Selective Eating Disorder - Causes, Effects and Treatment

September 21, 2021

Approximately 30 million people in the U.S. are estimated to be suffering from a selective eating disorder. These selective eating disorders are more than just vanity or fad diets. They are serious mental illnesses that may eventually become life-threatening and turn fatal. Despite heightened awareness about the common eating disorders, several misconceptions persist. To dispel those misconceptions, we need to look at the concepts of selective eating disorder, causes, effects, and treatment in a nuanced manner. 


What is an Eating Disorder?


Abnormal eating habits or severe disturbances in eating behavior are considered severe eating disorders. For some, eating disorders revolve around a limited amount of food for consumption, while for others, it may involve uncontrollable binging. It has been found that those with eating disorders are often obsessed with diet and exercise. Some even eat large quantities of food only to puke it out later. These disorders are not restricted to people of any specific gender, religion, race, or socio-economic background. It can happen to just about anyone.


Although most of us are concerned about our weight, health, or appearance, some people are fixated with their body weight or shape, weight loss and often control their food intake. This is a sign of an eating disorder with repercussions on physical and mental health. 


Eating disorder is not a choice. It is a type of obsessive-compulsive disorder that can be treated entirely. 


What is a Selective Eating Disorder?


A selective eating disorder is subsumed under the Avoidant Restrictive Food Intake Disorder (ARFID). Those suffering from ARFID are phobic and anxious about certain foods, have sensory aversions to certain textures, tastes, or swallowing, and often have a restricted diet. This is far beyond the realm of being a fussy eater. More than 50% of eating disorders are diagnosed as Bulimia, Anorexia, or Binge Eating Disorder. 


Talking of diagnosis, let us look into the different forms of selective eating disorders that exist.


Types of Eating Disorders


Let us dive straight into the most common forms of eating disorder, their symptoms, and their effects. 


Anorexia Nervosa


This is the most well-known form of eating disorder characterized by restricted food intake, such as limiting to only a particular food with a certain amount of calories. Those suffering from this condition are, quite often, underweight. Then, a binge-purge subtype implies that a person will have too much food followed by a vomiting spree. The symptoms include - 


  • Distorted body image
  • Restricted calorie intake
  • Fearing weight gain
  • Frequent weight monitoring
  • Being underweight
  • Linking weight to self-worth and esteem



Bulimia


This condition involves purging the food from the body to slash the number of calories consumed. This can be done by excessive exercise, vomiting, or consuming laxatives. Some bulimics devour large quantities of food and become painfully full. They binge on food and purge often to reduce the painful feeling of overeating. Most bulimics maintain average body weight as compared to anorexics. The symptoms typically include - 


  • Eating a lot within a short period
  • Lacking control while eating
  • Recurring compensatory behavior such as purging


Those suffering from bulimia experience physical repercussions such as - 


  • Severe dehydration
  • Tooth decay and eroded tooth enamel
  • Acid reflux
  • Ulcers
  • Frequent sore throats
  • Electrolyte imbalances
  • Intestinal distress


Those who have bulimia often have comorbid substance abuse issues or mental health issues such as anxiety, depression, or bipolar disorder.


How do I know If I have a Selective Eating Disorder?


Selective eating disorders affect adults and children alike. Anxiety, depression, and social impairment are symptoms that accompany a selective eating disorder. People who selectively eat only consider those they deem acceptable or safe, avoiding food with a particular color, texture, or taste. Some people cannot even bear to touch certain foods or dread them. Or, the thought of a certain food may lead to panic attacks.


Selective eaters have an aversion to an entire food group such as vegetables, pulses, or fruits. Those with a selective eating disorder are stressed to try different foods due to the fear of vomiting or choking. Most selective eaters do not have weight issues. They are usually within the normal BMI range.


Causes of Selective Eating Disorder


A selective eating disorder can be caused by trauma. It may be brought on by even a little unpleasant experience with a particular food, or choking on food, or worse, having witnessed someone choking. If the brain associates specific food with danger, it will protect the body by stimulating anxiety whenever there is contact with it. Selective eating is a way in which people are trying to exert control over their lives.

