The American Psychiatric Association may list a new diagnosis in its 2013 "Diagnostic and Statistical Manual of Mental Disorders," dietitian Denise Reynolds reports: selective eating disorder. SED has negative health and social effects that can follow children into adulthood. A child with SED differs from the normal "picky eater" some parents have to contend with; it's crucial to identify what's going on early. Selective eating disorder has both neurological and learned causes --- its basis seems both nature and nurture.
Selective Eating Disorder versus Picky Eaters
Children with selective eating disorder don't just have strong food preferences, psychotherapist Abigail H. Natenshon writes; they have extreme sensitivity to the sights, smells and textures associated with different foods. They have a hypersensitive gag reflex and trying new food terrifies them. Kids with SED often have neurological disorders such as Asperger syndrome, sensory integration disorder or pervasive developmental disorder. Picky eaters, on the other hand, can tolerate new foods and taste them. The picky eater may use food to attract attention or exert control.
Both picky eaters and those with selective eating disorder do have genetically based propensities for such behavior, but the picky eater is more likely to have become conditioned to his behavior by his environment. Duke University researcher Nancy Zucker explains that people with SED aren't just stubborn: They drastically limit their food choices because of sensory qualities other than taste.
Health Effects
Malnutrition is always a consideration when children have SED, and, considering that they're growing rapidly in terms of brain pathways and body, this is of great concern. They may encounter dental problems because of a preference for sugary food, the Sussex and Wessex Eating Disorders Association warns, and gastrointestinal issues if they don't get enough fiber. The foods that SED kids prefer tend to be bland, processed and salty, so high blood pressure and obesity are other risks associated with selective eating disorder. Such eating habits during childhood and young adulthood can severely affect health later in life.
Social Effects
Selective eating disorder can alter one's sense of self and self-esteem and affects family relations, sociability and academic and professional performance. Anxiety, conflict and social avoidance go hand in hand with SED.
In adults, SED interferes with work and social life; they may also become anxious about being bad role models for their own children. They're embarrassed by their eating behavior and will attempt to hide them by avoiding social events that involve eating or drinking or making up other excuses for not eating.
Treating Eating Disorders
Zucker works to help adults with SED accept themselves and their preferences and points out that SED kids aren't just being willful. Dr. Kay Toomey developed the sequential-oral-sensory approach --- abbreviate SOS --- for problem feeders. She says she believes that eating is a learned behavior, not simply instinctual. First you must determine why the child won't eat. Is it the smell? The texture? A physical disorder? A bad experience? Then you can figure out ways to address the issue and undo the negative conditioning.
Tense and coercive eating environments increase the risk that children will develop a problem; family meals should be pleasant and not pressured. Therapist Ellyn Satter notes that even if there is a biological problem, parents can learn to teach their children how to cope with their food preferences. Children with selective eating disorder must be monitored to be sure that they're getting adequate nutrition for their growth and development.
Considerations
Discuss your child's eating habits with her doctor, who may be able to diagnose eating disorders or can refer your child to a specialist. Your child's doctor can also give advice on proper nutrition for her condition.
References
- Parenting Bookmark; Feeding Disorders and Picky Eating Infants and Children; Abigail H. Natenshon, M.A., L.C.S.W., G.C.F.P.
- LiveScience; Adult Picky Eaters Now Recognized as Having a Disorder; Robin Nixon; Nov. 28, 2010
- Somerset and Wessex Eating Disorders Association: Other "Eating Disorders"
- eMaxhealth.com; Selective Eating Disorder: Extreme Picky Eating Becomes a Medical Diagnosis; Denise Reynolds, R.D.; Nov. 11, 2010
