Selective Eating Disorder: Extreme Picky Eating Becomes a Medical Diagnosis

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Children are often called “picky eaters” because of a hesitance to try new foods and seemingly surviving on little more than chicken nuggets and French fries. Most kids, as they get older, overcome the tendency to severely limit their diet; however, sometimes they grow into adults who continue extreme selective eating. The American Psychiatric Association is proposing a new medical diagnosis for this condition called “Selective Eating Disorder” or SED.

The British Journal of Clinical Child Psychology and Psychiatry describes selective eating disorder as a “little studied phenomenon of eating a highly limited range of foods, associated with an unwillingness to try new foods. When this happens social avoidance, anxiety and conflict can result.”

Read: Picky Eating Common in Autistic Children

SED is common in those with autism spectrum disorders.

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Researchers at Duke University’s Center for Eating Disorders have initiated an online national public registry of selective eating. In less than five months, 7,500 people have fully registered for the Food FAD Study (Finicky Eating in Adults) with more who have started the survey but have not completed it. The registry offers a place for patients to report on their unusual eating preferences and habits, giving researchers an insight into the disorder.

Director Nancy Zucker stresses that “people who are picky aren’t doing this to be stubborn” but actually experience food differently than the rest of us. Researchers aren’t sure if biology or psychology is the driving force – both are likely involved. Zucker believes that SED patients may be “super tasters”, meaning they taste certain flavors more acutely than other people. Other theories suggest an early negative experience with food, such as childhood gastrointestinal issues.

Read: Tips for Feeding Picky Eaters

In addition to nutritional deficiencies, SED patients may risk other negative health consequences such as obesity and high blood pressure as foods preferred tend to be bland, processed, and salty.

The American Psychiatric Association intends to make a final decision on whether to include Selective Eating Disorders in the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) due to be released in 2013.