Causes of Selective Eating Disorder


However, if the condition is severe, the person may suffer from malnutrition. It may be accompanied by physical problems such as digestive problems, low blood pressure, electrolyte imbalances, and a slower heart rate.


Selective eating disorders are also caused by factors that are psychological, biological, or societal. Some of them are enlisted below - 


Biological Causes


  • Genetics may cause selective eating disorders. 
  • Someone with a history of dieting may develop bulimia or the habit of binge eating. 
  • Those with Type 1 Diabetes are at the risk of developing a disorder. 


Psychological Causes


  • Perfectionism can lead to selective eating disorders, fuelled by the aspiration to look 'perfect' or eat only the 'perfect' food can lead to bulimia, anorexia, rumination disorder, or even more. 
  • Obsessive tendencies such as the fear of losing control lead to eating disorders. If a person feels they have no control over their life, they may turn to food since that is one thing that no one else can take control over. 
  • A poor body image derived from feeling overweight, being born into the wrong gender, feeling disproportionate, or having a different idea of what one should look like with an ideal body can trigger a selective eating disorder.
  • Depression and anxiety may trigger eating disorders. The person can be suffering from other mental health illnesses such as OCD's, or schizophrenia, or be bipolar. 


Societal Causes


  • Being bullied or teased about weight is a common reason for developing a selective eating disorder. With an increasing need to have a picture-perfect life on social media and the rise in cyberbullying, eating disorders are increasing, specifically among teenagers.
  • A history of abuse or trauma can lead to developing an eating disorder. 
  • Some people turn to eating disorders or binging and purging because they lack social support and feel bored. 


Effects of Selective Eating Disorder


Mental Effects


Selective eating disorders occur along with other mental illnesses. Most of them are related to anxiety disorders. They usually predate the onset of selective eating disorders. People suffering from this condition experience high scores on measures of perfectionism and experience depression.


Physical Effects


Since a balanced diet is essential for regular functioning, selective eating disorders may impact physical and mental operations. A person may experience medical consequences irrespective of whether they are underweight, overweight, or have a normal BMI. Selective eating disorders can, however, cause severe health issues. They include dental problems, fainting spells, cardiovascular problems, loss of hair, loss of menstrual period even post-puberty, disrupted sleep patterns, gastrointestinal issues, etc. 


Selective Eating Disorder Treatment


Selective eating disorders can be successfully treated when detected early because the more advanced the disorder, the higher the risk of medical complications and suicide. 


Family members play a significant role in selective eating disorder treatment by helping the person overcome body image issues or eating habits. They can offer support during the treatment, particularly for adolescents. It helps both the individual and the health care provider. Selective eating disorder treatment includes medical care and monitoring, psychotherapy, medication, nutritional counseling, or a combination of all. The goal is to stop binge-eating and binge-purging behavior, reduce excessive exercise, restore adequate nutrition and bring the weight to a healthy level.  


Self-Help


Those suffering from binge-eating disorder and bulimia nervosa can be self-helped by Cognitive Behavioral Therapy (CBT). The person may work through a manual, a workbook, or web platform, to learn about their condition and develop skills to overcome or manage it. Self-help is contraindicated for a condition such as anorexia nervosa.


Coping


Taking care of mental and physical health goes a long way in helping those with selective eating disorders. Additionally, support from a therapist, a common group, family, or a friend can help along the path to recovery. 


Beyond self-care, it helps to identify healthy distractions that can be turned to when people find themselves unnecessarily obsessing about weight or food or have the urge to experience disordered eating behavior. Here are a few healthy distractions to consider:


  • Invest in an adult coloring book
  • Explore a new hobby, such as knitting, painting, or photography
  • Try a yoga class or DVD
  • Practice mindfulness meditation
  • Write in a journal
  • Take a leisurely walk


Key Takeaway


Recovery from a selective eating disorder is not easy. Not only does it take courage, but it also takes the right support system to overcome disordered eating patterns. More often, people with eating disorders do not acknowledge the problem. This is where family members and significant others can play a crucial role in getting them the needed help. And, although recovery from a selective eating disorder is a long-term challenge, it is definitely possible. With the help of personalized help available on the phone, selective eating disorders can be treated.

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