Fussy eater - or eating disorder?

How can you tell what’s really going on, when a person refuses to eat anything except a very limited selection of foods? Are they just being picky? Going through a phase? Or is it something more serious?

If that person is your child, a friend – or if you have long struggled to eat anything but a few ‘safe’ foods - and it isn’t due to sickness, body-image or self-esteem – then this might be a burning question.  Read on, to learn the difference between being ‘off’ your food, and having a type of Eating Disorder.

Many young children go through a phase of rejecting food apart from certain favourites. This could be due to their more sensitive palates encountering unfamiliar texture or taste, and disliking its strangeness. Sometimes it is about being distracted and more excited to explore and play than in the process of eating. Or they might be upset by something entirely unrelated and in an uncooperative mood. This can go on for weeks or months and cause parental worry, but young children usually regain their appetite and start to enjoy new foods, given time and the regular offering of wide variety.

It is also normal for people to forget, or find it difficult to eat much, during times of unusual business, stress, emotion, or while recovering from sickness - and when they do eat, to stick to a few comforting or energy-giving staples, Again, this restrictive phase should pass naturally, with the alleviation of their problems.

But what if somebody doesn’t return to eating ‘normally’? And how long should it take?

There is no fixed time-frame, as a return to full engagement with food will depend upon what has caused restriction in the first place, as well as individual sensitivity and temperament. But if you begin to feel that something is wrong - don’t ignore it. Even if the cause is emotional or circumstantial, a limited diet still means limited nutrition and could result in health issues, so a gentle reminder or support in better eating will not go astray. The ongoing problem which is causing reduced appetite should also be addressed, for the sake of that person’s wellbeing on many levels.  

But if the refusal to eat a range of foods doesn’t seem in proportion to any explanation, or persists, then an Eating Disorder might be present. This is a mental illness which can have very serious physical results, and needs to be recognised so that the person can find support and a way to recover.

Most people are familiar with the term Anorexia, which involves the deliberate restriction of calories in order to control body image or supress painful emotions. But while all Eating Disorders involve an unhealthy relationship with food as a means to cope with difficult feelings and situations, they manifest in several different ways.  Other, less well-known E.D.s  may be more focussed on the type of food consumed, or the experience of eating in itself…

Orthorexia can occur when a person becomes obsessed with ‘healthy’ or ‘clean’ eating, to the extent that their fear of being contaminated by sub-standard nutrition affects their ability to freely choose foods, enjoy a normal lifestyle, or eat a substantial enough diet.

With ever increasing nutritional awareness and health concern in the public eye, Orthorexia is an Eating Disorder on the rise, especially among anxious young adults, as people do their best to avoid contaminants, and eat for better fitness, or in line with their ethical convictions. Responsible and noble choices can soon become fenced around by rules and fears in vulnerable individuals, to the point that positive change becomes obsessive anxiety and the rejection of nourishment needed by both the body and the mind.

If you have Orthorexia, treatments such as Cognitive Behavioural Therapy (CBT), Psychotherapy, and the detailed personal support of a Specialist Dietician with experience in eating disorders, can help you to reconcile ideals with reality, and turn from anxst-driven obsession to a healthier relationship with food.  

Then there is Avoidant Restrictive Food Intake Disorder – otherwise known as ARFID.

ARFID is the limitation of food – or sometimes drink - because of an inability to tolerate several different textures, or tastes, or due to a fear of choking or vomiting. It can be provoked by high sensory sensitivity present from birth (it is more common amongst people with Autism or Sensory Processing Disorder than the neurotypical population, and much more commonly diagnosed among children than other eating disorders). These conditions can make the taste or texture of food much more intense than it is for most people.

ARFID can also be brought on by a trauma or obsessive anxiety associated with eating or drinking – such as a near-choking experience. Obsessive Compulsive Disorder (OCD) and various phobias are quite common co-morbidities, as they contribute to the restrictive attitude or fears of food or liquid intake.  

For people with ARFID, though they may have a healthy appetite and no abnormal concerns around body-image, eating foods they are not comfortable with might seem an impossibility. This illness can turn the normal and enjoyable experience of eating and drinking, into a nightmare of fear and conflict. It is not being fussy, it is a very deep-wired reaction which means they cannot make themselves put the ‘unsafe’ substances in their mouth and swallow. Forcing them to do so can be traumatizing. What is needed to recover from such an automatic response to normal processes, is an investigation into the reason for their difficulties, and then careful treatment of any causative trauma, together with slow and gentle re-education of the senses and very gradual exposure until they can tolerate a much wider range of food. A person with ARFID needs to rebuild a positive and trusting relationship with eating itself. For all of this, professional help is advised.

Whilst some people with ARFID can take steps in recovery alone, or supported by those close to them - by learning all they can from reliable sources, and engaging carefully with both challenges and self-soothing practices – it is strongly recommended to seek clinical help. Time, in Recovery, is of the essence, and the advice and support of a Psychotherapist and Dietician specially trained in the area, working in co-ordination, can be invaluable in making progress towards enjoying food and a normal life.

Types of therapy especially successful in the treatment of ARFID include Eye Movement Desensitisation and Reprocessing (E.M.D.R)  and Clinical Hynotherapy to treat underlying trauma, and sensory-based psychotherapies such as Creative Therapy, Art Therapy, or Play Therapy for children. Cognitive Behavioural Therapy is also very helpful in teaching skills and thought processes to identify triggers, cope better, and reprogramme the cycle of reaction to fear-foods.

If you know someone who needs advice or support in dealing with an Eating Disorder, Flourish Therapy Clinic is always available with a whole team of experienced clinicians, including Specialist Dieticians, an EMDR and Hypnotherapy practitioner, a Creative / Art / Play therapist, CBT counsellors, and a Movement Psychotherapist, as well as specialist Eating Disorder Coaches. We have no waiting lists, no admission criteria, and are ready to help those who reach out as quickly as we can, with a Care package designed especially to meet each client’s individual needs. Don’t hesitate to reach out! Call us on 01772915735 or contact through the website www.flourishtherapyclinic.co.uk.