When someone mentions “eating disorder”, it’s the two well known ones that spring to mind. Anorexia and bulimia. Both are motivated by an unhealthy body image and a desire to be thin. The American Psychiatric Association plans to expand the eating disorder category in the Diagnostic and Statistical Manual of Mental Disorders (DSM) to “capture many very young children presenting with feeding difficulties” that did not meet the criteria for Feeding Disorder in Infancy and Early Childhood in the current DSM-IV. “This criterion has been modified to take account of the fact that many young children fail to meet current criteria because of the primary focus on failure to gain weight or weight loss, as well as the fact that certain features of presentation are also commonly seen in older individuals.” Avoidant / Restrictive Food Intake Disorder (more commonly known as Selective Eating Disorder) will be included in the 5th edition of the DSM, released in May 2013.
Statistics on this newly recognized eating disorder are not available. I often wonder how many adults who believe they are alone in their strange eating habits and parents who blame themselves for their child’s limited diet are out there not knowing they are one of many. For the longest time, I couldn’t think of anyone in my circle of friends who has a child that eats as little as mine.
And then I remembered Karen.
Karen is now a popular 15 year old who consistently does well in school. I first met Karen, and eventually her mother, at my sister’s home daycare. The other children were having soup and raw carrot sticks for lunch. Karen was having a peanut butter sandwich. Karen only ate peanut butter sandwiches. Breakfast. Lunch. Dinner. Peanut. Butter. Sandwich.
Karen now eats a few more things since she was a sandwich eating three-year-old. None of these include a bowl of soup, hamburger, hot dog, eggs, pizza, pie, any cooked veggies, or meat with the exception of chicken. Chicken is only acceptable coated with Shake n’ Bake or McDonalds nuggets, and only after being taken apart to deem what parts might be edible. She has given up her mainstay of sandwiches.
She lives off of bagels, plain white toast which must only be buttered by her and gold-fish crackers. Apples and oranges and only if cut a certain way. Raw beans, celery and carrots. Potato chips (she’s never tried any kind of dip). The only potatoes she will eat are French fries.
Her mother tries to keep her daughter’s limited diet a secret. “She has been harassed by others for her selective eating. I have been criticized by many for poor parenting.”
For a class in grade 10, Karen had to create a three course dinner for her parents. “We were served garlic toast, an okay food, but when it came to making the sauce for the pasta she lost it. Seriously, she started to gag as she was crushing up the tomatoes.” Her mother stepped in to help while Karen continued cooking the pasta. “While draining it she felt ill again. To her, the spaghetti reminded her of worms.”
Karen’s mom learned to accept her daughter’s quirkiness about food and made sure she always had a safe snack available when going somewhere. “Karen has even avoided going to friend’s houses at dinner time, fearing that some well meaning people will force or trick her to eat something that is not in her safe food repertoire.”
Karen’s mom suspects that an episode of choking on a piece of apple at 8 months and again on an ice cube at the age of three is a contributing factor to her daughter’s selective eating.
Karen’s younger sister was born with multiple disabilities and health problems, including an inability to swallow any liquids. Friends, family and doctors continuously talked about the baby’s declining health. “The baby was losing weight rapidly due to her severe heart condition.” Karen’s mom believes that the focus on the new baby’s feeding challenges only added to her daughter’s already growing anxiety toward food. “There was a lot of pressure to have the baby put on enough weight to survive the 11 hour heart surgery. Her sister to this day does not eat by mouth and is fed via G/tube. I have racked my brain trying to think where I had gone wrong as a mother.”
Fortunately, most of Karen’s closest friends accept her picky eating. Even some of the families are accommodating, although Karen usually keeps a package of gold-fish crackers with her at all times. More often than not she will tell families she already had supper or that she isn’t hungry.
“Karen gets very upset if we criticize or discuss her eating. Her grandmother is infamous for watching what she will and won’t eat and for trying to bribe her to try just a little taste. Any form of pressure just doesn’t work.”
What does seem to work is a communal family platter of Karen’s preferred but short list of fresh fruit and raw veggies. “I serve a platter each night and we all pick away at dinner. I find when they are cleaned, washed and served we all tend to eat off the platter.”
Karen’s mom has learned to accept and accommodate her daughter’s limited diet. “Approximately five years ago I stopped making a special dinner for her. Unless we are having Shake n’ Bake chicken, I will go about making our own supper. She does drink milk so she will often have toast, cereal (a specific brand name only), a bagel or crackers with her dinner. We always sit down together and eat supper as a family. We do not discuss her eating habits.”
Recently, Karen has been able to add rice cakes and Pillsbury croissant rolls to her diet, as well as frozen Yorkshire pudding. “She will not eat homemade or the ones from the packages.”
When asked what effects her daughter’s limited diet has had on her health, Karen’s mom speaks with pride and relief. “Karen is a normal height and weight for her age. She is also very active and plays on many sports teams. Most importantly she is healthy.”
Mealtime Hostage invites adult picky eaters and parents of children with feeding challenges to share their story. To share yours, contact us on Facebook.