I am glad my children are not picky eaters, but I must admit, when they were little, I forced them to eat foods they didn't want to try. Don't like the looks of that corn chowder? It won't go away from the table, and neither will you until you have eaten at least half the bowl. You think those shrimp look funny? They think you look funny too. Eat them. That arugula won't kill you, but I will kill you if you don’t eat it. I had some heart. They could can skip the dressing (but not the salad), and I was fine with serving foods on separate plates so nothing touched. I fronted foods with good info: You need that kale for your eyes! Your brain will thank me for that purple beet! You want long hair? Eat that chicken! Your growing bones need that mascarpone cheese stuffed in that pasta shell, or do you want to stay short forever? Our school lunches don’t help with this. HOME is where the broccoli falls and the spinach hits the fan. I am a monster food mama, and now my 8 and 11 year old kids eat almost anything, and they themselves are pretty proud of it. They see their friends who can’t eat anything, and they talk about it: They are glad they can. But mark my words, this was brought on by tough love, many-a stare downs at the dinner table (I won), and consistent home cooking. Bring on the prosciutto!
Arfid. Thank you NYT. We are new to this issue with our son's girlfriend, age 19. We have been baffled and at our wits end to feed her when she is here on weekends.
And "picky eater" appears to mostly apply to individuals within a certain range of being normal. Arfid is a whole different matter and you k ow it when you see it.
Sun-shiny advice and being judgmental does not cut it. These people have real problems.
And we were amazed that the list of food she will eat is similar to what is mentioned here: cheese quesadillas, cheese sandwich, macaroni and cheese.
And she picks at that food as well.
She is smallish but not rail thin.
The food she has never tasted or does not like is about everything we mention - common food like green beans, mashed potatoes, popcorn, it goes on and on and on.
She first described herself as a vegetarian but we soon discovered she does not eat vegetables. Huh?
My sympathies with individuals or parents who deal with this issue and if my sons relationship with her turns serious we need to have a sit down with him and make him aware of what we are learning.
And no. Growing a stupid vegetable garden is NOt the answer.
And "picky eater" appears to mostly apply to individuals within a certain range of being normal. Arfid is a whole different matter and you k ow it when you see it.
Sun-shiny advice and being judgmental does not cut it. These people have real problems.
And we were amazed that the list of food she will eat is similar to what is mentioned here: cheese quesadillas, cheese sandwich, macaroni and cheese.
And she picks at that food as well.
She is smallish but not rail thin.
The food she has never tasted or does not like is about everything we mention - common food like green beans, mashed potatoes, popcorn, it goes on and on and on.
She first described herself as a vegetarian but we soon discovered she does not eat vegetables. Huh?
My sympathies with individuals or parents who deal with this issue and if my sons relationship with her turns serious we need to have a sit down with him and make him aware of what we are learning.
And no. Growing a stupid vegetable garden is NOt the answer.
4
As the parent of autistic child I was amazed to see that the list of "foods he would eat" are the same as the foods my son would eat. While food preferences are clearly influenced by culture and family, it strikes me that within a similar culture, children with dissimilar problems, would choose the same foods. This makes me think biology...
I agree with a previous writer who notes the implicit parenting criticism in many or these posts. When dealing with a disorder this extreme I really doubt that 'growing vegetables in the garden' will change a child's condition. The smugness about exposing one's children to a variety of foods completely misses the mark. It's about as appropriate as saying anorexia can be treated by requiring a child to eat.
17
There may be undiscovered causes, but since eating disorders seem to be peculiar to humans, there's a fair chance that it's a learned behavior.
Animals in the wild do what works in the wild. Humans at home do, too. If parents inadvertently reward picky eating (by relinquishing control or giving attention), more of it will follow, and over time this can lead to "psychological problems" that started out as something as innocent as overindulging a child's early food preferences.
If not nipped in the bud, the child grows up, shops and cooks for himself, and continues the odd ways. At that point, what began as a behavior problem is now regarded (and may BE) psychological in the sense that it's being maintained without clear benefit. But it's still a behavior problem, and when we discard the behavior handle and talk of it as purely psychological or even physiological, it's harder to manage, because there's no handle to grab.
Animals in the wild do what works in the wild. Humans at home do, too. If parents inadvertently reward picky eating (by relinquishing control or giving attention), more of it will follow, and over time this can lead to "psychological problems" that started out as something as innocent as overindulging a child's early food preferences.
If not nipped in the bud, the child grows up, shops and cooks for himself, and continues the odd ways. At that point, what began as a behavior problem is now regarded (and may BE) psychological in the sense that it's being maintained without clear benefit. But it's still a behavior problem, and when we discard the behavior handle and talk of it as purely psychological or even physiological, it's harder to manage, because there's no handle to grab.
1
I still have this issue. I don't like seafood, raw fruits and veggies unless they are juiced or creamy salad dressings among a few other things. I don't chew gum, because I don't like keeping anything in my mouth for long.
This issue with the raw fruits and veggies is texture related. I think they taste fine, which is why I will blend them up and take them down.
Seafood is more psychological. I think sea creatures are scary and smelly. My first memory of seafood was going to the fish market with my mom and stepping of scales, seeing bloody aprons and fish with bug eyes and open mouths.
On Friday my mom would always cook fish and she would cook me spinach and boiled eggs. She sent me to school with baby food until I was in 4th grade. I never got help for it, but I was under weight for most of my childhood. But I'm not anymore. I eat what I like, take vitamins, and drink lots of raw smoothies.
This issue with the raw fruits and veggies is texture related. I think they taste fine, which is why I will blend them up and take them down.
Seafood is more psychological. I think sea creatures are scary and smelly. My first memory of seafood was going to the fish market with my mom and stepping of scales, seeing bloody aprons and fish with bug eyes and open mouths.
On Friday my mom would always cook fish and she would cook me spinach and boiled eggs. She sent me to school with baby food until I was in 4th grade. I never got help for it, but I was under weight for most of my childhood. But I'm not anymore. I eat what I like, take vitamins, and drink lots of raw smoothies.
