As a parent, I certainly appreciate someone else taking over the kitchen. Perhaps it’s a way both sides can meet on middle ground?

  8. I’m so glad I found this site! Recently I’ve been looking around on sites about picky eating, until I found out about Selective Eating Disorder. I looked up the symptoms and believe this is the problem in my diet. Ever since I was really little I’ve always been a picky eater. Now I’m 14, 5″2′, and 85 pounds. I’m pretty sure I am underweight and I think it has something to do with this. I eat a variety of foods, but almost no meat. I eat healthy most times, but I don’t usually eat any breakfast. I’ll eat lunch, but if I’m at school I won’t eat anything because I don’t want to eat in social situations and I am afraid that they will make comments about what I eat. I’ll eat heavy at dinner, but it’s mostly healthy. I always dread family gatherings when I know there will be eating involved! I avoid going to a friend’s house around the time they eat dinner because I know they will always be eating something that I don’t, and I don’t want to be rude by refusing to eat. People used to call me anorexic, but I know that has never been the truth. My family has always said my eating has to do with my body type, but I’m not sure if that’s true. I really, really want to fix this! I hate how this is getting in my way every day but I don’t know how to fix it. I am pretty sure if I told my mom about this, she wouldn’t believe me. She always says its a “Phase that I’ll grow out of” but I have been hearing that for 14 years now! The rest of my family is constantly picking on me and telling me that I should eat more types of food, and I really want to but there is always something stopping me. I’m sick and tired of this, and I really need to know how to fix it! Please help!

    • What is on your plate is no one else’s business. It is entirely your responsibility to choose how much you want to eat from what is offered, at home and away. You can decline or accept any offerings of food – it is not your job to please others with your eating.

      I will add that you are worthy of regular meals. Breakfast is exactly that – breaking the fast that occurs between the last meal of yesterday, and the 10-14 hours until it’s time to eat again the following day. Ignore what you think others expect from your eating, and listen to your own internal cues of hunger and fullness. Eat the food you enjoy in satisfying amounts and tune out the gossip in your presence that is nobody’s concern but yours.

  9. It’s strangely comforting to see that I am not the only one – because people usually treat me like I am a one of a kind freak!

    I remember for the first few years of my school life, where you had to have hot dinners, I pretty much spent the entire time in the headteachers office during dinner – because they served the dessert on the same plate as the hot food, it was all touching each other, it smelt funny, and it certainly didn’t look like something I wanted to be in the same room as – nevermind put it in my mouth. On one occasion that I did eat something, I despised the texture so much, I was sick for hours at the thought of it being in my mouth and now it’s my number 1 fear (even years later). So, because they couldn’t get me to eat – they would send me out and call my mum. They came to an agreement though where I’d have jacket potato every day (And I did, until I finished primary school – when I got to high school, I preferred not eating because it was so awkward socially).

    Although, I have always been lucky to have a mum that understands – well, maybe not understands, but accepts it. She has acknowledged now that I’m not just a fussy eater, different foods physically repulse me and I am actually scared of being around a lot of foods. So, I can go out for a meal with my mum and not worry about what I choose to eat, or not too eat and she’ll take me to a restaurant that I am familiar with and won’t have to worry about how they’re going to serve the food. I’m still building up the courage though to go out with friends, or colleagues (which is what bought me here!)My mum does worry because I am 5’8 and 110lbs, but she’s proud of who I am, and always encourages me to be proud of who I am.

    I often judge food on the colour though – I don’t eat any vegetables (unless we’re counting potatoes) and 97% of the food I eat will be beige and cannot touch on my plate. But I do like fruit – so, I guess that’s something.

    How I would do anything to just eat normally, I long to have a big meal full of all different foods and be able to go out for a meal with colleagues – but in the mean time, this will just have to do!

    • Kudos to your mom for giving you a safe food haven.

      We can count potatoes. And we will because the potato is a nutritional powerhouse. But it’s not so much the food you eat that is the issue as much as how you feel about your eating. It’s okay and socially acceptable to defend your plate and it’s no one’s business what you choose to put on it. Give yourself permission to be a “normal” eater, which is basically choosing food you enjoy in quantities that satisfy you. It’s okay to try things and not like them, and to leave food on your plate. Your mom is right – you have every right to be proud of who you are, regardless of what you do or don’t eat.

