When ‘Fussy’ Eating Becomes A Disorder

Getting ready for a black tie award ceremony she was hosting, Sarah Lyons*, had already prepared her cheese sandwiches and tucked them away in her clutch. White bread, margarine and Red Leicester in rectangular halves. She does this every time she goes somewhere unfamiliar, where she’s not sure what will be on the menu. She pretends to be too busy to eat and sneaks off to find a quiet spot to eat her sandwiches. “It takes the pressure off trying to eat something new,” says Lyons, a freelancer in her thirties, adding that she’d be mortified if anyone knew this. Lyons has selective eating disorder (SED) and has eaten predominantly beige food since she was 18 months old – potatoes, chicken, white fish, turkey. Carrots are sometimes okay, but only if they’re cut into rounds. Extreme fussy eating – being unable to eat certain foods or even whole food groups – generally isn’t taken seriously in our culture. Tabloids make a spectacle out of the woman who has lived off eggs and chips for 30 years, and TV shows portray them as a joke (see Harry Hill’s TV Burp), trivialising what is actually a serious problem and adding to sufferers’ sense of shame.

“Sufferers often keep quiet about it, because they don't want to draw attention to the limited way they eat,” says food writer Bee Wilson, adding that they often don’t seek help and prefer to live around their limited tastes rather than attempt to change them. “Lots of people have no idea that adult selective eaters even exist,” she adds. They share their problems and seek reassurance on private Facebook groups with thousands of other members, and websites like PickyEatingAdults.com. Wilson conducted extensive research in this area for her latest book, First Bite: How We Learn to Eat, and says she suspects there has been a rise in selective eating among adults in recent years. “Based on my interviews with people who run feeding disorder clinics, there's definitely a rise in picky eating among children, and therefore probably among adults too.” She cites a 2015 study of a random group of nearly 500 Americans, in which 35.5% described themselves as picky eaters. Wilson’s theory behind the apparent increase is that in previous generations, traditional home cooking exposed children to a wider variety of flavours, but today, she says: “the industrial 'kid food' for sale in supermarkets has a very homogenous palate of sweetness and saltiness. For kids who are reared on these foods, it's hard to develop a liking for real home-cooked food.” For others, selective eating habits arise from a traumatic experience with food as a child, such as choking, or later in life following a bad illness that makes them fearful of certain foods. Selective eating habits can also be associated with other mental health conditions, such as OCD and autism. The problem is gaining recognition among health professionals. In 2013, adult selective eating was added to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, the universal authority for psychiatric diagnosis, as avoidant/restrictive food intake disorder (ARFID). It’s also known by some people as SED.

However, there’s a big difference between 'picky eating or ordering different parts of a meal 'on the side' like Meg Ryan's character in When Harry Met Sally, and a full-blown disorder, when tastes are so limited that someone refuses invitations to eat with friends and experiences nutritional deficiency. “The difference between being a ‘fussy eater’ and having a selective eating disorder is the fear associated with particular foods,” says Dr Joanna Silver, an eating disorders specialist at Nightingale Hospital in London. And unlike anorexia or bulimia sufferers, because people with selective eating disorder don’t restrict their food intake to lose weight and don’t usually have a distorted body image, they don’t necessarily appear unwell and, as such, aren’t taken as seriously as they should be. Felix Economakis, a chartered psychologist and former psychological coach on BBC Three’s distastefully titled Freaky Eaters, tells Refinery29 that he has treated up to three adults per day with the disorder for years, most of whom are between 25 and 35 years old and feel extreme shame and anxiety. “A lot of people just don’t understand it and think sufferers are attention seeking, but it’s just as valid as any phobia,” says Economakis. “There’s a lot of ignorance about it and judgement around the subject.” In such a climate then, it’s understandable for selective eaters to avoid social situations in which they wouldn’t be able to stick to their food rules. “Patients often lead very restricted lives – avoiding relationships, restaurants and even jobs,” says Dr Silver. “One patient I saw moved countries and spent thousands of pounds shipping out Skippy peanut butter to where she lived as it was one of her few safe foods.” Restrictive diets can make work life a nightmare, too. For Anna Wilson*, 24, being a selective eater is particularly inconvenient because she works for a healthy eating magazine, where quinoa is the norm. “Being a journalist, there are lots of foodie conventions and events and I have to swallow things I hate for fear of looking fussy,” she says. She can’t eat mixed food, such as lasagne or shepherd’s pie, and is terrified of new textures, so being surrounded by clean-eating colleagues can be frustrating. They’re constantly hiding avocado in brownies and other baked goods in a futile bid to convert her.

She says she wishes she had more confidence to try new things; something echoed by most selective eaters I spoke to. Eating out at restaurants and trying the latest food trends are such huge parts of our culture – particularly for young people in cities like London – that as a selective eater it’s easy to stop trying new things altogether, including looking for love. “Some people just avoid dating because they’re too embarrassed to say they only eat chips,” says Economakis. “One 24-year-old women told me she’s never had a boyfriend because she’s afraid to go out and eat with a man, in case he tries to get her to try new things.” Even when sufferers do become romantically involved, over time their limited diet can really put their relationship to the test. Foodie Brenda Wong, 23, says her ex-boyfriend’s aversion to anything other than plain chicken and chips was a factor in their break-up. Wong recalls calling the restaurant where she was throwing her birthday dinner to check there was something plain enough on the menu for him to order. However, when they got there, she says: “He couldn't eat it because there was coleslaw in the burger and refused to eat anything else.” Ultimately this proved too much for her to deal with. Lyons says her eating has had a momentous impact on her life and while she’s sought professional help, unfortunately it hasn’t worked. “I’m not happy about how I eat and wish I could eat a far wider variety of food – especially now I have my own family,” says Lyons. “I’d hate for my daughter to pick up on any of my habits.” Hopefully as society continues to take mental health issues more seriously, awareness of selective eating disorders and their potential triggers will increase, limiting the risk of them being passed on to future generations. *Names have been changed