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Comments

Since the first day I introduced food to my son he has been extremely picky. He is currently 14 years old and practically eats the same things that he ate when he was a toddler. He eats grill cheese , pizza no cheese, only my chicken cutlets extremely thin and only fried (he doesn't eat it typically he drowns it in sweet and sour sauce and alot time just eats the ends). he will eat eggs if each egg has 3 to 4 pieces of cheese melted on it and he never finishes it. he loves chocolate and pancakes I am able to make pumpkin apple and blueberry all these are purred into pancakes so smooth. he sometimes eats some ribsteak drowned in sweet ands sour (always the same brand). He will eat the inside of strawberries if chocolate syrup and whipped cream on it. he will eat bananas French. Toast and at time couple of bites of sweet potato with syrup. he will eat corn on cob but very particular aboutbit. he never eats at family parties unless he ,hides up in room. My family always comments on his limited diet. he will never eat at a restaurant except for pizza or grill cheese. Iif we r at another person house he will not eat. pls help not sure what to do and I know it's affecting him socially to embarrassed at school at lunch. I get upset I try to help him and nag terribly about eating but only because I love him and worry about health. I revved food pyramid with him and try to give him info regarding heathy eating ..
My sympathy to you. My son also has an extremely limited diet and has refused new foods since the age of 1. He is now 10. We work with occupational and behavioral therapists several times a week, but still he fears food. It's very hard socially. People just don't understand that this is a real disorder and that it's possible for a child to prefer to starve rather than eat a food outside his comfort zone.
I am an adult who is a picky eater. For a picky eater like this, all the focus people have on a meal, why they don't want to eat, etc.. is overwhelming. It actually makes things much much worse. Try to make it a non-issue and allow him to feel safe. Then see how you can take the foods he does like and expand from there. A tiny nibble is absolutely horrifying to him, I know. Try to take something he likes, say french fries, perhaps, and color them... it will be hard for him to eat the same french fry if it is green, but it can help him over come the fear. Just a thought...
I'M AN 11-YEAR ILD WHO IS PICKY AND POSSIBLY SUFFERS FROM SED. I'M SO SICK OF ALL U TALKING ABOUT PICKY KKIIDDS LIK ME. I MEAN HONESTLY WE R KIIDDSS! WE R HUMMAAANNN!! WE R NOT PERFECT SO STOP TALKING ABOUT US LIKE WE R SOME TYPE OF ALIEN OR UNKNOWN SPECIES!!!! U WANNA CURE US!!!!!! THEN STOP MAKING US FEEL LIKE HELPLESS LITTLE FREAKKS WHO COULD DIE AT ANY MOMENT!!! I MEAN SHEESH IM ELEVIN AND IN MIDDLE SCHOOL NOT IN A HOSPITAL!!!!!!!! IM NOT GONNA DIE IF IM NOT PERFECT!!!! If this disorder is real, then do something about it. put it on the news on tv. Dont just blog about it. u wanna help us kids, then makin us feel so scared and helpless, make us feel lik we can help ourselves and that we wont just die off one by one.
I'm sorry that you feel that your are treated like an alien but you have to understand as a parent it is extremely diffcult to have to focus so much time on trying to teach your child to make healthy choices. I don't expext you to understand at this age. The news and t.v does not make an issue important. Someday you will also understant this, I hope. My daughter has SED to the point where she will starve herself If we take a trip somewhere and she doesnt have any of her comfort foods. She has not qrown in a year and is always sick. We have been working with a nutrionist and she is slowly starting to try foods. With the help of suppliments, nutrition shakes, support from doctors and yes other parents. Many parents like myself are scared for the health of thier child when it becomes this extreme and they often need to reach out to other parents for support and advice. This is the way a lot of adults learn to help and deal with thier own feelings and fears. Your right you will not die if you are not perfect. After all there is not such thing as perfect human we are all different. I just want her to be healthy and happy.
I understand what you are saying. I have a 3 year old that only eats apple sauce, cottage cheese, pizza, waffles (only a specific brand) and some crackers/cookies. He won't eat outside of the house and distracted with t.v. He doesn't feed himself because he gets really upset if food falls out of the spoon and will cry/scream if he gets some on his hands or face. Just the smell of food (other than his) makes him uncomfortable and he usually leaves the room until we finish eating. The pediatrician says he is developing normally but I know has something beyond being a picky eater. We are already noticing how it affects him and us in social gatherings and I worry about school in the future. I am taking him to a developmental pediatrician but I am afraid I will get the same answer...he is just a picky eater.
No, he is NOT just a picky eater. He falls under the autism spectrum (probably aspergers) and he is not alone. Our son is there as well. We make his lunch for him everyday for school, so at least lunch time is a no stress, reassuring atmosphere where he knows he can eat in peace. Sure, social gatherings are tough. I always try to ensure that he eats before we go to these gatherings, and when we get there, he picks and chooses what he wants to eat. If I sense that there will be an issue with the host, I will pull the host asied and explain the situation. My son had a sensitivity issue to touching foods, etc. As a boy I worked in a kitchen washing huge pots and pans and had to touch all kinds of cooked food left in pots. So, one day, I took him to the sink and we "played a game." The faucet was running if he needed it. But he held his hands in the sink and I started pouring various foods in his hands. Things like ketchup, mayonaise, leftover corn flakes that were soggy, etc. Yeah, it was gross but when he saw it in my hands and having fun, he tried it too. And he realized that it was actually kind of cool. Messy, but cool. And all he had to do was hold his hands under the running faucet and everything just washed away.
I feel all of you bc. Im in the same situation, i feel frustrate with my 2 years old son he doesn't eat he does not development well he is under weights, I been trying everything sometimes I just get my car and drive away crying bc is so frustrate knows he needs food, he is all bones, anemic I ever thought he had something else i wish they have a pill you can give them and they automatically eat, But is not that way I glad not be the only person with this problem