  10. Hi, as far as I can remember, i hated vegetables. Especially Green leafy vegetables. I would squirm whenever I chew and hear that crunch and that leafy juice that goes out of it. All my life I would order Burgers with no salads. I want to be healthy but I don’t know what to do. I always vomit/ feel like vommitting each time I eat vegetables. i could get the smallest green leaf on my meals. I seriously need help. I am gaining so much weight. but most of all, I want to be healthy. I envy those who can munch on salads like they are chips. Can you suggest any methods? I am 25 by the way.

    • I would hazard to guess that you just don’t like leafy green salad things, and it’s absolutely okay. You don’t have to eat salad to be healthy.

      I’d also like to caution you about using weight to determine the state of your health. There is a good deal of research to support the ineffectiveness of dieting – and I admit I’m drawing conclusions based on the envy of salad munching and your concern about weight gain.

      To be healthy, let’s change the context of this conversation to activity and take food out of the equation. To that end, move your body in ways you find rewarding – walk, dance, ride a bike, yoga… by yourself, with a partner, or in a group, whatever brings you joy.

      As for eating, don’t deprive yourself of good tasting food and please don’t suffer through offensive food because someone says it’s “healthy.” Instead, be diligent about feeding yourself regularly, and eat until you feel satisfied. I recommend reading Linda Bacon’s Health At Every Size, and Ellyn Satter’s Secrets to Feeding a Healthy Family to start your journey to good health on the right foot.

  11. Wow, thank you for this. The “light bulb” has just come on for me. This article is very enlightening and helps to ease the frustration when dealing with my 4 year old. I believe him to be a selective eater (along with having some oral sensory issues, perhaps even on the autism spectrum) and not a “picky eater” (as Ive been told since he was 18 mo).
    So my question to you is – WHO do I go to for help with this? Are there occupational therapist that can help me?

    • WHO you see depends on what specifically the issue is. It wouldn’t hurt to have his oral motor and swallowing skills assessed, but if he can handle a variety of textures, then it’s unlikely therapy will be helpful.

      Autism can look like many things and many things can look like autism. Selective eating is all about anxiety (which is common on the spectrum, but not exclusive). I would recommend support for you – as the provider of the food – because you have full control over that realm, and he has none – to create a stress-free, and no-pressure feeding environment where he can be successful with eating.

      For your own peace of mind, have an RD evaluate his diet – a balanced diet at his age can be spread over a few days or a week.
      Valuable reading:
      Love Me Feed Me, by Dr. Katja Rowell
      Secrets to Feeding a Healthy Family by Ellyn Satter
      Web support: How to Feed resources at http://www.ellynsatterinstitute.com
      And the parent to parent support at https://www.facebook.com/groups/MealtimeHostage

  12. Hi! ive had SED since i was 1. and now im 16 and still have it. My parents think its normal and ill go back to eating like normal but its not and no one has ever taken me seirously and it upsets me sometimes. How do i handle my situation i need help:( Thank you.

  13. My youngest son has early onset bipolar disorder and has literally not had a fruit/vegetable since he was eating baby food around 9 months old;; a EXTREMELY picky eater. The meat items I can get him to eat, he is now refusing. He would eat dried cereal, crackers, and anything sweet all day. This is becoming a very big problem because he literally will not eat, which is never good w/a cycling bipolar child. We end up just buying him a cheeseburger( he literally won’t eat Chick Fa Lay chicken anymore because it “changed” according to him) just to get him to eat some form of protein. HIs doctors have mentioned putting him in the eating disorders unit at Children’s Hospital in Dallas, but I just don’t know that the standard unit deals w/this kind of eating disorder( I have an older daughter who has bulemia and has been in the hospital twice, so I’ve been around the eating programs that seemed to be more geared towards anorexia/bulemia; and add to that having the knowledge of dealing w/an early onset bipolar child). We have spoken to another family w/a son who has early onset schizophrenia who literally will only eat protein bars for every meal. After placing him in Children’s eating disorder unit, there was no improvement. I would love for my son to eat a protein bar; that would never happen. Any suggestions would be great as this is becoming a serious issue, not to mention the meds he is on for bipolar( and we have been told they strongly feel he will remain on meds for his entire life) cause weight gain/potential metabolic problems!! HELP!!!

