Parents and families are calling into our office stating,

“I don’t think my teen can go to birthday parties because he won’t eat pizza!” 

“How is my teen going to go on dates when she only eats chicken fingers and mac-n-cheese?!”

“Why is it we can’t go to a nice restaurant without worrying if my daughter will be able to eat anything?

In the past two years a new diagnosis called avoidant restrictive food intake disorder (ARFID), better known as selective eating disorder, has quite strongly made its way into our day-to-day lives. Parents and loved ones are starting to notice and they have every right to be concerned. The problem slips under the radar, sometimes unable to be deteced due to norms associated with weight, social status, and after-school activities.

It may first appear like anorexia because a child refuses to eat specific foods. He or she may just completely avoid or refuse to eat meals or maybe you’ve gotten into a routine of being a short order cook to your family.  When did this all begin and who is at fault?  No one and that is where we begin.

Yes, and it’s different than the ones you know!  It seems to be strangely unique. There may be no body image concerns and your loved one is eating.  Sometimes what ends up happening is a person will indulge with a safe food because that specific item is a comfort to them and anything outside of this causes stress and worry for him or her.

No!  In fact more and more eating difficulties have traits of ARFID and selective eating causing the more glaring and intense symptoms. When a person starts to find habits that keep them feeling in control they mature physicially. Psychologically they may be stunted with anxiety or avoidance.   Some adults have eaten this way for decades. Some up to and through college and now recognizing something needs to change.

First, ask your child or adult if any of the three situations below often or sometimes comes into their mind.

1. 1. Trauma – they had an bad experience like being sick, frightening their relationship with food
   2. Super Taster – We see this often. A person can be a “super taster” and only feel comfortable with specific textures, tastes and presentations.
   3. No Appetite – A child, adolescent or adult never had strong hunger cues to begin with.
   4. He or she just doesn’t know – the choice is there and feeling stuck is a daily occurrence.

Approach the situation understanding that anxiety is very difficult to escape. They may not know exactly what is going on.

Understand this happens a lot. Take your time. Don’t pressure the situation and also find ways to ease worry through coping that can help the person become distracted or more tolerant of the moment.

You may need someone who has the training and the eating disorder/relationship with food knowledge to get to the heart of the matter.

We approach this systematically and with a lot of education and support.   No one has been trained to help selective eaters until recently.  Hilltop Behavioral Health is one of the first in the area to take this difficulty head on using CBT-AR (CBT for Arfid).  We often need to look not just at the amounts of food, but also the selection of items, the anxiety your loved one is going through, create an understand that this is a biological underpinning and proceed with informed evidence based care. We always have to remember – It’s not their fault and it can be changed.