4
I am a dietitian and have had experience with picky eating and eating disorders professionally and with people I know. As mentioned by some above, I use many of Ellen Satter's principles for cases where there is a lot of parental anxiety even though the child is thriving, but these do not always work with everyone, especially past preschool. Once there is a threat of clinical consequences due to inadequate nutrition, it would be helpful to have other effective and proven interventions that are longterm and involve the child and family. I have noticed that in my locality, there are very few resources for parents dealing with this and eating disorders in general. Most are expensive and often not covered by insurance. Perhaps, having a label will lead to more research, treatments and education re this for therapists, pediatritions, and dietitians along with good reimbursement for services. I also believe there are genetic and food sensitivity issues that need to be identified and worked into treatment.
3
Most people don't realize that food can hurt. If I eat something and it hurts my stomach (numerous tests show "no problem), I will not eat that food again or anything like it. My body, by touch, taste or smell, will force me to reject it even if I try to eat it. I have learned to listen to my body and work with what it tells me.
3
Feeling full quickly, lack of appetite, little appetite; these can also be symptoms of GI disorders. Our daughter has the issue of selective eating as well.
Eventually it was found with testing that her stomach motility was very slow. Despite the evidence of this we were told over a period of years by other non GI Drs, friends and family that she was trying to "control" us with her limited diet. The damage done to her psychologically was immense. In the years we have been searching for the root of her GI issues we have learned that other families have dealt with limited/selective eating as well.
I would hope that a GI assessment would be done with any child or adult alongside the assessment for selective eating.
Eventually it was found with testing that her stomach motility was very slow. Despite the evidence of this we were told over a period of years by other non GI Drs, friends and family that she was trying to "control" us with her limited diet. The damage done to her psychologically was immense. In the years we have been searching for the root of her GI issues we have learned that other families have dealt with limited/selective eating as well.
I would hope that a GI assessment would be done with any child or adult alongside the assessment for selective eating.
7
Whenever I read about extremely selective eaters, I have to wonder if there's an underlying physiological cause not yet identified by medical science.
Perhaps their food choices are perfectly appropriate for distinctive physiological, genetic, etc. reasons we just don't understand yet. Perhaps food sensitivities are manifesting for these folks in ways that current lab tests can't detect yet. I'm not talking about obvious or gross abnormalities like swallowing issues, but subtle yet high-impact biochemical differences at the cellular level, for example.
The human body works in complicated ways -- science has thus far uncovered only the tip of the iceberg -- and this wouldn't be the first time that we treated something with a biological root cause as a behavioral health AKA psychiatric disorder, a brain dysfunction that we can simply "train around" or "treat around" using cognitive-behavioral techniques, OCD meds and the like.
Perhaps their food choices are perfectly appropriate for distinctive physiological, genetic, etc. reasons we just don't understand yet. Perhaps food sensitivities are manifesting for these folks in ways that current lab tests can't detect yet. I'm not talking about obvious or gross abnormalities like swallowing issues, but subtle yet high-impact biochemical differences at the cellular level, for example.
The human body works in complicated ways -- science has thus far uncovered only the tip of the iceberg -- and this wouldn't be the first time that we treated something with a biological root cause as a behavioral health AKA psychiatric disorder, a brain dysfunction that we can simply "train around" or "treat around" using cognitive-behavioral techniques, OCD meds and the like.
7
My kids ate all vegetables and now my grandchildren are the same. I kept introducing veggies all different ways. If they didnt like them I made them a different way and told them just try it. It worked!
Get kids in the garden growing the vegetables. The love of veggies will come from growing and eating them in the field. At our community garden the children there are always munching on veggies.
Kids need to eat real food thats been grown out of the ground to get nourishment.
Get kids in the garden growing the vegetables. The love of veggies will come from growing and eating them in the field. At our community garden the children there are always munching on veggies.
Kids need to eat real food thats been grown out of the ground to get nourishment.
5
Well, Therese, aren't you and your family lucky to be so perfect!
I have two children who have been introduced to different foods in the same way and have very different tastes. What works on one child will not necessarily work on another.
I have two children who have been introduced to different foods in the same way and have very different tastes. What works on one child will not necessarily work on another.
4
I'm so tired of this kind of advice. Some children/ adults struggle with food and it isn't always because they've been indulged ornament encountered real food. We have a small kitchen garden. I cook from scratch. We go to farmer's market. I make my own jams, pickles .... I involve my son in these activities and with shopping. He's a distrustful eater. Fortunately, for us he likes a wide range of veggies as long as raw or very lightly steamed, fruits as long as there is a crunch, so no berries. He's not afraid of flavor. He'll eat Indian, Vietnamese, Japanese, Thai, Mexican. . . But don't give him pasta, potatoes, soup . . . He could take or leave most traditional junk food.
4
My husband is a very selective eater, as is our older son. Both refuse vegetables, except potatoes and tomato sauce.
It hasn't been easy to understand and accomodate, but now I really do believe a lot of these foods simply taste bad to them. They perceive the flavors differently. Both, by the way, also have very keen senses of smell.
The grandfather was the same way.
Now that my son is old enough to reason and knows diet matters for health, I've started to insist more. We're up to three green beans, a couple of times a week.
It hasn't been easy to understand and accomodate, but now I really do believe a lot of these foods simply taste bad to them. They perceive the flavors differently. Both, by the way, also have very keen senses of smell.
The grandfather was the same way.
Now that my son is old enough to reason and knows diet matters for health, I've started to insist more. We're up to three green beans, a couple of times a week.
5
My experience might not be relevant but..... My friend's kid is a picky eater and they always serve food made the exact same way. For instance, they have a recipe for spaghetti that requires exact ingredients in measured quantities.
When our kids were toddlers, we were hooked on a buffet restaurant called "Health Choice". They did not charge at all for really young kid so the four of us ate for $15. Their buffet was really huge. It was a great way for the kids to eat a variety without my cooking being an issue. It was really relaxing to go there after a busy day.
My kids went on to go with us to a huge variety of restaurants. We favored small ethnic restaurants. As toddlers my kids loved steamed oysters and their favorite meal was probably calamari in tomato sauce. As adults there is absolutely nothing they won't eat.
Another way to get kids to eat a variety of stuff is to let them cook. I bought a play kitchen for my boys and let them cook real food too. They did a lot of BBQ which also let them play with fire. Now one is a real gourmet cook.
When our kids were toddlers, we were hooked on a buffet restaurant called "Health Choice". They did not charge at all for really young kid so the four of us ate for $15. Their buffet was really huge. It was a great way for the kids to eat a variety without my cooking being an issue. It was really relaxing to go there after a busy day.