  14. Reading this page makes me realise I’m not the only one that has to go through this battle with food everyday
    Looking back I’ve always been a ‘picky eater’ but I have noticed this more so in the last few years
    This time last year I did go to the doctors due to my weight dropping to 6.5 st the lowest it’s ever been they sent out all the appropriate forms which I never sent back as I thought I could over come this, maybe I’m just stressed etc and that’s making it worse
    I did manage to put in over a stone and would be happy at 8st, but here I am a year later and once again my eating has got worse and I’m currently at 7st
    I’m 31 years old and it drives me crazy as I just want to eat but when it comes to choosing meals it’s the most frustrating thing ever I could cry.
    A few months back my mom noticed I could actually eat chicken pies and enjoyed them, so this was something she bought in quite regularly and now I can not stand them and it’s stupid
    I also hate eating in public it makes me anxious and has also caused tension on previous relationships, certain smells of foods make me gag and I feel at the end of my tether with all :(
    Time to go back to the doctors

  15. I’ve been struggling with this all my life. I’m in my early 50’s. Family says I couldn’t/wouldn’t eat at a very early age, 6 months old apprx by their memories. It’s a relief to find this. Comments from strangers, family, ex spouses make it worse-Just eat! Why can’t you eat! Deal with it eat! .Been tested for diabetes 2 plus thyroid disorder, both negative. Dr orders to drink nutrition shakes. I’ve seen a nutritionist. Had an ulcerous condition at age 15, chronic stomach pain from age 5 to 49, went on medication for anxiety, depression, which had affects on increasing appetite, and decreasing stomach pain. I’m to go back in 6 months for more blood screens.

  16. Pingback: putting a name to a disorder | Amusement

  17. At the age of 6 months I refused to drink from a bottle. My parents took me to many different food studies to pinpoint the problem. Turns out all I wanted to do was hold the bottle myself. They saw it as me just wanting my own way.
    The real problem occurred when I was around school age. No vegetables. No red meat, no foods of certain colors or texture and no foods that were mixed with other foods. I was labeled a “difficult” or “fussy” child, who no one wanted to take out to dinner because there was nothing on the menu.
    Things took a turn for the worst when I entered 6th grade. I was only 65 pounds and about 5’2, which is underweight. Doctors tried to convince my mom that I was anorexic, thankfully she never believed them because she knew how much I loved to eat sweets! I was bullied horribly, kids would even leave food in my locker with a note that said, stop starving yourself! Because of my poor diet I suffered from headaches and constant dizziness which is still a problem today. My skin color is never normal, you can see just about every vein in my body and I always have huge dark purple circles under my eyes( really embarrassing.) My mom took me to a nutritionist and I hated every minute of it. She just didn’t understand my situation and thought I was trying to starve myself when I was fearful of trying new foods. I always thought to myself that I have a phobia of trying new foods, but no one believed me.
    I’m now 17 years old an almost an adult and nothing has changed. My “food list” is still under twenty foods and all of my habits are the same. The only new “food” I was willing to try was coffee! I was really relieved when I found out about selective eating disorder! I am only left with one problem and this is trying to convince my parents that I do have this, I am just not sure the best way to go about it ??

    • Macie,
      Your mom sounds like she has always wanted nothing more than to do her best to free you of this burden, and probably blames herself. Nothing would relieve her more than to hear: “This is not your fault.”

      If you don’t know what to say, show your parents this post, and the hundreds of comments that follow. There are thousands of adults with SED (now known as ARFID) around the world. You are not alone.

      You can do this.

