Are You a Picky Eater? It Can Be a Serious Problem

We have all known little ones who are picky eaters-children who turn up their noses at vegetables...never try new foods.. and often have just three favorite foods. But not adults, right? As it turns out, picky eating in adults is much more common than you might think.

Although most children eventually expand their palates and eat normally, many don't–and their finicky eating habits persist into adulthood. In recent years, researchers have begun to recognize that this type of picky eating, also known as selective eating disorder (SED) or food neophobia, adversely affects a significant number of adults, leading to nutritional deficiencies and even interfering with a normal social life.

An Eating Disorder?

Picky eating is not yet considered by health professionals to be a diagnosable disorder in adults, but that may soon change. Currently, this eating problem is officially recognized only as a diagnosis in children younger than age six and is characterized by selective eating that causes significant weight loss or a failure to grow normally.

However, an American Psychiatric Association task force is now investigating whether a new disorder should be proposed-one that is redefined to include children of all ages and adults whose food aversions and/or food avoidances lead to marked weight loss...nutritional deficiencies...dependence on tube feeding or supplements...and/or impaired social functioning. The proposed name of this newly defined disorder is avoidant/restrictive food intake disorder.

The Problem In Adults

Researchers do not yet know exactly why this disorder occurs, although several factors may contribute. Some picky eaters may have a genetic predisposition to taste sensitivity...or they may have grown up with parents who were selective eaters. For some selective eaters, a prior illness, such as food poisoning or acid reflux, can make them fearful of eating and worried about getting sick again.

Because few studies have been done on picky eating in adults, the characteristics are still being discovered. Researchers do know, however, that picky eaters are highly sensitive and reactive to taste, food textures and odors.

For example, they often avoid foods that are chewy, stringy or slimy, such as cooked vegetables, and instead prefer crispy, crunchy foods, such as chips. They often dislike bitter foods, such as broccoli, but frequently have no problem with sweets. Sometimes, even the sight or smell of certain foods can bring on feelings of anxiety and/or disgust...and make them gag. Most people dislike some foods intensely-but it's different for adults who are picky eaters. They not only have extreme reactions to many foods, their reactions also cause them extreme emotional distress.

Adults with the disorder are often ashamed and embarrassed about their eating habits. Social occasions that revolve around food, such as family functions or business dinners, cause these adults severe anxiety. In fact, extreme anxiety about their eating habits may even hold them back professionally.

When To Get Treatment

If a person's limited range or quantity of food is threatening his/her functioning-for example, one's health, job or relationships-it's time to seek help. Health professionals who are trained to help people with the disorder (not all doctors have even heard of it) do so through a combination of cognitive behavioral therapy, occupational therapy that focuses on the sensory aspects of eating and nutritional guidance. Techniques found to help…
Support groups. Selective eating isn't a well-known problem, which can make people with the disorder feel isolated. Many might not even realize it is a problem that others share. Participating in an online support community, such as Picky Eating Adult Support (www.picky eatingadults.com), may be useful.
Behavioral therapy. One key aspect of therapy for these patients is to help them acknowledge that they have an eating disorderthat is, in essence, a physical disorder like so many others. These people are not trying to be "difficult when it comes to their food choices, they simply experience food differently from those who don't have the disorder. The goal of treatment will differ for each individual. However, in general it should help limit the restrictions that eating may be imposing on the person's daily life. This may involve improving the range of foods the person feels comfortable tasting or even liking. For others, treatment may focus on targeting the social isolation that has become associated with their dietary habits.
Dietary help. Nutrition professionals who are trained in treating this disorder will try to help patients move toward consuming a more balanced diet. Although it is not known how much a picky eater's food repertoire can be expanded, there are some ways that nutrition experts might work with a patient to expand his diet. (See box.)

A Not-So-Picky Diet

Techniques that may allow a picky eater to expand his/her diet…

Experiment with different preparation methods. If you don't like plain cooked vegetables, try adding them to a soup or stew. Some people who avoid broccoli, for example, have no trouble eating broccoli and cheese soup.
Try the same food, different texture. Sometimes it's the consistency rather than the taste of a food that is offensive to a picky eater. A person who doesn't care for the texture of applesauce may enjoy apples, whole or cut up. People who dislike cheese may be able to eat a small amount melted on a piece of toast. Or put a tiny bit between two crackers. That way, in addition to tasting the cheese, you'll experience the crunch of the crackers.
Find a healthier alternative. Many selective eaters favor crispy, crunchy foods like potato chips. Instead, try a crunchy raw vegetable such as celery with a little salt.
Take it slow. Introduce one new food at a time, and allow yourself to get comfortable with it before attempting to add another one.