My kids went on to go with us to a huge variety of restaurants. We favored small ethnic restaurants. As toddlers my kids loved steamed oysters and their favorite meal was probably calamari in tomato sauce. As adults there is absolutely nothing they won't eat.
Another way to get kids to eat a variety of stuff is to let them cook. I bought a play kitchen for my boys and let them cook real food too. They did a lot of BBQ which also let them play with fire. Now one is a real gourmet cook.
6
I was never a picky eater, but in my forties developed several food allergies (medically diagnosed, not fads) as well as sinus and throat problems requiring surgery. I have spent years choking and coughing on many foods I used to love - even with foods that don't cause allergic reactions. Constantly having to refuse food at parties or public events is both embarrassing and tiresome, as is having to leave a table/room/restaurant because of choking or coughing, sometimes to the point of vomiting. I can sympathize with the Arfid sufferers - sometimes it's easier just not to eat at all.
10
I'm a picky eater but my 16 year old son is a picky eater in the extreme, and I'm sure he would be diagnosed with this, but I don't see it as that big of a problem since he is extremely healthy and slim. He may get a cold once a year or after flying on an airplane but otherwise has never been sick. He never uses his health insurance except to get eyeglasses. The problem arises when eating away from home, but is remedied by bringing his own food. He likes yogurt/fruit smoothies so he puts flax oil, fiber powder and whey protein in it. I buy him probiotics/quality supplements which he takes. I buy him Atkins protein bars because they have a lot of fiber in them. I give him liposomal vitamin c when he flies to try to avoid getting sick. This is disgusting to him but he takes it because he hates having a cold more. Most of what he does eat, I try to buy him organic versions of. All his life he could never tolerate hot/warm foods and certain textures. He is a natural vegetarian and has never wanted/liked any kind of animal flesh, but likes certain cheese, milk, and dairy products. He also eats lots of candy. He was breastfed exclusively, and has never had a vaccination in his life. He has high-functioning Asperger's syndrome and is almost savant-like when it comes to math and certain other subjects, and has been reading since he was 3 years 4 months old. Like I said, I don't see it as a problem, as I think it benefits and suits him well.
5
Not being vaccinated is not something to be proud of since scientifically invalidated. Lots of preventable diseases coming his way. I suggest he get all up to date.
Eating lots of candy offsets all the good stuff. Bad teeth, high cholesterol, diabetes are in his future.
I suggest you use his health insurance and get a physical and lab work to verify his extremely good health. Then get physicals every year.
Also get him to a dentist to see how many cavities he has from eating a lot of candy. Sugar is a drug. Don't you wonder why he needs so much?
Young genes overcome a lot of bad habits.He's setting himself up for problems in his 20's-30's. Don't assume his current habits support long term health. Imagine him being 20, 30, 40 years old and eating "lots of candy".
He needs help rather than enablers, especially since he has insurance.
Eating lots of candy offsets all the good stuff. Bad teeth, high cholesterol, diabetes are in his future.
I suggest you use his health insurance and get a physical and lab work to verify his extremely good health. Then get physicals every year.
Also get him to a dentist to see how many cavities he has from eating a lot of candy. Sugar is a drug. Don't you wonder why he needs so much?
Young genes overcome a lot of bad habits.He's setting himself up for problems in his 20's-30's. Don't assume his current habits support long term health. Imagine him being 20, 30, 40 years old and eating "lots of candy".
He needs help rather than enablers, especially since he has insurance.
11
I was a picky eater, and in my generation it was really not categorized as such. One either ate of did not. There are times from my childhood when I can remember sitting for hours after supper, refusing to eat and eventually being able to go to bed, wearing my parents down. My legs at 12 years of age in grade 6 looked like arms, I was so skinny. In those days we were skinny and it was not a fashion statement.
My 2nd child was a picky eater as described herein. We would provide what she would eat, and not make a fuss. She too, cried and expressed her frustration at not being able to eat in a "normal" fashion. I always assured her she would outgrow this, as I had. And she did.
To this day we are both complete omnivores and relish every bite we put in out mouths.
I am an Executive Chef, as a Profession and she is an outstanding Pastry Chef and Cake Designer.
There you have it...all kinds of ways to overcome potentially devastating food issues and incorporate healthy eating habits.
My 2nd child was a picky eater as described herein. We would provide what she would eat, and not make a fuss. She too, cried and expressed her frustration at not being able to eat in a "normal" fashion. I always assured her she would outgrow this, as I had. And she did.
To this day we are both complete omnivores and relish every bite we put in out mouths.
I am an Executive Chef, as a Profession and she is an outstanding Pastry Chef and Cake Designer.
There you have it...all kinds of ways to overcome potentially devastating food issues and incorporate healthy eating habits.
6
I wonder if sometime picky eating is an inherited trait. My husband's grandmother was a picky eater; he is a picky eater; and our grandson is a picky eater. None, thank goodness, to the extreme mentioned in this article or the comments, but still, challenging. Texture seems to be the main issue; squishy = bad; crisp = good. We eat a lot of raw veggies in our house!
8
Maybe there is something in the shape of their throat that makes them gag more than other people. How are they at the dentist?
1
I have read many comments claiming, or at least hinting, that children from poor nations don't have this problem. I knew a pediatrician at Mass General who treated a Romanian child who had been sent from an orphanage for treatment of her heart defect. The child rejected most foods and had rigid requirements as to how the foods that she would eat were served. For example, she would accept chicken on the bone, but she would not touch chicken served any other way. She would have starved rather than eat foods outside her acceptable range.
This article is not describing the effects of spoiling children. It's not even describing "picky" eating, and it's probably a bad idea to use that label. It's describing a form of mental illness or psychological disability that manifests itself through food avoidance. As with other psychological illness, there may be familial or social behaviors that contribute to the severity of the problem, but they are not its cause. You can't spoil a child into Arfid.
This article is not describing the effects of spoiling children. It's not even describing "picky" eating, and it's probably a bad idea to use that label. It's describing a form of mental illness or psychological disability that manifests itself through food avoidance. As with other psychological illness, there may be familial or social behaviors that contribute to the severity of the problem, but they are not its cause. You can't spoil a child into Arfid.
