Picky Eating in Adults
By Abigail Natenshon, MA, LCSW, GCFP
Feeding and picky eating problems are real; they are hard-wired
and neurological. Their far-reaching effects are nutritional,
interpersonal, behavioral and developmental, altering the sense of self
and self-esteem, family relations, sociability, as well as academic and
Picky eating adults
Feeding problems in children typically go undetected, and/or are
mistaken for the more benign picky (preference) eating behaviors. Adding
to the ambiguity of diagnosing these problems, by the time problem
feeders reach adulthood, the diagnostic terminology describing feeding
problems reverts back to being called "adult picky eating." (see
PickyEatingAdults.com). Problem feeders describe the one out of twenty
children between the ages of birth and 10 who refuse to eat or who will
only eat limited numbers of selected foods.
Children with feeding disorders (as well as picky eaters to a lesser
degree) tend to demonstrate clusters of traits that indicate a broader,
more pervasive, neurologically based dysfunction. (Natenshon, 2009 P.
134) Also known as perseverant feeding problems, or food neo-phobia,
these problems are characterized by a strong fear of trying new foods,
leaving its victims at risk for malnutrition and failure to grow
normally. Problem feeders tend to demonstrate diverse clusters of
traits, covering a spectrum of broader, more pervasive,
neurologically-based dysfunctions which compromise the person's
existence; these might include sensory integration disorder (SID),
Asperger's syndrome, Non-Verbal Learning Disability (NVLD), and/or
Pervasive Developmental Disorder (PDD) and include such symptoms as
choking, gagging, vomiting, difficulty swallowing, etc. Individuals
suffering these disturbances in early life in many instances carry
varying degrees of pathology with them into their adult years.
Harnessed with restrictions, compulsions, fears and limitations in their
relationship with food, children and adults find themselves feeling like
pariahs and societal outcasts, alone, isolated and seriously
misunderstood, not only by loved ones, but by the vast majority of
health professionals as well. Generally perceived as stubborn,
inflexible, obstinate and unadventurous, their behaviors dictate that
they deny themselves more than nourishment; adult as well as child picky
eaters miss out on so many of life's pleasures…the sociability,
recreation, celebration and self-care that is so much part of feeding
oneself. The achievement of developmental/emotional milestones, as well
as the opportunity and emotional capacity to use them to adjust to life,
to newness and the anxiety of uncertainty may be forfeited as a result
of these problems.
Profiles of Picky Eating Adults
One adult picky eater describes having trouble with tolerating
variations in her foods. She says, "…there are a lot of processed foods,
like hot dogs, macaroni and cheese, rice, and others, where I can really
tell the difference between brands. I only like Kraft Mac and Cheese and
only Ball Park hot dogs, for example. I'm finally able to tolerate Ball
Park hot dogs that aren't 100% beef; I used to insist on all-beef Ball
Park hot dogs. If the store didn't have them specifically, I'd rather go
without." She goes on to describe her fear about what might happen if
and when her boyfriend tries to make Campbell's Tomato Soup with water
rather than milk (Campbell's Tomato Soup and milk is one of her favorite
foods.). She admits that she hasn't had the soup in the three years
since having moved in with him because she is worried about how her
palate would react to the soup being made with water. It is significant
to note that rather than taking the risk of experiencing the event and
challenging herself to deal with it, she opts for total abstinence,
choosing to avoid altogether the possibility of experiencing discomfort
that she does not trust herself to handle and survive. Note that
manipulating one's environment in lieu of making emotional demands on
the self to accommodate and cope with challenges is also the preferred
choice of those afflicted with the clinical eating disorders, such as
anorexia nervosa and bulimia nervosa.
This picky eating adult goes on to exclaim, "Oh, and for me its not so
much about the taste being different, but if the texture varies even
slightly from what I'm used to, I find it very hard to tolerate." She
describes throwing out a whole pot of rice recently because it was
mushier than she could tolerate. Another picky eater describes his fear
of tasting new foods. "You just know that it's going to taste bad before
you put it in your mouth. I really have to be "ready" to try something
new, to work up to it. I cannot try something on the spur of the moment.
This is even worse when I am out in public. Variations on things I
already eat aren't that bad, but something completely new…Don't even go
In contrast, a medical doctor who is, and was, a picky eater as a child,
recommends that parents of picky eaters "…do as my parents wisely did.
Give the child a vitamin pill and let her grow out of it. Too much
attention could make it worse and lead to an eating disorder."
Describing her continued preference today for sugary, fatty and bland
foods, she still gravitates towards hotdogs, hamburgers, chicken
nuggets, French fries, and ice cream and has only learned to eat
vegetables as an adult. She claims that her eating preferences have in
no way compromised her daily existence or professional function, which
is not the norm with such cases.
Visit http://www.pickyeatingadults.com/page4.html: to read Profile of a
Picky Eating Adult
Just Take a Bite: Effective Answers to Food Aversions and Eating
Challenge (2004) by Lori Ernsperger and Tania Stegen-Hanson offers some
suggestions for afflicted children; adults who wish to make changes can
also benefit from some or all of these techniques and practices. They
are as follows:
- People with SID benefit from systematic desensitization programs
offering short exposures to new textures and oral sensations in
small, incremental doses. This requires the investment of time,
initiative, and creative thinking, with the goal of introducing new
foods that are similar to those he already likes and is accustomed
- The feeding team may alternately choose to reduce the demands
for varied eating, and focus on other ways to maintain a healthy
diet… Parents are wise to utilize supplements and vitamins to
achieve maximum nutritional balance.
