“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 few years, a new diagnosis called avoidant restrictive food intake disorder (ARFID), better known as selective eating disorder, has made its way into daily life. Parents and loved ones are starting to notice and they have every right to be concerned. The problem often goes undetected due to weight, social status, and after-school activities looking normal.

Yes, and it’s different than the ones you know! This eating disorder seems to be strangely unique because the person is eating and there may be no body image concerns. They sometimes indulge with a safe food because that specific item is a comfort to them. Any other food causes stress and worry.

No! In fact, more and more eating difficulties have traits of ARFID and selective eating, causing more glaring and intense symptoms. When a person starts to find habits that make them feel in control, they mature physically. Psychologically, they may be stunted with anxiety or avoidance. Some adults have eaten this way for decades and now recognize the need to change.

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

1. 1. Trauma – they had an bad experience like being sick, which affected their relationship with food in a negative way.
   2. Super Taster – 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.

 

This happens a lot. Take your time. Don’t pressure the situation. Find ways to ease worry through coping that can help the person become distracted or more tolerant of the moment. You’re likely to need the help of a therapist who has the training and the eating disorder/relationship with food knowledge to get to the heart of the matter.

We approach this systematically 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 address selective eating disorder head on, using cognitive behavioral therapy for ARFID (CBT-AR). We often need to look at not just the amount of food, but also the selection of items and the anxiety your loved one is experiencing. We create an understanding that this is biological and proceed with informed, evidence-based care.

Always remember, it’s not their fault and they can change.