43
It's amazing to read all of the criticism in the comments here. You all must have been such perfect parents and human beings, oh and I'm assuming your all have medical degrees as well? The parents of these children are not at fault- like the article says, it is a disease. As someone who has struggled with an eating disorder in the past, these disorders surrounding food are very real. Instead of voicing your negative, judgmental comments you should just be grateful that you are not someone who has to struggle with something like this. Open your eyes, read what the article is saying and keep your opinions to yourself. I wish Brendan and all of the others mentioned here, the best of luck.
32
So glad to find a name for this. My 11-year-old niece has been a lifelong non-eater of almost every food, and two years ago declared herself vegan, much to my poor sister's consternation. My niece is pale, super-thin, and listless—obviously not healthy. Her doctor(s) all these years have just been taking a "she'll grow out of it" attitude, while gradually my niece accrues various diagnoses, like ADD and sensory processing disorder. Now we add ARFID to the list. Not sure how my single-parent sister is going to find the resources for more therapy, but treatment seems crucial, the sooner, the better. If anyone can suggest the most reliable online info sources and any treatment centers for this in Michigan, I’d appreciate it.
11
I have this and have struggled with it my whole life. I have a fiberglass plate in my head from infancy when I had a premature closing of the sagital suture. Maybe that's why. My sensitive food issues made all meal times difficult for my family and my extended family. They often resorted to force feeding me which was horrific and didn't help anything. Food scared me. I ate to live. I was malnourished, underweight and always sick. When I went to college and discovered I could have as much as I wanted of the food I liked I finally put on weight. Now I get vitamin IVs and B12 shots and I'm doing better. My friends know this is my "weird food thing." Trying to get a person with this to change is like screaming at a deaf person to hear. I will always choose Cheerios over sushi. I don't want to be like this. It's horrible. But it's better than a lot of other things that can happen to a person. It's also kept me strangely young looking. I look 15-20 years younger than my real age. Possibly it's from long periods of low food intake.
24
I really don't understand the comments here saying that this is a "first world problem" or probably doesn't exist in Africa. (I saw a few of them and commented briefly on one below.) Who cares, and how is that relevant in the least? Yes, there may be what the DSM calls "culture-bound syndromes," and I guess it can be interesting and perhaps somewhat useful to examine what those are and why they prevail under certain social conditions, but it seems that these comments were more about dismissing the suffering of others in our midst because it is somehow not as bad as that of other people in other places. These comments seem to imply that Americans with Arfid are spoiled or overly privileged, and that that is the cause of their ills. Why don't we, rather, try to extend empathy and compassion to fellow humans who suffer in all of the myriad ways that humans can and do suffer, and check our judgment as assiduously as we tend to check our privilege?
33
Or it may be that third-world patients of this disorder don't survive early childhood, which would have the effect of making it a first-world problem I guess. It's not nice to see the intolerance here. I had a baby with failure to thrive and then other feeding problems in toddlerhood, so I have some empathy for these parents when there seems nothing you can do. Fortunately she outgrew it, although she is still somewhat picky. We found out in childhood that she cannot smell, and in high school that she has a brain anomaly that causes many of her other problems.
Kids with autism sometimes have very restricted eating habits. So I think it might be possible that this condition has a neurological basis as well, like autism and sensory processing disorders likely do.
Kids with autism sometimes have very restricted eating habits. So I think it might be possible that this condition has a neurological basis as well, like autism and sensory processing disorders likely do.
25
What a fascinating phenomenon. I love to eat and will try anything once, however gross and evil looking or smelling. I wonder if the problem has to do with viewing the food as something alien and invasive, taking into your body something that will do harm. Imagine being presented with a dinner plate full of pencils or a bowl of sand, and being told that they are good for you and you must try to eat them. Thinking about the situation immediately arouses in me anxieties and aversion.
That may sound silly, but it may be similar to how these people view the items they're supposed to eat. As foreign bodies. WIth all the attendant anxieties and parental pressures. The more I imagine the situation, I can almost understand the phenomenon.
That may sound silly, but it may be similar to how these people view the items they're supposed to eat. As foreign bodies. WIth all the attendant anxieties and parental pressures. The more I imagine the situation, I can almost understand the phenomenon.
20
Yes! You've just described how I felt one evening when I picked up a delicious piece of fried chicken. Suddenly, despite my hunger and the appealing smell, it became a non-food. I could not move it toward my mouth.
I soon realized I was pregnant... Hormones, among many other things, can have a very strong effect on how we experience food.
I soon realized I was pregnant... Hormones, among many other things, can have a very strong effect on how we experience food.
12
Pickier eating leads to risks for inadequate levels of key vitamins/minerals.* This in turn can effect mood, behavior, and cognition. We also know that what we eat can impact the microbiome--within 24 hours.** Would be interesting to see the gut bacteria of people with Arfid -- this seems like a DSM category crying for microbiome profiling to correct imbalances.
* Food variety as a predictor of nutritional status among children with autism. https://www.ncbi.nlm.nih.gov/pubmed/21556968
** Diet rapidly and reproducibly alters the human gut microbiome.
https://www.ncbi.nlm.nih.gov/pubmed/24336217
**
* Food variety as a predictor of nutritional status among children with autism. https://www.ncbi.nlm.nih.gov/pubmed/21556968
** Diet rapidly and reproducibly alters the human gut microbiome.
https://www.ncbi.nlm.nih.gov/pubmed/24336217
**
22
I wonder if this only happens in the USA? I bet they don't have it in Africa.
9
You have no idea of what you are commenting on-
21
No. The website affiliated with my book on extreme picky eating has visitors from 85+ countries (according to Google Analytics), including the following: Bangladesh, China, Dominican Republic, Croatia, Indonesia, Iraq, Kyrgyzstan, Lithuania, Malaysia, Mexico, Nigeria, to name a few. That would indicate that this is a world-wide problem, at least for some people in these countries, as they are looking it up online and viewing our website that has the word "extreme" in the name.
19
This is apparently a real problem.
I wonder, though, how many children who are actually starving due to geopolitical strife have this problem?
Maybe the treatment centers should have a 2 week stent in South Sudan, sub Saharan Africa, or parts of Asia. Not as punishment but to offer new experience of food and what it means for our survival.
It's hard during this time of seeing child after child only order "pasta with no sauce" off of menus. The central norm has created extremes.