- Individuals whose systems are continually in the "alert mode"
have difficulty calming themselves; they need the right atmosphere
for eating, so that mealtimes become pleasant, fun and stress-free
social experiences. It is critical that there is no TV at mealtimes,
lots of talk, and no threatening food discussions or forcing of
- People need to make friends with food by exploring and handling
food, in many contexts and through all of the tactile senses.
- Techniques for stimulating/exercising the tongue diminish the
gag reflex. The side of the tongue, rather than the tip, is less
sensitive to strange new tastes and is the best place to introduce
Carolyn Black Becker of Trinity University in San Antonio, Texas
describes a treatment technique that she calls "food chaining." This
involves "chaining" off the foods the child is willing to eat, and
limiting availability to the child's favorite and most nutritious foods.
Working within the context in small leaps, child and therapist search
out increased numbers of barely acceptable foods, which became
progressively more acceptable as the person eats more of them. As an
example, pizza is a good food to chain off; pizza could be expanded to a
grilled cheese by creating a pizza sandwich, by toasting mozzarella
cheese and pizza sauce instead of a more flavorful cheese. Or, by having
hot pizza sauce served in a cup next to a child's mac and cheese, he
could be encouraged to dip occasional bites of mac and cheese into the
sauce, expanding his taste combinations.
The Feldenkrais Method
The Anat Baniel Method for Children Based on the work of Dr. Moshe
This mind/body holistic approach to treatment accesses, reorganizes and
integrates the central nervous system, creating an empowered, more
integrated perception of the self, improved integration of sensory
processing, and ne potential for possibilities of neurological change.
It does so experientially, bypassing the area of the brain that relies
on language alone to facilitate learning. Thus, the technique is
designed and well-suited for children as young as the new-born, a boon
to the pre-mature population of babies who may be the most prone to
developing these types of feeding difficulties.
Through gentle and pleasurable movement, and during play, the technique
integrates mind and body, reduces anxiety, and increases self confidence
and enhanced well-being. Kids access the gentle movements through song
and play, as well as through one-on-one work with a skilled
enjoy the option of one-on-one treatment or attending Awareness through
Movement@ or Functional Synthesis © classes that are available through
private practitioners of the Feldenkrasi Method or the Anat Baniel
Method based on the work of Moshe Feldenkrais. Such classes are
typically offered through fitness clubs, community centers, and park
By facilitating self- and body-awareness, Feldenkrais techniques promote
emotional versatility and integration. Offering a novel opportunity to
seek and discover alternative solutions, it enhances coping skills and
adept problem-solving, upgrading all aspects of physical and mental
function. Click here for more
information on the Feldenkrais Method in the treatment of eating
Initially, the place to go for help with these disorders may best be a
properly trained occupational therapist, rather than a psychotherapist
or medical doctor. Having said this, it goes without saying that there
is certainly a place, and the need for, a multi-disciplinary team
approach to serving the multi-dimensional, integrative needs of the
eating dysfunctional child and family. The professional team optimally
includes a pediatrician or internist, psychologist, occupational
therapist, speech pathologist, dietician and physical therapist, capable
of assessing and meeting the needs of the whole person, and all the
issues, not just their own area of specialization. Because these are
disorders of the central nervous system, we have noted how Feldenkrais
and Baniel work can be ameliorative of the problem at its very soured.
The work of the individual and family psychotherapist is important in
helping the individual and family to deal with the social and emotional
implications for the patient as well as loved ones.
Once diagnosed, young adult students with tactile/sensory problems can
and should be supported by community resources such as the school or
university, through educational and personal accommodations. Examples
might include use of laptop computers to accommodate poor fine motor
problems, shorter writing assignments, longer times for test taking, or
special dispensation if the child is unable to wield a pencil
sufficiently to complete an art assignment to satisfaction, or eat in
the lunch room or dining hall.
Despite ambiguity, misdiagnosis and a serious lack of understanding in
the professional health community, in understanding that many of these
problems in adults are neurologically based and hard wired into the
central nervous system gives sufferers reason to be optimistic about
healing. Increasingly, holistic approaches to healing food related
problems have been shown to have ameliorative effects on body awareness
and on neurologically based sensory changes. Challenging one's self to
take risks with food, or with new behaviors in other life spheres can be
a wonderful way to create new behavioral inroads along with new neuro-pathways
in the neuro-plastic brain.
Should there be a "cure," there will certainly be no quick fixes.
Treatment will invariably be challenging and involve discomfort and
risk-taking, albeit in a controlled environment. Problems are so much
easier to treat early on, before they have become too deeply rooted.
Curative interventions not only provide the opportunity and vehicle for
making changes, but is so doing, reassure the afflicted individual that
he or she is not "crazy," not alone, and not so misunderstood after all.
Books and articles
1. Lask and Bryant-Waugh: Anorexia Nervosa and Related Eating Disorders
in Childhood and Adolescence. Psychology Press 2000.
2. Lask and Bryant-Waugh: Eating Disorders- A Parents Guide Psychology
3. Ernsperger and Stegen-Hanson. Just Take a Bite: Effective Answers to
Food Aversions and Eating Challenges Publisher Future Horizons, 2004
4. Marcontell, D.K., Laster, A.E., & Johnson, J. (2002).
Cognitive-behavioral treatment of food neophobia in adults, Journal of
Anxiety Disorders, 16, 341-349.
5. Nicholls, D., Christie, D., Randall, L., & Lask, B. (2001). Selective
eating: symptom, disorder or normal variant? Clinical Child Psychology
and Psychiatry, 6, 257-270.
6. Seminars: http://www.sensoryresources.com/conf_details2.asp?cid=915