Selective eating disorder: what is it

One of the eating disorders is selective eating disorder. Under this term is not a child’s caprice, when a child wants to eat certain foods and rejects others, but a conscious balancing of the daily diet without certain foods in it. This situation leads to restriction of the diet, which over time provokes various somatic and endocrinological disorders.

First of all, we are talking about the development of diseases of the digestive system and disruption of the function of the endocrine glands. This through the association of eating problems with the hormones that control satiety and hunger: leptin and ghrelin – causes leptin and then insulin resistance. You will learn how to diagnose and correct such a pathological condition in this article.


  1. What is it.
  2. How does the pathology manifest itself.
  3. Appetite.
  4. Causes.
  5. Diagnosis.
  6. What happens if you leave everything as it i.
  7. Treatment.

What it is

In international medical practice, this eating behavior is recognized as a disease. Its essence is simple: the list of products from which the patient refuses over time becomes more and more, and his diet is minimized to a few items. The genesis of the pathology is psychoneurological in nature, and this behavior is most often characteristic of children. But adults are not left out either.

Symptoms of the pathology can easily be confused with orthorexia, when patients also consume only certain foods, but there are fundamental differences:

  1. Orthorexics can clearly explain why they eat one thing and refuse another, in selective eating disorder there is no logical reason.
  2. Orthorexia is based on an obsession, which is not the case with this pathology.
  3. Orthorexics spend a lot of time making menus and have a negative attitude toward the eating habits of normal people, with selective eating disorder everything is limited to the rejection of bad foods.
  4. A similar symptomatology is found in bulimia, there are also bad and good foods, but the bad ones are not rejected, but punished themselves with them.

How does the pathology manifest itself?

Parents who encounter such a problem must not miss the fine line of the child’s crankiness with the debut of the pathology. In other words, early contact with a doctor is very important. How to understand where the red line begins, which is undesirable to cross?

By a number of signs:

  1. The baby refuses not just one product, but rejects a whole group of food substances at once: meat, milk and its derivatives, for example. He does not like the consistency, shape, color – everything disgusts him.
  2. The child has difficulty swallowing unpleasant foods.
  3. A physiological reaction to the food eaten at the pressure of the parents: nausea, vomiting, dyspepsia.

The baby does not understand and cannot explain why he does not want to eat, conscious motives are not available to him.


This is a key point. If parents have doubts about the physiology of the processes taking place, it is necessary to follow the baby’s diet. Healthy fastidious child does not suffer from lack of appetite and eats his favorite dishes with pleasure, getting all the necessary nutrients for the body, if parents accept his taste preferences and offer an alternative to unpalatable products.

A sick child’s appetite disappears at the mere sight of bad food. Realizing that he can only eat a limited amount of food, he unconsciously restricts his natural needs, trying to fill up on one product. The result is a lack of nutrients in the body. In this case the leptin-hypothalamus chain is disrupted and the response is reversed, because the feeling of satiety is perverted. The body is disoriented by the child’s eating behavior.


It is difficult to say exactly why this happens: the disease is poorly studied and its objective triggers have not been established. However, physicians have a strong impression of the pyschogenic nature of the disease.

And, indeed, the diagnosis of selective eating disorder cannot be made if the selectivity can be explained:

  • intolerance to certain products or allergies;
  • the disadvantaged financial situation of the family with a lack of money to buy certain products;
    religious traditions;
  • individual taboos.

But if logic cannot explain the lack of consumption of certain foods, there is reason to think about an eating disorder. There are many triggers in the development of the pathology. Psychiatrists say that by being selective in their food, the baby is talking about an internal conflict. There is an unacceptable provocateur for the baby, but the child cannot name it in words.

Most often it is:

  • a particular situation;
  • specific actions of others;
  • an observable change.

The easiest way to express your dissatisfaction is to refuse food. It is very easy to divide food into “good” and “bad”. Sometimes some traumatic event for the baby happens while there is a certain product or a prepared dish on the table. This is enough to never encounter it again, because there is unconscious fear. This is how a rejection reaction is formed. Other mechanisms for such fears are also possible.

A child may witness vegetarians talking about why they do not eat meat and permanently gain a fear of eating food that they associate with murder. It’s even worse if they played with the pig in the yard before, and now they’re being forced to eat it.


The treatment algorithm for eating disorders is standard. It always begins with the collection of the anamnesis, a detailed story of the parents about the selectivity of the child’s diet, the first manifestations of the pathological condition. It is very important to try to find the trigger of the disease. If the problem is recognized in time, the symptomatology will have a pronounced pychodependent nature. If the pathology is neglected, somatic disorders are not excluded.

Therefore, the doctor, first of all, pays attention to:

  • BMI compliance with the age norm;
  • biochemical tests, including a hormonal profile with determination of leptin and, if necessary, ghrelin levels in the blood;
  • gastrointestinal symptoms;
  • vegetative manifestations: weakness, asthenia, vertigo, sweaty palms.

The diagnostic set of measures includes anthropometry, weighing, screening blood and urine tests, and an initial neurological examination. If deviations from the norm are detected, the baby is referred to specialists for a detailed follow-up examination. In this case, we must not forget about the differential diagnosis with other digestive disorders.

This may include:

  1. Anorexia nervosa, when there is a sharp loss of weight against the background of refusal of food. However, in this case it is not certain foods that are rejected, but all food is rejected indiscriminately.
  2. Orthorexia, when there is a division into “good” and “bad” food. But in this variant only environmentally unfavorable products are rejected, whereas at the given pathology the division is unconscious.
  3. About psychogenic vomiting, but in this case it does not depend on the type of food consumed.

In childhood and adolescence, a child with a selective eating disorder rarely worries about his or her appearance, so losing weight may not be the goal of giving up food. This should be kept in mind.

What happens if you leave everything as it is

The most unpleasant thing about the situation with selective eating is the lack of nutrients. Normally, a person’s diet must be varied to get all the necessary nutrients and building blocks, vitamins, minerals, proteins, fats, carbohydrates. One group of products is not able to provide this. If we exclude at least one product, the body will suffer from a lack of useful elements. In the case of selective rejection of food, several useful food items suffer at once. Often a child eats the same food day after day.

Because the cause is a mental attitude, appetite disappears, leading to:

  • hypotrophy or cachexia;
  • impaired absorption of nutrients from the digestive tube;
  • hypo- or avitaminosis.

To maintain the normal vital activity of patients, probe feeding, parenteral nutrition are used. If the psychological factor is not removed, dependence on this way of eating can develop.


The goal of therapy is to eliminate the trigger of the pathology, and the main way to correct selective eating disorder is cognitive-behavioral therapy. It is necessary to identify the thoughts triggering the perverse emotional reaction and try to direct them in the right direction. To do this, the therapist and patient must interact with each other, trusting each other completely and making a joint effort.

They have to do it together:

  • to fully disclose the essence of the stressful situation that provoked this type of eating disorder by talking it through;
  • to form an attitude toward it;
  • to develop a behavioral response to this stressful emotional trigger.

In the process of correction, the doctor will suggest a more rational reaction to what is happening, advise how to manage stress without combining it with food, and how to learn to control your emotions. The pattern of thoughts and behavior that already exists in the patient should be destroyed. In this case, meals will be perceived as nothing more than acts of satisfying a natural need, and not as ways of reflecting inner feelings and thoughts.

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