I wonder, though, how many children who are actually starving due to geopolitical strife have this problem?
Maybe the treatment centers should have a 2 week stent in South Sudan, sub Saharan Africa, or parts of Asia. Not as punishment but to offer new experience of food and what it means for our survival.
It's hard during this time of seeing child after child only order "pasta with no sauce" off of menus. The central norm has created extremes.
4
The other interesting thing is that they all seem to "prefer" the same/similar limited foods. ... "plain pasta", hard, crunchy things... limited fruits- no veggies, no meats.
I'd love for my 8 year old to get involved with a study--- I feel we have so much to share that could help others and so much of it is documented bc of the programs he's been involved with (speech (for eating), OT (for sensory) , PT (for lack of muscle tone - prob related to not getting enough proteins) - intensive pediatric eating programs etc) Our entire family has been at this for 7 years now- and although we are feeling way ahead of identifying he had this problem/fear of food even before ARFID lable was created, it's still concerning bc we haven't made "enough" progress despite all the efforts! Also, As much as I love my pediatrician, I never listened to "he'll grow out of it", once he fell off the growth chart before 1 yrs (and yes I knew what I was doing - he's my third boy ) I took it into my own hands and searched everywhere for help. Our Childrens House with Cooks hospital is where we started our journey with learning and therapy to help get him as adjusted as possible to the "regular" world around him and food. It took years just to get him to the family dinner table bc of the smells and how it all looked. And even now with big groups (holidays) he'd rather hide than deal with all the food.
I'd love for my 8 year old to get involved with a study--- I feel we have so much to share that could help others and so much of it is documented bc of the programs he's been involved with (speech (for eating), OT (for sensory) , PT (for lack of muscle tone - prob related to not getting enough proteins) - intensive pediatric eating programs etc) Our entire family has been at this for 7 years now- and although we are feeling way ahead of identifying he had this problem/fear of food even before ARFID lable was created, it's still concerning bc we haven't made "enough" progress despite all the efforts! Also, As much as I love my pediatrician, I never listened to "he'll grow out of it", once he fell off the growth chart before 1 yrs (and yes I knew what I was doing - he's my third boy ) I took it into my own hands and searched everywhere for help. Our Childrens House with Cooks hospital is where we started our journey with learning and therapy to help get him as adjusted as possible to the "regular" world around him and food. It took years just to get him to the family dinner table bc of the smells and how it all looked. And even now with big groups (holidays) he'd rather hide than deal with all the food.
7
I am a developmentally based pediatric speech pathologist. This article is so exceptionally frustrating. I wish the author had thought to share the importance of reducing anxiety around meals and around helping families understand that it is possible to raise healthy, competent eaters regardless of their food preferences. Ellyn Sattur's work - The Division of Responsibility and Katya Rowell's work, as well as the entire developmental perspective on feeding is much more effective, efficient, respectful, and most of all, encouraging of healthy, happy eating. This goal of a few more bites and "chasers" disgusts me. This is about "training" children to comply and to consume something, not about supporting engaging and enjoyable mealtime.
28
You are right that Ellen Satter has done some great work. You are mistaken in thinking that her strategies will work for all picky eaters. My son has Arfid, and I can assure you that I read all of Satter's books, and tried to do things her way. For the 3% of kids with Arfid, her strategies simply will not work in the long run. I wish there were more doctors, therapists, OTs, and speech pathologists who understood Arfid, but so far, most of them vastly underestimate the scope of the problem, and do not have useful advice for families.
21
Kirsten--agreed. The things that work for neurotypical children don't necessarily cut it with kids who are on the fringes for neurological or other reasons. My daughter had failure to thrive as an infant and no interest in eating, no signs of hunger, and absolutely would not feed at night. Even with a best fried who is a registered dietitian, I had to find my own way with her. She'd have quite cheerfully starved herself. She had a great aversion to texture , a milk allergy, and toddler's diarrhea on top of everything else, and when she was able to feed herself she'd try to drink her meals and avoid solids entirely. We worked through it and fortunately by age four she was a pretty good eater. But later it was discovered she had no sense of smell and a brain disorder.
13
My son- now 23- has also dealt with this his entire life. (At birth his umbilical cord was wrapped around his neck, and he had to be suctioned fiercely. I have often wondered if that was the trigger.)
He also felt very badly that he could not eat like his friends did, no matter how hard he tried. But by high school he learned to accept it as part of who he was, and his friends accept it as well. He learned some strategies to use in social situations. And we always make sure that any meal has at least one thing that he likes, because eating together in a relaxed way is what is important to us as a family.
He also felt very badly that he could not eat like his friends did, no matter how hard he tried. But by high school he learned to accept it as part of who he was, and his friends accept it as well. He learned some strategies to use in social situations. And we always make sure that any meal has at least one thing that he likes, because eating together in a relaxed way is what is important to us as a family.
21
He realized there's nothing wrong with him? He now knows what is wrong with him and can take measures to deal with it. Hypnosis would likely benefit him.
7
I'm dismayed by the judgmental and naive comments being made about these kids' parents.
I am on the autism spectrum (finally diagnosed in my late 30s--it made sense of SO MANY things!) and have been a lifelong picky eater. Not to this extent, but there is a whole category of food I simply cannot eat. For me, it's condiments and anything that seems slimy/mushy to me. Dressing on my salad, mayo on my sandwich, sour cream on Mexican food, yogurt . . . anything with this texture really triggers my gag reflex. I would much rather go hungry than consume food with this texture.
I wasn't spoiled. I did chores. I was expected to get good grades. I walked to the bus stop and helped care for my younger sister. I was expected to eat my vegetables, and I did. My parents believed in discipline, and they didn't hesitate to apply it. But they came to realize that I wasn't being contrary. I just couldn't deal with eating that kind of food. So they taught me instead to eat around the stuff I didn't like, to always thank people for giving me food (whether I chose to eat it or not), and to make healthy choices for myself within my limited palate.
Believe me, I'd rather not be like this. It's a pain. I'm anxious about socializing that involves meals. Ordering meals at restaurants is embarrassing and often doesn't get me what I want anyway. I would love to just decide to stop being picky. It's not that easy.
I suspect there have always been people like me. It's just getting talked about now.
