Archive for June, 2008

Picky Eating Teenager

We often gets posts from moms of picky eaters. A desperate cry came to me from one such mom who’s son had stopped eating a lot of food he had previously eaten.  I do not wish to post her email to me, but I will post my reply.

First off, if you are harboring feelings of guilt as to your sons condition, I will ask you to try and let them go.  So many parents blame themselves for this disorder, and the evidence just doesn’t support that.  All sorts of clinical studies are now showing that eating preference, especially in extreme cases like ours, seems to be mostly genetic and only slightly environmental.  For whatever reason, our bodies just reject different foods.  I can tell you that personally, There are many things today (at age 29) that I wouldn’t eat at age 15 or 5.  There are also many things that I would eat at age 5 (McDonald’s Chicken Nuggets for instance) or 15 that I won’t go near now.  Most people go through this and don’t really notice it, but for us it is such a major thing because adding or removing a food makes a huge difference for us.

Second, I see that your son is 14.  While that is still extremely young, you also need to try and let go of his eating somewhat.  (This sentence may sound harsh, and I’m sorry, but it needs to be said.)  No one, least of all a teenager, wants someone harping on them all the time about what they are doing, eating, etc.  Trust me…I completely and totally understand your concern for his health, but as for me, the constant harping on what I was and wasn’t eating only lead to one thing for me. Anorexia. Seriously…all the comments about how unhealthy my eating were eventually caused me to rebel into not eating at all. I got so incredibly tired of it…being told I would die, being told I would be fat, being told I would never succeed, etc…psychologically it put a huge toll on me which lead me to a “real” eating disorder.  Again, I am not trying to be mean or harsh with this stuff, but rather give you a realistic view of what happens when people try to control an aspect of another person. It almost always leads to rebellion. 

Third, while I don’t recommend candy and brownies as a meal, I say at 14, your son needs to start making those decisions on his own. Perhaps give him control of packing his own lunches or buying what he wants to at school.  You might find that if he has that control back, he will start to make some wiser choices on his own. But if he doesn’t, that is still his decision to make. In 4 years, he will legally be allowed to move out and make whatever food choices he wants. It would be better he learn while he is still under your care.

Lastly, it sounds to me like you are extremely understanding.  I commend you for that, because it is really hard for someone without this disorder to understand what living with it is like. Your son likely feels guilty and depressed about the way he eats.  He may not be ready to face that yet, but he will likely in time become ready to deal with it. Don’t force the issue, but make sure he knows that it isn’t his fault that he is that way. There are others out there like him and there is strong evidence that this is a genetic condition that one day will be studied and hopefully “cured.”  But until then, he needs to learn to deal with it in the best way he can.  I went to college, I did well in school, I am successful as an adult, I am happily married, etc.  I went away to college at age 17…anorexic and extremely depressed.  But I got through it and was better for it on the other end.  Don’t hinder your son…even in your mind…because of this condition. I am sure he is completely capable of surviving in college and life thereafter. But you will have to let him go to find that out, and I bet you will be surprised at how well he will do. 

I don’t have a great answer for you. Your son’s eating is in the level we call EPE or extremely picky eater.  But so is mine, and I have managed to do a lot of things despite it.  Not only that, but given my poor eating habits, I am still a relatively healthy young adult.  I need to lose about 20 pounds, but I am working on that through exercise and what little dietary stuff I can do.  I guess ultimately, my best advice is to try not to worry a lot about it.  Make sure your son is eating something and not losing weight, because that is more dangerous really than eating too much.  His age is what makes it the hardest because I can remember at 14 how I felt about my parents getting on me or even just trying to talk to me about stuff.  But if you think he is open to talking about it, just ask him what you could do to help…be that leaving him alone or working with him to find foods he likes.  Let him pick out things at the grocery store that he thinks he might want to try.  Let him decide what he wants to take for lunches.  If he is open to talking to a therapist, try and find a good and understanding one (they are out there, though hard to find).  And the therapy shouldn’t be to force him to eat new foods, but rather to help him accept himself for who and how he is.

If you have further questions for me or there is anything I can do to help, please feel free to write me back.  I am sorry this isn’t more definitive.  I wish so much that I could give you a name of a doctor who would make it all better. I’d be willing to fly over to the UK if there was a promise of that waiting on the other end.  Unfortunately, we simply don’t have anything like that yet. The different methods of therapy, etc. that have been tried by all our different members have pretty much all come back moot.  You are of course welcome to join our group and read the different things that have been tried. Your son would be welcome to join as well if he wanted to.

I do wish the best for you and your son.

Jessica

Fear of Food

I will summarize what this person wrote to protect their identity.

Question:

The person wants to know if there is any type of help for “fear of food.”  They state that after extreme illness with a lot of stomach pain, they no longer trust food…especially food they have not prepared. Their spouse is concerned and upset because the effected is unable to eat out at restaurants.  This person also mentions not liking to feel full.

My Response:

Most of us in our support group understand the fear and frustration of eating out in restaurants. For different people, the severity ranges from minimal to extreme.  Personally  I only like to eat safe foods at safe restaurants and rarely venture out of my comfort zone. For most of us, the problem starts in infancy and though we don’t typically know the causes, results in an extremely limited number of foods we can eat. Just for instance, I don’t eat any vegetables, unless you count potatoes and occasionally I can choke down some lettuce.

