What Is Selective Eating Disorder?

Most people think of anorexia or bulimia when it comes to eating disorders, but that's not always the case. Binge eating, avoidant restrictive food intake disorder (ARFID), rumination disorder, and other conditions fall into this category, too. For example, ARFID — which was previously known as selective eating disorder, causes an aversion to certain foods or types of food. Surprisingly, this condition has nothing to do with body image or size, notes the Anxiety and Depression Association of America (ADAA). Instead, it's a form of extreme picky eating.

Selective eating disorder is more common in children, but it can also affect adults. The Recovery Village estimates that about 9% of adults and 22% of children treated for eating disorders on an outpatient basis have this condition. Boys and adult women are more susceptible to ARFID than other groups. Certain conditions, such as autism spectrum disorder, anxiety, or the fear of choking, may increase the risk of developing ARFID.

We all have heard stories of children who eat nothing but fries, pizza, or pancakes. Earlier this year, Gulf News wrote about Alex, a boy who only ate steak, meatballs, and a few other foods. At some point, his food choices were limited to chicken nuggets and chips. His mother initially believed that he was just a picky eater, but she eventually realized Alex had an eating disorder.

"In ARFID the disturbance in feeding is associated with a lack of interest in food, avoidance based on sensory characteristics of food (for example smell, texture, etc.), or a fear of choking or vomiting. In clinical practice, we often see a combination of these reasons and the reasons do switch over time," psychiatrist, Dr. Waleed Ahmed, told Gulf News. For example, Alex refused to eat his favorite foods if they were cooked in a slightly different way than usual. The Meadowglade, a rehab facility, notes that people with ARFID often feel stressed when being introduced to new foods or having to eat in the presence of others. 

Specialists also explain that selective eating disorder, or ARFID, is often due to a traumatic event early in life. For instance, someone who choked on his food in childhood may have a higher chance of developing this condition. These individuals are not concerned about their body weight as those with bulimia and anorexia might be. Instead, they believe that eating certain foods will kill them. 

A selective eating disorder can make it difficult to vary your diet and get the nutrients needed for optimal health. Some people also experience digestive distress and end up relying on dietary supplements, warns the National Eating Disorders Association. Over time, this condition may cause dramatic weight loss, lethargy, dizziness, dry skin, hair loss, anemia, irregular periods, and increased sensitivity to cold. The nutrient deficiencies associated with ARFID can affect immune function, sleep, memory, muscle function, and heart health.

The underlying cause of this disorder isn't always apparent, which makes diagnosis difficult (via Neuropsychiatric Disease and Treatment). Moreover, there is no standard treatment for ARFID. Sufferers often see different doctors and seek answers while their condition worsens.

Center for Discovery, a rehab facility specializing in eating disorders, notes that psychotherapy yields the best results. Most patients could benefit from exposure therapy and cognitive or dialectical behavioral therapy, depending on the severity of their symptoms. Dietary supplements may be necessary, too, says The Recovery Village. 

If you are struggling with an eating disorder, or know someone who is, help is available. Visit the National Eating Disorders Association website or contact NEDA's Live Helpline at 1-800-931-2237. You can also receive 24/7 Crisis Support via text (send NEDA to 741-741).