Identifying Selective Eating Disorder and Treating It

Sometimes known as ARFID (Avoidant/Restrictive Food Intake Disorder), selective eating disorder is not is a psychological disorder that can result in nutritional imbalance or even malnutrition in extreme cases. It’s characterized by refusal to eat any but a very few types of food. But it’s much more than simple “picky eating.” Many small children are picky eaters, and most people have foods they don’t like.However, 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 as recognized as bulimia nervosa or anorexia nervosa, but it is listed in the Diagnostic and Statistical Manual of Mental Disorder V. This means that the psychiatric community has identified several unique criteria that indicate a diagnosis can be made:

  • Failure to meet nutritional requirements and appropriate weight maintenance. This failure may require people with SED to undergo a weight management regimen and to receive supplemental nutrition.
  • A diagnosis of selective eating disorder must not be related to cultural values or lack of access to different kinds of food – for example, if a Jewish person will not eat pork or a person is in a food desert and can’t get a certain kind of vegetable, they do not necessarily have SED
  • A diagnosis of selective eating disorder cannot be explainable by another medical condition or mental illness

Eating disorder treatment centers provide treatment for selective eating disorders using cognitive behavioral therapy, dialectical behavioral therapy, nutritional counseling, and other talk therapy and cognitive retraining methods. Selective eating disorder treatment is not a simple process. SED needs several in-depth sessions to identify in the first place, even before treatment starts – 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.

Types of Treatment

Cognitive Behavioral Therapy 

CBT is a subtype of psychotherapy that teaches people with SED how to recognize negative thought patterns so they can be replaced with more rational ones. People who need eating disorder treatment normally have a distorted body image – distorted beliefs about their body shape, an obsession with “attractiveness” and weight, and low self-esteem. Cognitive Behavioral Therapy shows the client that these thoughts are flawed and unrealistic and helps them understand how that has been affecting their behavior. 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

Usually, an eating disorder treatment specialist will ask their client to think about how they’ve dealt with stressful or difficult situations in the past. If that centers around disordered eating patterns, they work together to accept that these behaviors are harmful and work to replace them with more positive coping mechanisms. By regularly “rehearsing” positive thoughts regarding stress and other triggers for disordered eating, cognitive rehearsal helps SED patients learn to use positive thoughts to deal with current issues related to their selective eating disorder. 

Exposure Therapy and Selective Eating Disorder Treatment

There are more possibilities than only CBT for treating selective eating disorder, although many are similar cognitive retraining methods such as DBT (Dialectical Behavioral Therapy). There are more aggressive activities that can be implemented as well, like exposure therapy.

Originally designed to help people with extreme phobias, exposure therapy involves exposing people with selective eating disorder to the foods they avoid, if only for a short period. For example, if they refuse to eat dairy products, the therapist may have them take a sip of milk or eat a tiny piece of cheese, even if it causes some distress. Or, a small piece of cheese could be melted on a hamburger instead of eaten alone. The goal is to eventually get them accustomed to including this type of food in their regular eating pattern.

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 your research and reach out to a treatment center today.