Selective eating disorder: what it is, symptoms and treatment

Selective eating disorder is a relatively common childhood eating disorder, which occurs when a child always eats the same foods, rejecting all other options outside of their acceptance pattern. Thus, it is common for children to always like to eat the same meals, rejecting new foods, and having difficulty eating in restaurants and at other people’s homes.

This disorder is often seen by parents as a child’s tantrum and, therefore, ends up being devalued. However, if it happens very frequently, it should be evaluated by a pediatrician or a psychologist, who will be able to confirm or rule out the possibility of some type of disorder.

Food refusal is common in children between 2 and 6 years of age, and therefore should not be a cause for excessive concern. It is normal for parents to need to “negotiate” the introduction of a new food, however, when this behavior seems exaggerated and the child only eats the same foods, a more detailed assessment is recommended. See how to introduce food gradually.

Main symptoms

Some signs and symptoms that can help identify this type of disorder are:

• Always eat the same foods, eating a maximum of 15 different foods;
• Avoid entire food groups, such as the milk and dairy products group or all fruits;
• Close your mouth tightly to avoid in any way eating a different food;
• Throwing tantrums at mealtimes, making it a stressful time for the whole family;
• Experience nausea and vomiting when faced with the need to eat new foods;
• Prefer only cold or warm foods;
• Prefer foods with a mild flavor such as light colored ones such as milk, bread, pasta;
• Not tolerating the smell of a certain food, having to leave the kitchen or living room, and having to vomit.

These signs and symptoms can persist into adulthood when the disorder is not properly diagnosed and treated, causing tension and constant fights at mealtimes.

How to confirm the diagnosis

The diagnosis of this type of eating disorder is made based on the clinical history of the signs and symptoms presented, which must be taken to the pediatrician and/or child psychologist to assess the severity of the food rejection. Keeping a food diary for 1 week, in addition to the feelings shown when eating the food, is a good way to begin to understand the problem.

In addition, the doctor will also check for the presence of other problems that could lead to food rejection, such as difficulties chewing and swallowing, food allergies and gastrointestinal problems. The child does not always have low weight or developmental problems, but they may have difficulty at school with poor academic performance, as well as dry skin and weak hair and nails, due to a lack of nutrients due to a poorly varied diet.

Main causes

Exaggerated and persistent food refusal can be caused by psychological problems, social phobias, and changes in taste such as ‘super taste’. Difficulty chewing, swallowing or feeling upset in the stomach or pain in the belly can also influence this disorder.

How the treatment is carried out

Treatment so that the child can eat everything normally involves medical monitoring and psychological treatment, where strategies are created to improve the mealtime environment and encourage the child to try new foods, through cognitive behavioral therapy. Some strategies that can help vary children’s diets are:

• Reduce stress and arguments during meals, promoting a calm and peaceful environment and not leaving the child grounded if he does not want to eat;
• Do not give up on serving new foods to your child, but always put at least 1 food on their plate that they like and eat naturally, which may have been chosen by them;
• Offer the same food varying in preparation, presentation and texture. For example: offering baked potatoes, boiled potatoes in slices or pieces drizzled with olive oil, not exactly the same as mashed potatoes;
• Offer new foods and eat these foods in front of the child, showing how tasty they are, because this habit encourages the child’s acceptance;
• Trust the child’s choices and leave them free to eat as much as they want during meals;
• Show similar characteristics between some foods that the child accepts and other new ones, to encourage them to try them, for example: pumpkin has the same color as carrots, kale tastes similar to spinach…

Watch the following video and check out these and other tips that can help your child eat better:

Furthermore, if the child presents problems in the development of chewing, speaking, swallowing or gastrointestinal problems, follow-up with professionals such as a speech therapist and occupational therapist will also be necessary because specific techniques will be implemented that can be used to improve the child’s experience with the foods.

Warning signs to go to the doctor

Selective eating disorder can cause serious problems for children, particularly delayed growth and development due to a lack of nutrients and adequate calories. Therefore, the child may be a little smaller and lighter than it should be, although this is not always a characteristic that attracts much attention from parents. A lack of vitamins and minerals can also lead to bleeding gums, bone weakness, dry eyes and skin problems.

Furthermore, an excess of the same nutrient, obtained by excessive consumption of the same food, can also cause health problems such as itching, tiredness, weakness and joint pain. Therefore, if these symptoms are present, it may be necessary to take a blood test to identify a deficiency or excess of a nutrient, which may require medication.