Selective Eating in Adults

1. It's a good idea to start by writing down what you do eat using a food diary, to track what you eat, how much of it, where and when you eat.
2. Then, think about what might have impacted your decisions to eat; were you sat in a different place, was it served on a different plate, who else was there, was it noisy or were you distracted by the TV? Is there something in common about the foods you do eat; the texture (e.g. crunchy foods or soft), the colour (e.g. often beige), the shape, the temperature, the way it's eaten (e.g. with your hands)? This might help you notice trends in the foods you do eat or the environment which encourages you to eat.
3. Next think about your motivation to make dietary changes – how would you like your health to improve (e.g. weight changes, energy levels), are you missing out on social activities because of selective eating, do you worry that your children might be copying your eating habits? Being aware of why it is important to you to make changes will be helpful.
4. Consider when/how you could make small changes to increase the range of foods eaten using the tips below. Consider which type of foods you would like to focus on first.

• Stick to a routine with meals and snacks to avoid under/over-eating, and have a plan of when new foods will be tried.
• Aim to eat meals in the same place, where possible so the environment becomes familiar.
• Have accepted/safe foods alongside new foods to try – this might look like dipping a new food in a sauce you already like.
• New foods should be tried several times as studies show we may need to try a food more than 10 times before accepting it.
• You may find it helpful to have distractions during mealtimes like talking to friends/family about other things.
• You may feel limited by cooking skills, start by expanding foods that are easier to prepare, and gradually expand your cooking skills by attending a class, watching videos and reading recipes.
• If other people in your home are involved with preparing your food, make sure they are aware of your goals so they can support you by offering new foods following these tips. You may want to talk to them about how you can be more involved such as choosing the new food to try.
• Try Food Chaining to offer foods similar to those already liked (food chaining is described in more detail below).
• You may wish to consider buying an appropriate multivitamin, to ensure you are meeting your requirements. Speak to a pharmacist for advice.

ARFID is an eating disorder affecting the variety of foods eaten, which may appear as a lack of interest in food, avoiding foods due to their sensory characteristics, or other concerns around consequences of eating. ARFID is diagnosed when this eating disturbance is combined with weight loss, nutritional deficiencies, a dependence on nutritional supplements and psychological or psycho-social challenges. People with ARFID do not restrict their diet to impact their body weight or shape.  

Not all selective (picky/fussy) eaters would have a diagnosis of ARFID.

People with ARFID often avoid entire food groups and have very few 'safe' foods (often less than 10). These people tend to be very sensitive to taste, texture and appearance of foods and may have experienced distress with food e.g. choking, vomiting, reflux.

People on the autism spectrum or those with ADHD are more likely to develop ARFID. If you are concerned you have ARFID speak to your GP.

Unfortunately CDDFT dietitians do not offer a service for patients diagnosed with ARFID or selective eating. This website created by the North East and North Cumbria (NENC) Provider Collaborative may be a useful resource. Although it is titled ‘ARFID’, a lot of the information can be applied and be helpful even if a diagnosis is not confirmed. 

Other websites that may be helpful include BEAT, ARFID Awareness UK and The Royal College of Psychiatrists. 

Regularly seeing the new food is the start of the food becoming familiar - perhaps in the kitchen, on the table, on a family members' plate or in a bowl next to your plate. Looking at pictures can also help. Try reading recipes or watching cooking videos which include pictures of these foods.

Making a food more familiar through touch can help. You may start by touching the food with your fingertips, then holding the food, then touching it with your lips. Remember there is no expectation to try the food at this stage, you are just aiming for it to become more familiar.

Smelling the food can help to begin to build up an idea of the flavour of the food.

When you are ready to taste the food, you may choose to lick the food, or may bite the food but spit it out. This can increase your awareness of the food, building up to tolerating it. It's important to continue to revisit the food multiple times (ideally 10 or more). When tasting new foods it's a good idea to offer two familiar or liked foods, with the new food to reduce anxiety.

• Favourite cheese cracker > Different shaped cheese cracker > Different flavoured cheese cracker > Plain cracker with cheese > Toast with cheese > Cheese toastie > Potato with cheese > Vegetables with cheese
• McDonalds French fries > Burger King French fries > Oven cooked at home French fries > Homemade French fries > Chunky chips > Smiley faces > Fried potato > Roast potato > Mashed potato