I am on the autism spectrum (finally diagnosed in my late 30s--it made sense of SO MANY things!) and have been a lifelong picky eater. Not to this extent, but there is a whole category of food I simply cannot eat. For me, it's condiments and anything that seems slimy/mushy to me. Dressing on my salad, mayo on my sandwich, sour cream on Mexican food, yogurt . . . anything with this texture really triggers my gag reflex. I would much rather go hungry than consume food with this texture.
I wasn't spoiled. I did chores. I was expected to get good grades. I walked to the bus stop and helped care for my younger sister. I was expected to eat my vegetables, and I did. My parents believed in discipline, and they didn't hesitate to apply it. But they came to realize that I wasn't being contrary. I just couldn't deal with eating that kind of food. So they taught me instead to eat around the stuff I didn't like, to always thank people for giving me food (whether I chose to eat it or not), and to make healthy choices for myself within my limited palate.
Believe me, I'd rather not be like this. It's a pain. I'm anxious about socializing that involves meals. Ordering meals at restaurants is embarrassing and often doesn't get me what I want anyway. I would love to just decide to stop being picky. It's not that easy.
I suspect there have always been people like me. It's just getting talked about now.
64
Many individuals, particularly individuals with autism spectrum disorders have differently functioning nervous systems. Specifically, they respond differently to sensory inputs that they experience throughout the day. The response may be much stronger or much less than others in reaction to the identical input. When the differences interfere with an individual's ability to participate in typical day-to-day activities, this reflects a sensory processing disorder. Check out the STAR Institute for additional information. https://www.spdstar.org
4
Probably in he Autism Spectrum, high functioning /Asperger end.
11
As a feeding disorder specialist (SLP) who has written a book on the subject (Helping Your Child with Extreme Picky Eating), I have to chime in. One of the biggest issues these kids face is anxiety about eating foods they deem as unsafe, and for many, food can be seen as not only not pleasurable, but actually as poison. These kids (and adults) are not just 'picky', and most parents would do anything to help them eat in a normal way. Truly understanding what the underlying issues are is difficult, and one must go back to early eating experiences (as early as during infancy) to figure out where things went wrong. If you don't understand how the sensory system works, and how it informs the oral motor system as to what to do with the food, then you can't dismiss a child's need for specific sensory characteristics in their food. You can, however, explore other options with them that might fit those characteristics and work toward building a more trusting relationship with food.
63
Thank you for chiming in.The ignorant,insensitve and even cruel comments underneath this piece have been very disturbing.
30
"And her son, now 14,realizes that this will be a lifelong issue."
"While he realizes his anxiety around food will never completely disappear.."
Who has taught this young man that "this will be a lifelong issue" & that his anxiety around food will never completely disappear"?!
I was misled to believe that I could never recover from several eating disorders.
The most I could ever hope for was to be "in recovery from an eating disorder".
I was taught that relapse was inevitable,and relapse I did, as hard as I tried .
Then,I commenced intensive Cognitive Behavioral Therapy with a marvelous psychologist whose was left to correct all the untruths I'd been taught about the impossibility of recovering from eating disorder,s in addition to treating me for the orginial disorders.
Today,thanks to this extraordinary psychologist,I have recovered.
Those who have taught this young man,and are teach others,that "this will be a lifelong issue" and "that his anxiety will never completely disappear" are doing him,a disservice, and the New York Times is doing it's readership a disservice by spreading this myth.
I am living proof that that is simply not true.
"While he realizes his anxiety around food will never completely disappear.."
Who has taught this young man that "this will be a lifelong issue" & that his anxiety around food will never completely disappear"?!
I was misled to believe that I could never recover from several eating disorders.
The most I could ever hope for was to be "in recovery from an eating disorder".
I was taught that relapse was inevitable,and relapse I did, as hard as I tried .
Then,I commenced intensive Cognitive Behavioral Therapy with a marvelous psychologist whose was left to correct all the untruths I'd been taught about the impossibility of recovering from eating disorder,s in addition to treating me for the orginial disorders.
Today,thanks to this extraordinary psychologist,I have recovered.
Those who have taught this young man,and are teach others,that "this will be a lifelong issue" and "that his anxiety will never completely disappear" are doing him,a disservice, and the New York Times is doing it's readership a disservice by spreading this myth.
I am living proof that that is simply not true.
32
While I agree that CBT can be lifesaving for eating disorders, the article indicates that this is more of a sensory or neurological disorder. When it is diagnosed in babies and toddlers, and is unrelated to weight or body image, it seems closer to ADD or autistic syndrome issues - treatable, but not "curable."
2
I was in intensive therapy as well for most of my life, and I have never been able to cure my ARFID. I'm 20 years old now and I can't even make myself eat an apple for lunch. For me, this is absolutely a lifelong issue and I cannot fathom a future where I don't struggle to eat.
1
I'm 60-years old and I'm a picky eater since infancy. I 'eat to live' and not 'live to eat.'
I prefer crunchy and salty over sweet; though I will eat cookies. Fruits and vegetables are disgusting. Anything soft and mushy is disgusting. The smell of cooking eggs, vegetables, liver, beef tongue, and other things is disgusting to me.
I essentially live off of junk food, and guess what...I get a clean bill of health at my annual physical.
Quit trying to fix picky eaters and just accept that's how our bodies work.
I prefer crunchy and salty over sweet; though I will eat cookies. Fruits and vegetables are disgusting. Anything soft and mushy is disgusting. The smell of cooking eggs, vegetables, liver, beef tongue, and other things is disgusting to me.
I essentially live off of junk food, and guess what...I get a clean bill of health at my annual physical.
Quit trying to fix picky eaters and just accept that's how our bodies work.
14
Did you read the article?This child was malnourished as a result of his eating issues. His body wasn't working.
You get a clean bill of health at your physical-until the day you don't. That applies across the board to everyone.
You get a clean bill of health at your physical-until the day you don't. That applies across the board to everyone.
26
No. That is how your brains work. Your bodies need the same vitamins, minerals, and fiber that every single human body needs.
14
I do understand how frustrating this must be for parents, but there is no excuse for letting it get to point of malnourishment (at age 12, no less, when puberty is approaching). With a bit of creative cookery, the textures of all manner of foods can be altered dramatically, to suit the particular needs of a child with these issues.
