It was just three years ago when I tried my first salad, and just a few months ago I finally found out why so many people eat broccoli with cheese. Last year, feeling particularly adventurous, I furtively stuck the tip of my tongue onto a spoonful of clam chowder (not a fan, sorry, Massachusetts). OK, so what? I'm picky when it comes to food. But after reading this Yahoo! piece on Adult Selective Eating, I started to think: Does my aversion to most foods mean I have an eating disorder?
It's an open question. Of late, researchers and doctors have been paying more attention to two potentially obsessive food styles that do not have their own categories as eating disorders, but may cross that line: Super-picky eating, otherwise known as "Adult Selective Eating" disorder; and super-healthy eating — a la tofu and wheatgrass — also known as orthorexia.
Picky Eaters, Extreme Edition
Those with "Adult Selective Eating" disorder can have extremely picky palettes, as described in this msnbc piece, to the point that social lives and overall health are disrupted.
Take Heather Hill for instance, described in the Wall Street Journal as a 39-year-old whose food choices read like a kid's menu at a chain restaurant: French fries, pasta with butter or marinara sauce, vegetarian pizza, cooked broccoli, corn on the cob and cakes and cookies without nuts. Those are not just her favorite foods — it' all she eats. And this kind of eating behavior, while not as obviously dangerous as those living with bulimia and anorexia, can still have adverse effects, as the WSJ explains:
People like Ms. Hill have long puzzled clinicians and medical experts because their behaviors don't fit the definition of a traditional eating disorder, in which people aim to achieve a certain body weight. But picky eaters' diets can be so limited that their food preferences interfere with their social and professional relationships, which is one of the hallmarks of a true disorder.
Last year, the Duke Center for Eating Disorders and the University of Pittsburgh Medical Center launched the first national registry for adult picky eaters (you can participate in their ongoing study by taking an online survey, here). While plenty of research has been done on children who are picky eaters, doctors involved with this survey hope to learning more about how these habits affect adults.
Diagnosing someone with ASE can be difficult since there are no set guidelines to go by. The Diagnostic and Statistical Manual (DSM), known as the psychiatric standard in the classification of mental disorders, has not yet recognized ASE. Right now, it's in the "eating disorders not otherwise specified," category, or EDNOS.
"It's more of a gray line than a line — there's disordered eating and there's an eating disorder," said Trisha Gura, eating disorders expert and author of "Lying In Weight: The Hidden Epidemic Of Eating Disorders In Adult Women."
Gura suggests getting help if your picky eating is interfering with your daily life; if you feel like you are not able to cope with it; or if a person you know recognizes your condition and recommends you seek treatment.
Is There Such A Thing As Too Healthy Eating?
"Orthorexia starts with a fixation on healthy foods, and it becomes obsessive," Gura said, "to the point of complete obsession."
Dr. Steven Bratman, a physician specializing in alternative medicine, coined the term 'orthorexia' in 1996. 'Ortho' is derived from the Greek word for "right" or "correct," a parallel, he writes, to anorexia nervosa. Bratman describes the disorder in his book "Health Food Junkies," which JAMA reviewed (read the review here):
“[A]s orthorexia progresses,” the author writes, “a day filled with wheatgrass juice, tofu, and quinoa biscuits may come to feel as holy as one spent serving the destitute and homeless.” In the full-blown stage, “within the orthorexic is a grim sense of self righteousness that begins to consume all other sources of joy and meaning.”
Bratman should know: as a recovering orthorexic, he describes his journey to recovery in his book.
Orthorexia is also in the Eating Disorder Not Otherwise Specified category. According to Gura, it's not clear how long this disorder has been around, but it is becoming more pervasive. Time.com has a great piece on orthorexia and the fight to get it included in the DSM as an official eating disorder.
Treatments for ASE and otrhorexia include cognitive behavioral therapy and talk therapy.
Further reading: The National Eating Disorders Association has a list of resources for individuals affected by eating disorders.
This program aired on April 27, 2011. The audio for this program is not available.