The fear of foods for us isn’t something we would consider irrational as most of the time just trying a new food is enough to make us gag and sometimes even throw up.  Was your food selection limited before your illness a few years ago?  If not, a lot of things would be different for you from us, but that is probably to your favor. If you don’t have a deeply rooted inability to eat different foods, then it is likely that most of your fear is psychological and therapy would help you. If I may be personal, I would ask if you have spoken with a doctor about this?  I would wonder if some anti-anxiety medications and relaxation techniques might be helpful in your recovery.  I would also suggest that you try “new” foods in your home where you can watch or be in control of how there are prepared. That would take a lot of the anxiety out of the situation. 

As for your not eating enough…I have been there. I spent a long period of time as an “active” anorexic. I say active because doctors say you never truly get rid of anorexia, you simply go into remission and are able to control your behaviors.  Another personal question would be, have you ever struggled with an eating disorder?  If so, then you absolutely need to get help from a therapist you trust or a medical professional.  The reason I relate to your not being able to eat enough is because after starving myself for so long, I had an extremely hard time eating large meals. And by large, I mean normal healthy portions.  With time, I was able to stretch my stomach back to a normal size and eat healthy sized portions again.  But it may require you eating frequent snacks even when you are not hungry.  I understand not liking to feel full and I understand what it is like to feel sick from being too full.

I need to head off now, but I wanted to get in a quick email to you before I went to bed.  If you feel like it, I would love for you to write back and answer some of my questions and I will try to guide you to some sources of information that I have which might help.  If you do not want to divulge that sort of information to me, I completely understand, but I would urge you to please try and get some help from someone you do trust.  Being underweight is just as unhealthy as being overweight…perhaps even more-so.

Is Picky Eating a Phobia?

I get asked this question a lot:

Is Picky Eating a Phobia?

I know I have expressed this opinion before. It may be a very unpopular one…especially for people who don’t like to let go of control in their lives and insist that they can change this thing in their life too…if only they could figure out how. Attributing this disorder to a phobia is a popular notion to take. But look at the definition of phobia:

A persistent, abnormal, and irrational fear of a specific thing or situation that compels one to avoid it, despite the awareness and reassurance that it is not dangerous.

At first read, this seems an accurate enough description of what many of us have. But look further into this. It is an irrational fear of a specific thing. We all say food right? Wrong…I don’t think too many of us are genuinly afraid of food. In fact we all eat some foods, and therefore we cannot be afraid of food in general. Ok…so we have thousands of phobias then…I have broccoli phobia, corn phobia, vegetable phobia. No, none of these generalizations or specifics will work either. I am perfectly fine being in the vicinity of these items. Most of us have no problem watching other people eat these things. I may not like the look or smell of some things, but I am not afraid of them. So what is the fear? Is it a fear of new things? Well, no, not new things in general. As has been stated most of us are extremely talented and smart, meaning we have had to take on new things and get good at them. Ok…so then a fear of new foods? Maybe! But unlikely because most of us can chain foods to some extent, very very very slowly adding a food here or there. Some are more extreme than others of course, but I don’t think the grand majority falls into this category of simply fearing new foods. Ok, well what else is left? Perhaps it is a fear of how others will react? No, because again, the vast majority of us started this “behavior” at a very young age…prior to our own memory. A 1 year old is not afraid of how people will react to trying new foods. A 1 year old is still completely self-centered. Well what then…if we do have a phobia, what is it? The only logical thing left is that we are afraid of what will happen when we put that food in our mouth. Since most of us have experienced that gut wrenching gagging and vomiting that results in an offensive item entering our mouth, this would be logical. But then, is that really an irrational fear. A fear of something we know might very well happen. Certainly throwing up is not dangerous, but then it is highly unpleasant and it certainly isn’t how a “normal” person reacts when trying new foods. So I think it would be incredibly wrong to say the fear is irrational. It is quite logical in fact given that I don’t know anyone who actually enjoys throwing up and/or gagging. And even if you can argue that it is indeed a phobia, it most certainly was not the original issue here. It would be most unlikely that a 1 year old has a fear of throwing up if and only if new foods are introduced. If the phobia exsisted for that child, it would more likely pertain to all food and would then refuse to eat.

I think people too quickly forget that for most of us, this started at infancy. And while infants can develop psychological problems, there would have to be some pretty specific things going on for a psychological problem of this capacity to be happening. As no one has been able to come up with any sort of tie to this effect, it is fairly safe to say that it is unlikely. However a large number of us can come up with at least one other person in our family who has this same sort of eating issue. Most of the time it is on a different scale, so one is more extreme than the other. But it would suggest largely that genetic involvement is completely and totally logical in these cases. In my case, my grandpa, my dad, a cousin on my dads side, and my brother are all affected with this disorder to different degrees. In every case, there is a normal eating child present too that has been raised by the same parents and not had the selective eating issues or if they had them, have outgrown them.

Beyond that still is the fact that psychological problems go way beyong environment and nurturing. Many psychological problems are genetic as well. Babies are born alcoholics even if no drop of alcohol has ever entered their blood stream. Addictive behavior is passed on through the genes from generation to generation. OCD is genetic. Depression is often times genetic. I would honestly go so far as to say that unless your parents abused you from infancy, if your eating disorder started before you started school, it is genetic…either a defect or a hereditary gene. Otherwise, we’d all just be able to do behavior modification therapy and kick this thing to the curb. But having been in cognitive therapy for 10 years now, no such thing has happened.