6
Sorry but you are wrong. I am the mother of an extremely picker eater and I am also a passionate cook. No amount of manipulation, changes in cooking methods, spices, flavors or textures can make my daughter eat what she does not want to eat. Most kids with these problems also have sensory integration issues that need to be addressed. People like you are the plight of my life, Keep your good advice to yourself.
82
Early eating patterns from first bites sliding into phobia. I was a picky eater and stubborn but my mother nade sure I still ate some nutritious food. Raw vegetables rather the mushy cooked ones etc. No food rewards using junk food!
Being under weight and undernourished meant vulnerable to illness. We didn't have the highly processed factory food as 1st choice or even 4th choice. This is a modern world problem, there will always be phobic eaters all over the world but survival rates will vary.
Being under weight and undernourished meant vulnerable to illness. We didn't have the highly processed factory food as 1st choice or even 4th choice. This is a modern world problem, there will always be phobic eaters all over the world but survival rates will vary.
3
I agree. One of my three sons had sensory issues, not only with food but with clothing, lights, noises, and more. With professional help and time, he learned to cope - but not all children fare as well.
It is easy to judge from a distance and after reading only one article. Babysitters, teachers, friends, and others who got to know my son recognized that he was simply...unique. And a wonderful individual.
It is easy to judge from a distance and after reading only one article. Babysitters, teachers, friends, and others who got to know my son recognized that he was simply...unique. And a wonderful individual.
1
My daughter also has a fear of choking on food, after witnessing my having to Heimlich a piece of beef from her mother at dinner.
She manages by cutting her meat into tiny pieces before eating it.
Next . . .
She manages by cutting her meat into tiny pieces before eating it.
Next . . .
3
Your daughter's problem is obviously- fortunately- not on the order of what the people described in this article are dealing with. Apparently, it's not as easy or simple for them just to move on as your flippant "next..." suggests it should be.
29
A first world problem.
28
Easy for you to say until you or someone you love is dealing with it. Certainly betrays your lack of compassion or empathy.
42
The type of "picky eating" described in this article sounds like a form of a phobia or an obsession. Various phobias and obsessions have existed in all human populations throughout history, but the form they take is often culturally determined. So yes, probably outside of a "first world" context these people's issues would not revolve around eating. But they might have had some other severe fears or obsessions. Maybe they'd be afraid of the rain, or obsessed with weather conditions, for example.
16
You have no idea what your commenting on! This is a very real physical and psychological diagnosis. No child of 1 yr old - refuses babyfood, falls off the growth chart, goes through years of theropy- some intensive programs and weekly sessions to just have no results!
Don't comment if you don't know, I pray you never have a child he is literally "scared" of eating
Don't comment if you don't know, I pray you never have a child he is literally "scared" of eating
20
"Like Brendan, he was a picky eater from infancy; at age 2, he would eat only Cheerios and applesauce."
He probably became addicted to sugars, perhaps as a consequence of being fed corn-syrup sweetened baby formula as an infant. Whatever the cause of his eating problem, treating it as a behavioral problem will ensure that any underlying cause, perhaps some sort of genetic or metabolic disorder, will remain hidden.
He probably became addicted to sugars, perhaps as a consequence of being fed corn-syrup sweetened baby formula as an infant. Whatever the cause of his eating problem, treating it as a behavioral problem will ensure that any underlying cause, perhaps some sort of genetic or metabolic disorder, will remain hidden.
5
With respect, I think your assumption about infant formula goes too far. You don't know whether he as bottle fed. But maybe the roots of this behavioral issue go even deeper than presumed early exposure to added sugars. I think it's a way of self medicating.
The one commonality I see between his toddler diet and the foods he accepts in later life is a preference for starches. Given that the source of this food phobia is pervasive anxiety, it makes sense that a naturally anxious (one genetically prone to anxiety) person would find relief in a starch-heavy diet.
The one commonality I see between his toddler diet and the foods he accepts in later life is a preference for starches. Given that the source of this food phobia is pervasive anxiety, it makes sense that a naturally anxious (one genetically prone to anxiety) person would find relief in a starch-heavy diet.
3
Sounds like you know an awful lot about this child's early life. Were you interviewed for this article, as one of his caretakers during infancy, when you claim he was fed "corn-syrup sweetened baby formula"?
And what would you say about picky eaters who were breastfed for six months to a year to two years, by mothers with no allergies and a varied diet?
And what would you say about picky eaters who were breastfed for six months to a year to two years, by mothers with no allergies and a varied diet?
25
Surely false and very shortsighted of you. This individual was already diagnosed with mental health disorder - ADHD - and Arfid is recognized as a mental disorder as well. Plus, what do you know what they fed him as a baby? Where does it say he had sugary infant formula? In fact, sugar in the form of M&Ms help his symptoms tremendously as per the article. Sugar overconsumption among children is a problem in America, that is true, yet only 3% of children suffer from Arfid. Therefore, your conclusion that sugar is to blame for Arfid-type behavior cannot be true.
20
This article is fascinating. I have never heard of this disorder, but I'm sure it is extremely challenging.
I am an LCSW, but I don't specialize in eating disorders. Maybe I should.
I am an LCSW, but I don't specialize in eating disorders. Maybe I should.
9
Please do- we need help out here in the world!
4
There aren't enough therapists who specialize in eating disorders, especially for children. it's super tricky--it's the mental disorder with the highest death rate of all.
3
I am a picky eater: no red meat, sauces, sugar, alcohol, fried anything, or luncheon meats or processed foods. I am healthy and I am slender and I love it.
5
@Jan:
Glad that you found a diet that works for you, but this is not the kind of "picky eating" that the article is talking about. The people described in this article have an involuntary and pathological avoidance of most foods, they are not simply "picky" about red meat, alcohol, etc.
Glad that you found a diet that works for you, but this is not the kind of "picky eating" that the article is talking about. The people described in this article have an involuntary and pathological avoidance of most foods, they are not simply "picky" about red meat, alcohol, etc.
35
"I am healthy and I am slender and I LOVE IT."
Your last 3 words point towards your having either Orthorexia,or a combination of Orthexia and anorexia.
Your last 3 words point towards your having either Orthorexia,or a combination of Orthexia and anorexia.
23
@Jan: I don't think what you're saying is at all relevant to this article, do you? I can think of hundreds of things that you could eat that fall into your restrictions. The people in the article can only eat a half-dozen things and are NOT healthy.
