Illustration by Douglas Holgate

 

Once considered a childhood quirk, picky eating is now recognized as a feeding disorder.


One of my friends says she won’t “do” olives, mushrooms or anything curried. She’s not wild about strawberries. Even whipped cream is off-limits. She is “officially” a picky eater. The notion of being happy with whatever lands on your plate is foreign to her.

It’s common for children to go through a finicky phase, but for some, it lasts a lifetime. They are the hard-core picky eaters, and they have difficulty eating certain foods. In May, the Diagnostic and Statistical Manual of Mental Disorders, a guide that helps mental-health specialists diagnose patients, defined picky eating as an “avoidant/­restrictive food intake disorder.” This is the first time that the manual has recognized a long-term feeding disorder that causes adults — not just infants and small children — to avoid certain foods because they’re extremely sensitive to appearance, color, smell, texture, temperature or taste.

Unlike those with medical conditions like anorexia or bulimia, people with this umbrella disorder do not have body-image concerns like weight or shape. Nor are food allergies the problem. But how they perceive the food can be.

Take Bob Krause, who in 2003 created the website Pickyeatingadults.com, aka Picky Eating Adult Support. On a typical day, the Virginia Beach, Va., resident might down several vitamins, a bottle of a nutritional-­supplement drink and a gulp of milk at breakfast. For lunch, he grabs a handful of peanuts and munches five slices of bacon plus a glass of milk. Later he grazes on a pack of peanut-butter crackers. Dinner is buttered toast and a glass of milk. His last snack of the day is cheese popcorn. Once a week, he splurges with the elaborate menu of a grilled-cheese sandwich and fries.

“Most foods do not look like food to my brain,” he says. Tomato-based products “are just gross” to him. Being around chili or spaghetti and meatballs can trigger a severe gag reflex.

The diet of Marla Lopez, a real-estate broker based in Coeur d’Alene, Idaho, is also limited. She doesn’t eat fruit or any meat other than bacon. Unlike Krause, who sometimes eats raw celery or carrots, she is unable to eat vegetables other than potatoes. Her mainstays are french fries, cereal, bread, potato chips, cookies and milk. Despite what sounds like the ultimate anti-South Beach diet, she is slim and her blood tests are normal.

That is not surprising, says Sondra Kronberg, MS, RD, CEDRD, nutritional director of the Eating Disorder Treatment Collaborative/F.E.E.D. (Facilitated Eating Events and Direction) programs, which are based on Long Island and in New York City. Blood chemistry is usually the last thing that’s going to go, she says. Blood will stay in a life-sustaining range unless a person is in a diseased state and the organs begin to malfunction.