Characterized by a compulsion to only eat certain types of food, selective eating disorder is not simply being a “picky eater” but instead is a psychological disorder that can result in nutritional imbalance or even malnutrition in extreme cases. While pickiness is common in most small children and infants, teenagers and adults who continue eating only very few types of food may need to seek selective eating disorder treatment to overcome this disorder.
Currently, selective eating disorder (SED) is not a widely known eating disorder, but it is listed in the Diagnostic and Statistical Manual of Mental Disorder IV. Also called “avoidant-restrictive food intake disorder,” (or ARFID) selective eating disorder has several unique criteria that indicate a diagnosis can be made:
- Failure to meet nutritional requirements and appropriate weight maintenance. This failure may necessitate patients begin supplemental nutrition or enteral feeding due to significant loss of weight and/or nutritional deficiencies
- A diagnosis of selective eating disorder must not be related to cultural values or lack of access to different kinds of food
- A diagnosis of selective eating disorder cannot be explainable by another medical condition or mental illness
Eating disorder treatment centers address SED using cognitive behavioral therapy, dialectical behavioral therapy, nutritional counseling and other methods that comprise an eating disorder recovery program for anorexia nervosa, bulimia nervosa or binge-eating disorder. As with any type of mental health disorder, SED needs several in-depth sessions to identify – some symptoms may be similar to other types of eating disorder as well as sharing characteristics of autism and other well-known mental health diseases.
Cognitive Behavioral Therapy
CBT is a subtype of psychotherapy that teaches patients how to recognize negative thought patterns so they can stop them immediately and replace them with positive, more rational thoughts. People who need eating disorder treatment share some common symptoms that revolve around self-image and body image – distorted beliefs about their body shape, an obsession with “attractiveness” and weight, and low self-esteem. CBT shows people in this situation how powerful an impact their thoughts have on their emotions and behaviors. It reveals the irrationality of these disordered thoughts to the patient through a series of logical discourses between patient and therapist.
CBT and Cognitive Rehearsal
An eating disorder therapist will ask a SED patient to think about how they’ve dealt with stressful or difficult situations in the past. The patient and therapist then brainstorm to find positive solutions to that problem by discussing other ways they could have approached the issue. By regularly “rehearsing” utilization of positive thoughts regarding past issues, cognitive rehearsal helps SED patients learn to use positive thoughts to deal with current issues related to their selective eating disorder.
CBT and Validity Testing
An eating disorder recovery program implemented at residential eating disorder treatment centers may include validity testing as a method to challenge someone’s irrational or disordered beliefs. Patients are allowed to defend their viewpoint regarding their eating habits but must support beliefs with objective evidence. For example, if the patient believes eating only carrots can still provide a full nutritional balance, the therapist will ask them to bring a scientific study that proves this assertion. Over time, the irrationality of the beliefs will become clear, and the patient can begin to attempt a more balanced diet.
Exposure Therapy and Selective Eating Disorder Treatment
Originally designed to help people with extreme phobias, exposure therapy involves exposing SED patients to new foods for short periods. If a patient refuses to eat dairy products, the therapist may have them take a sip of milk or eat a tiny piece of cheese every day. Or, a small piece of cheese could be melted on a hamburger instead of eaten alone. The goal is to eventually get the patient used to the taste and texture of foods they previously avoided.
Eating disorder treatment centers offer professional in-patient or outpatient help for teens and adults with selective eating disorder, anorexia nervosa, bulimia nervosa or other lesser-known eating disorders. There is more than one way to approach recovery; while CBT is often used, many other techniques may also prove useful. If you’re struggling with ARFID or selective eating disorder, do you research and reach out to a treatment center today.