33
Thank you for this article. My son is 17, 6'6", very thin and has no natural appetite. I've had concerns that he suffered from disordered eating of some sort but after reading this article I have a name for his issue and can start to look for resources to help him.
33
Hi Sally - I'm with Eating Recovery Center. Your comment stood out to us. We're sorry to her about your struggle. If there's anything we can do to help you, please don't hesitate to reach out. We can help point you to resources or how to find treatment.
2
My son has always struggled with being a picky eater. This article describes exactly his fears and issues around food. At 18, he's down to about six things that he will eat regularly, none of them vegetables, and the only "meat" is chicken nuggets from Chik-fil-a, or McDonald's. When we moved to another country last year, he survived on peanut butter sandwiches (using only a US peanut butter brand we have to source at great cost and inconvenience) and the local McD's.
He recently spent three months back in the States and has managed to grow a little pot belly from gorging on all his favorites, though he remains quite thin for a six-footer. When he returns to us this week, we'll be back to completely separate grocery shopping and meal preparation, something we have done pretty much since he was a year old.
It's hard to reconcile the realities of living with someone who has such strong taste and texture aversions, and we've always tried very hard to be understanding, but gosh it would be so nice to enjoy a nutritious, filling, and delicious meal together as a family! I doubt we will find resources for therapy or treatment for our son, but at least now we have a better idea of what to look for. Thanks for this article.
He recently spent three months back in the States and has managed to grow a little pot belly from gorging on all his favorites, though he remains quite thin for a six-footer. When he returns to us this week, we'll be back to completely separate grocery shopping and meal preparation, something we have done pretty much since he was a year old.
It's hard to reconcile the realities of living with someone who has such strong taste and texture aversions, and we've always tried very hard to be understanding, but gosh it would be so nice to enjoy a nutritious, filling, and delicious meal together as a family! I doubt we will find resources for therapy or treatment for our son, but at least now we have a better idea of what to look for. Thanks for this article.
22
What are you going to do when the is 25?30?35? Keep acodmidating him? better for him and you if you can get him some psychological help.
7
You have allowed your son to manipulate you (and convince himself) into a diet of fast food junk. This is not a psychological disorder. This is being spoiled.
12
Hi Mrs Smith - I am with Eating Recovery Center and I hate to hear you say that you doubt you'll find resources. There are resources and treatment out there for you and your son. Feel free to call us if you feel like you need some help getting pointed in the right direction.
5
What extraordinary creatures we are. And to those that help people with these types of conditions to develop the tools to grow healthier and contribute to society, my deepest respect and admiration.
47
Walden Behavior and the Eating Recovery Center are very smart. Picky eaters have been around forever. But they came up with a catchy name -- Arfid -- got it inserted in the Diagnostic and Statistical Manual and now can bill Obamacare for thousands of dollars every time a fretful mother is upset when junior won't eat his carrots.
9
Sorry, Rick. I've been teaching school for 37 years, and I have an autistic student who has this. All he will eat are Ramen noodles, scrambled eggs, pizza, and pop tarts. If his mother doesn't send one of those things for lunch and breakfast, it's Katie bar the door!
23
if your would read these stories, you would realize that these people are not normal and need our help. It seems they do not get better on their own. It is not a matter of "pull up your boots" in every case.
49
@Rick: Oh, come on. If you actually read the article, you would see that this is NOT when "a fretful mother is upset when junior won't eat his carrots." People who only eat a handful of foods can actually be malnourished. I don't understand it, either - but not everything that you or I don't understand is fake or silly.
53
Old people also deal with this problem, which can be dangerous.
17
This is a timely article. I don't have statistics, but it seems that more and more young people are having these difficulties, and with a few exceptions (e.g. the rise in autism and its concomitant sensory processing difficulties), it is unclear why the numbers are growing. Regardless of the cause, feeding/eating difficulties are incredibly stressful to families. Making sure our children have adequate nutrition is a fundamental parental instinct, and when things go wrong, it is devastating.
As a speech-language pathologist, I have worked with young children who have difficulties with feeding skills for a variety of reasons. I believe it is extremely important to distinguish between food avoidance that is primarily sensory based ( avoiding foods with certain textures, appearances, smells, or flavors), or anxiety based ("this is new, and I'm nervous about it,") or a combination. I've seen some young children evolve from the sensory avoidance to a combination type.
Motor difficulties (e.g. neurological impairment that causes difficulty with chewing or swallowing) can also be involved in the mix, but can also be a separate thing altogether, requiring significantly different management. Impaired ability to recognize hunger and satiety also require different management.
Working on feeding difficulties, whatever their etiology, requires a team approach, and an appropriate assessment of the factors involved will drive the decision of who is on the team and what roles they play.
As a speech-language pathologist, I have worked with young children who have difficulties with feeding skills for a variety of reasons. I believe it is extremely important to distinguish between food avoidance that is primarily sensory based ( avoiding foods with certain textures, appearances, smells, or flavors), or anxiety based ("this is new, and I'm nervous about it,") or a combination. I've seen some young children evolve from the sensory avoidance to a combination type.
Motor difficulties (e.g. neurological impairment that causes difficulty with chewing or swallowing) can also be involved in the mix, but can also be a separate thing altogether, requiring significantly different management. Impaired ability to recognize hunger and satiety also require different management.
Working on feeding difficulties, whatever their etiology, requires a team approach, and an appropriate assessment of the factors involved will drive the decision of who is on the team and what roles they play.
33
@KEL: Any sense of why this seems to be increasing? I assume it always existed to some extent - is that true? Thank you for sharing your expertise with other readers.
3
I've always wondered why.... had all kinds of tests done with ent, speech therapists, phycologists, the onset for my child was in infancy. Two factors I can spell out are: 1) he was a born little early- not premie, and 2 his tonsils were abnormally large and taken out very early at age 2. He has been diagnosed with sensory issues- were on a break- but have been attending therapy and speech for eating for years. Still have only 3 goto foods(brand and look specific) and a handful of other snacks and 2 fruits. He's never had a meat or veggie - I give him vitamins and pedicure to help compensate. I worry all the time and am always looking for the "miracle helper" to increase variety. He's 8 now and hasn't added a new food to his diet dispute our efforts for years.
6