  18. I cried reading this. I’m 24 & have been struggling with this forever. I’ve had so much pressure from partners, friends & even family telling me to “just try it”. No-one understands the crippling fear I feel when I’m invited around for dinner at a friends place, or when someone offers to cook for me. I have to know what will be served. If I’m going to a restaurant I look up the menu online to work out if I can actually go or if I’ll be “too busy”-an excuse I use frequently to avoid embarrassment & making a scene. I will either have a big meal before going out so I can say “Oh no I’m not hungry, thanks” or I’ll just go hungry.. It’s so terrifying & embarrassing for me to admit that I generally only eat unhealthy, processed, fatty foods. I hate admitting it. I only eat bacon & chicken breast as forms of meat. It HAS to be chicken breast, & even then I study each bite before I eat it incase there’s any darker meat… But the thing for me is that it’s causing me to be overweight. I want to be slimmer so bad, just because I want to be healthy & feel fitter. Not for any fat-shaming reasons. But no matter how much I exercise, I know it’s almost completely in vain because it’s the eating & nutrition part that is crucial. I’ve lost 20kgs then put it all back on again time & time again. I’m in New Zealand, if anyone can send me in the right direction of someone or something that could help me overcome this horrible anxiety & fear so that I can broaden my diet & get healthy & lose some weight I would be ever so grateful. I’ve spent countless on hypnosis & what feels like everything else.. I really really want this, & I know that’s the first step. I just need some help.

    • Sarah, I’d like to offer you some hope. There are two distinctly different issues in your comment.

      The first one is the anxiety you experience about what you eat. You are allowed to choose the foods you enjoy eating and you can always decline to be served food you don’t want to eat. Your plate is your business and it is perfectly reasonable to politely refuse to accept comments and advice from others about what you eat. It really isn’t all that odd to prefer chicken breast over other pieces, and until you are comfortable with eating around other people, it’s best to ignore all the nonsense you read about “unhealthy, processed, fatty foods.” What is more important is that you eat at regular intervals (snacks and meals) and until you feel full. You do not need to clean your plate, and you do not need to feel guilty about what you do or don’t eat.

      The second issue is the stigma of being overweight. Weight is not an accurate determinate of health, and to be honest, nobody knows how much you should weigh. There is a growing body of evidence that shows weight cycling (repetitive losing and regaining) is more detrimental to health than being overweight. A much better strategy is to find an activity you enjoy and then, enjoy doing it.

      Please take a deep breath and believe that you do not need to eat by someone else’s standards or weigh what someone else says you should. You can be healthy eating the food you enjoy eating now and at any number on the scale. The stress that fear and anxiety bring will kill you faster than anything you might eat or those 20 “extra” kgs.

  19. Very well and informative, this outlines everything i suffer from. I suffered with this from very early age and my mother has coped and managed to get me eating some foods after some changes to my own frame of mind or distracting me as i eat. Im now 23 and currently just got sent home from work after having to cover for a collegue at the kitchen which caused me to have a panic attack and throw up due to handling the smells and clearing up cold food. I myself find alot of food nice and enjoyable however i avoid many dairy products due to taste and texture, half of the fruit variety. However i believe only thing thats helped me without any medical advice was jsut having friends and family there for you who unerstands that all we need is encouragment when needed and to not always question our tastes as sometimes the nerves of waiting for a meal and worrying that its edible makes it even harder to intake food. The “natural” or “average weight” doesnt worry me but to show how i changed i went from 8 stone at age 18 to what friends now see as better at 15 stone age 23 almost age 24. So all i can say guys who are like me is dont let it get you down, we can eat the food we just need support so speak to your family and explain to them why you dislike something.

    ps : Sarah on comment above, i know the feeling however you are your own self, i although may seem selfish started to think of myself and that alone so if someone says to try something i say no thank you im happy with what ive got or i dont like it sorry. Weight should never be a concern, to build confidence there is many other things to take part in and to worry about weight would always be a knock on affect to your health and life. Keep fit without the lose weight in mind and i can guarentee it will work better then focusing on the weight loss.