I found this website to be a help. My daughter who is now 16 has always been a "picky" eater from age 2 1/2 on, before that she ate a good variety of foods. My husband is a "picky" eater but eats a wider range of foods than my daughter. My father and mother-in-law were also "picky" eaters. I was a "picky" eater as a child but have outgrown it and have always hoped my daughter would as well, but I'm not so sure now! Over the years I would discuss this with my daughter's doctor and she didn't seem to be overly concerned. She said as long as my daughter was gaining weight and was healthy there was no reason to worry. But I do see social issues with this and it concerns me. I wonder if this is inherited? I also wonder if this is an anxiety related problem. My daughter has a bit of anxiety and OCD slightly and a mild case of ADHD. And as a small child she had "selective mutism" tendencies which is also an anxiety related disorder, which she eventually outgrew.So I supposed having a selective eating disorder shouldn't come as a surprise. I also wonder if it is a bit of a control issue. I welcome other people's comments and experiences. Maybe we can find a reason for this "disorder" (a word I don't like to use as I feel my daughter is quite normal overall and I don't like lables, sometimes they become a self fulfilling prophecy.) Thanks.
When my son was in his high chair, he would devour everything put in front of him. Then, as if a light switch turned off, he started pushing most things away. He is now 12. Although it has gotten slightly better, there are still many things he cannot eat. No pizza probably because of the sauce. All pasta must be served without sauce. He can eat turkey and ham on rolls but not in a sandwich made with bread. Can't eat any gravies and no condiments at all on hot dogs and hamburgers. Just plain. Can't eat mash potatoes but loves french fries. Loves apples but hates apple sauce. Sure it's an inconvenience, but we stopped fighting it long ago. He is who he is. We learned long ago he wasn't being picky, he, for some reason, was incapable of eating what we thought was "normal" food. He takes a vitamin everyday, an occasional protein drink, and we all just try to be a stress-free about it as possible.
I can totally relate to all of the postings. I truly believed that I was to blame for my child's fussy eating issues as it all began when I introduced lumps into her smooth blended baby food. My daughter was around the age of 2 when it all started going down hill. Even the foods she had eaten previously seemed like they were scaring her to death. If I tried to feed her a simple bowl of mash she would immediatley start to freak out her eyes would change and she would almost make herself sick. A million doctors and specialists later I was no wiser and worrying constantly about her health. Then one day I heard about a selective eating disorder workshop and it completely opened my eyes to what it actually feels like for our children. I understand now that it is an actual fear of food just like a fear of anything. It affects them physically and they are not trying to be difficult. I actually apologised to my daughter when I returned home and told her that I finally understood how she felt. My daughter is now 8 and I no longer push the issue as I know it wont help the situation but actually make it worse. She still eats the same foods we havent really moved very far from the carbs and dairy oh and the occasional apple and banana. I was completely floored a week ago when we were in a restaurant and as usual I am freaking out worrying about what she could possibly eat from the menu and to my suprise she actually ordered a kids meal of spaghetti bolognaise. This has never happened before and when it came out the spaghetti wasnt spaghetti but fettucine pasta and I waited for the response because fettucini isnt a safe food but she sheepishly picked up her fork and ate at least a third without any fuss at all. I have never been able to get my daughter to eat meat unless it is in the form of a sausage roll so to see her eat the bolognaise mince was truly a magical experience. I have taken her for blood tests and she is completely healthy and I have no idea how that can be possible. I give her incremin every couple of days and omega 3 capsules so maybe they are helping. My biggest worry is that due to the limitation of food groups she will have issues with her weight as she has started to fill out recently. It was very helpful to read all your comments and I think that sharing out stories can only help make us us feel somewhat better.
My son is a picky eater he never sit on the table to eat with us he loves fries chocolate ice cream crackers but this is not real food he is just 2 years old how he can possible not eat or want to eat I try everything he is under weights anemic I feel frustrate bc I cant do anything to make him eat like a normal kid, i push him sometimes, some times i let him watch tv while i put a spoon of food in his mouth sometimes work sometimes he has his mouth full for an hr bc he doesnt want to eat, i feel like he punish me,
It is somewhat comforting to see other people also dealing with a child that won't eat much at all,but I can't help to be worried sick about my almost 3 year old daughter. She was exclusively breastfed until 5 months , when I then introduced fruits and then vegetable and she ate pretty much everything until right before she turned 15 months .It literally happened overnight that she started refusing all familiar foods and next thing I knew her diet became more limited every day, little by little. Nowadays we won't eat any kind of meat, very seldom will have chicken nuggets from a particular chain only. Her diet consists basically of plain white rice, pasta with butter, crackers, yogurt, occasionally a piece of toast, lettuce and cucumbers and when I am lucky I can squeeze in a banana , Apple or tangerine. Sometimes she will have a pediasure. She likes chocolate , popcorn and salami, which I avoid giving her for the high salt and fat content . Sometimes like for the past 3 days when she is sick, she will refuse everything and will only have yogurt or breastfeed, which is far from ideal but better than nothing . I feel very discouraged and don't know what else to do. She is developing fine and is very active but is underweight .if anybody has had any success with any appetite enhancer or supplements, please let me know.many thanks in advance