Selective Eating/ARFID
“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?
If you’ve said this or something similar about your child, you’re not alone.
What is a selective eating disorder?
Yet, something is dramatically off. Children refuse to eat specific foods. They may even completely avoid or refuse to eat a meal. Maybe you’ve gotten into a routine of being a short order cook to accommodate a child’s eating habits. When did this begin and who is at fault? No one is at fault, and that is where we always begin when treating ARFID.
Question #1: Is selective eating an eating disorder?
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.
Question #2: Does selective eating only affect children?
Question #3 How do you approach the subject?
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- Trauma – they had an bad experience like being sick, which affected their relationship with food in a negative way.
- Super Taster – A person can be a “super taster” and only feel comfortable with specific textures, tastes and presentations.
- No Appetite – A child, adolescent or adult never had strong hunger cues to begin with.
- 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.
Question #4: What if it just feels like it’s too much?
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.
Question #5: What can be done to treat selective eating disorder?
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.
We are seeing strong results with a mix of family-based treatment (FBT) and CBT-ARFID. Through direct education, informed approaches around fears and stress, and compassionate and supportive challenge, people are making wonderful changes.
Imagine your teen looking at you and saying, “I would like to try that broccoli because I’ve never really had it. I’ve never really given it a chance. I want to try it!”