  20. Very well and informative, this outlines everything i suffer from. I suffered with this from very early age and my mother has coped and managed to get me eating some foods after some changes to my own frame of mind or distracting me as i eat. Im now 23 and currently just got sent home from work after having to cover for a collegue at the kitchen which caused me to have a panic attack and throw up due to handling the smells and clearing up cold food. I myself find alot of food nice and enjoyable however i avoid many dairy products due to taste and texture, half of the fruit variety. However i believe only thing thats helped me without any medical advice was jsut having friends and family there for you who unerstands that all we need is encouragment when needed and to not always question our tastes as sometimes the nerves of waiting for a meal and worrying that its edible makes it even harder to intake food. The “natural” or “average weight” doesnt worry me but to show how i changed i went from 8 stone at age 18 to what friends now see as better at 15 stone age 23 almost age 24. So all i can say guys who are like me is dont let it get you down, we can eat the food we just need support so speak to your family and explain to them why you dislike something.

    ps : Sarah on comment above, i know the feeling however you are your own self, i although may seem selfish started to think of myself and that alone so if someone says to try something i say no thank you im happy with what ive got or i dont like it sorry. Weight should never be a concern, to build confidence there is many other things to take part in and to worry about weight would always be a knock on affect to your health and life. Keep fit without the lose weight in mind and i can guarentee it will work better then focusing on the weight loss.

  21. I’m 13, im not sure what i have but i have something… Ever since i can remember, ive eaten like this, since i was 4 or 5 …cant remember why. I live on carbohydrates, apples oranges sugar and water basically ….i don’t like milk on its own, vegetables or fruits or meat…their texture is disgusting, It is embarrassing when people ask me why i have so little variety on my plate or when the waitress is surprised there is no meat or veg on the plate… but even if i wanted to, i just can not eat it….my parents used to try to get me to eat more, and bribe me with money but even as a younger child, that did not work….and my list gets shorter nearly every year…Sometimes i wish that i were normal and that if there is a ‘meal deal’ that everyone ends up getting in a restaurant, that i am not the exception that orders rice and curry sauce with no chicken…i don’t care if my food touches another food, but it used to be like that when i was 6 or so but now its this… And as you said its TRUE that when people try to alter or hide things in food, it turns me off the food….and its completely obvious, i can taste it, you cant hide turnip in mashed potato….Do you think i will grow out of this, even though im so stuck in my ways? im glad that there is at least people who have this as well…

    • Lily-may:
      I applaud you for being proactive about your eating and reaching out for support. I hope you have support at home and among friends.

      Everyone is picky to some degree, however, when picky goes beyond disliking food and begins to negatively affect you socially and emotionally, we’re entering territory that needs attention. If you want to talk in more detail, get in touch via the Contact page.

      First, start with acceptance. There are any number of reasons to explain one’s choices in food. For now, ignore all the “shoulds” and “oughts” you’ve heard about eating healthy, and accept what you do eat as normal for you. What’s on your plate is nobody else’s business. (And, fwiw, hiding turnip in anything is nothing short of cruel.)

      It’s okay to have a preference for carbohydrates, apples, oranges and rice and curry sauce without the chicken. In your own time, when YOU are ready and when (and if) YOU want to, you can try foods that look appealing to YOU. My most recent post “Interview with a Picky Eater” may help you understand your eating a little better and help you explain it to others so they can be the support you need.

  22. Hello – I am so glad to have found this post. I have a 13 year old son who struggles with eating. He has a few things he will eat – hamburgers, spaghetti and meatballs, cheerios, animal crackers, chocolate chip cookies, milk. There are many foods that he will not touch at all. He says the smell and texture look gross and nasty. What is the best way for me to help him with trying new foods? Our family all has some dietary issues – lactose intolerance, gluten intolerance, etc. I try to provide varied meals, but it is difficult with some of us having restricted diets. Over the years, I have resorted to the option that if you do not want what most of the rest of us are having, you can have a bowl of Cheerios. My son is happy and fed, but he gets a hard rap from extended family. I have come to the conclusion that there are bigger battles to fight than over food. But, I would like to help him feel more comfortable and able to deal with social gatherings. Any thoughts?

    • Until he learns how to defend himself, you’ll have to be the one to defend him from external sources of pressure. The Feeding Doctor has a great post on this topic here: http://thefeedingdoctor.com/family-interferance-on-turkey-day/

      The more “normal” he feels about his eating, the better able he will be to deflect comments from others. Little things like just having cheerios available with the meal instead of “if you dont like this, get something else” teaches a child how to manage in socially acceptable ways around food. It depends where he is with his own acceptance. It would be wonderful if no one felt the need to interfere with another’s eating, but unfortnately having a sensitive palate can draw a lot of unwanted attention.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s