SED Selective eating behavior usually begins in early childhood and is not a fussy behavior but a serious illness.

The appearance, consistency, texture, smell and taste of certain foods or other reasons can be the cause of the aversion to the certain food / food group.

The longer the selective eating disorder goes untreated, the greater the likelihood that it will become chronic. The earlier it is treated, the greater the healing success. It is never too late to start therapy. A distinction must be made between Picky Eater and Supertaster. Selective eating disorder should be considered when a child regularly refuses food based on appearance, smell, taste, or texture.

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Causes:

• traumatic experiences

• negative experiences with a food / dish as a child

• Disorders of the sensory processing (especially more pronounced  Sense of taste)

• special family dynamics: certain problems with food are exacerbated

• Consequences for patient / s: Difficulties in many other areas of life

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Description of SED:

- there is sometimes a disturbed relationship with food

- Avoidant / restrictive eating behavior: can be very different and relate to a wide variety of foods.

- Certain foods that cannot be eaten even though they want to be tried cannot be swallowed, often causing a gag reflex

- even the sight /  The smell of certain foods / dishes can also trigger gagging / nausea

- The taste of a food / dish is perceived intensely because the sense of taste is particularly strong. Even the smallest differences in taste are noticed.

- Either there are problems with one or a few foods or there is only a narrow selection of foods that are consumed at all

- there is a high level of sensitivity with regard to different consistencies

- Usually begins in childhood with picky eating behavior, but can also develop later

- the limited dining options limit the freedom of action

- Affected people either have a normal appetite, eat enough overall, and grow and develop normally

- or eat very little if you have an avoidant / restrictive eating disorder, generally have very little interest in food and / or avoid certain foods completely and permanently due to sensory properties

- Possibly there is also a reduced communication / difficult relationship with the reference person / s

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Picky Eater:

Picky eating behavior characterized by fear of trying new foods. Various studies have shown that new foods have to be offered between 8 & 15 times before they are accepted & tolerated by children. In addition, our brain only gets to know and love tastes over time.

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A person affected founded a self-help group in the USA:

http://pickyeatingadults.com/index.php/videos-2/

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Non-connoisseurs, normal connoisseurs & super tasters

Due to a genetic variation, some foods taste particularly bitter for Supertasters. There are significantly more taste buds on the tongue of a super push button, so that overall the sense of taste is greater. The sense of smell is also part of the sense of taste. A clear nose is therefore important in order to be able to taste properly. This could be a reason for not wholesome food choices.

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Dangers from SED:

- protein deficiency

- Vitamin and mineral deficiencies

- Deficiency in essential fatty acids

- Lack of fiber

- Deficiency of secondary plant ingredients

- Risk increases for the following diseases: diabetes, gallstones, gout and cardiovascular diseases

- mental health problems such as depression and social impairment.

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Therapy of SED:

You should react in good time to treat SED with nutritional therapy, psychological and hypnotherapy (medical hypnosis), not only when there is a threat of underweight / malnutrition. If you are already underweight, support is urgently needed to avoid development delays. The longer the SED lasts, the longer a therapy can last or reduce the chance of an improvement in the symptoms. Therefore, the earlier support is obtained, the better for the success of the therapy. The variety of flavors develops especially in the first years of childhood. If you don't try a lot of foods here, this can lead to SED in the long run. It becomes problematic if the child does not leave the phase of not / little trying out different flavors / consistencies and his behavior does not improve even after the age of six. Parents often blame themselves for the disease, but this is unfounded.

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Why is nutritional therapy essential?

Nutritional therapy will help you resolve your eating disorder. An energy-adjusted wholesome diet under the supervision of a certified nutritionist can lead to your long-term success. The diet is adapted to your current weight and a jointly defined goal for weight gain / or loss. Your individual situation and needs will be catered for so that you can get rid of your eating disorder permanently. The aim is to supply all of the fatty acids, micronutrients (vitamins and minerals) that are important to you, energy and protein in the measure that your body is optimally supplied with. For this purpose, foods that promote inflammation are specifically avoided and plenty of anti-inflammatory foods are consumed.

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Explanation of the nutritional therapy: initial and follow-up discussions

Clarify triggers for the disease, personal goals for weight gain / loss, recommended energy and protein requirements, possibly recommendations for nutrient intake in a vegan / vegetarian diet, instructions for keeping a nutrition protocol, reviewing the medical diagnosis / laboratory values,

Inquire and determine the patient's bio-psycho-social anamnesis, goals / wishes and expectations.

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Content of the consultations:

• Take away fears of eating

• Approach foods that go and should be tried next

• Constant expansion of the food selection for more flexibility in everyday life

• Strengthening your own strength and motivation

• Choose consistencies / processing & types of preparation that go best and are suitable for the respective person

• Goal: healthier food choices - what is possible

• Accompaniment and control of the weight (1 x weekly weighing at the same time & the same conditions, e.g. always in the morning or always in the evening)

• Support with all questions about healthy nutrition

• Dissolve thought carousel

• Achieve normal weight and maintain it for the long term

• Learning of individually adapted full portion sizes

• Which nutrients are important and essential for me?

• Which substances does my body absolutely need and also every day so that it is well?

• Understand the body's metabolism

• Relearn healthy eating and listen to your body intuitively

• Delusion and feel hunger, satiety and fullness

• Tricks to implement a healthy diet for everyday life

• Healthy use of fats and sugars

• Lose fear of not handling food in moderation

• Enjoyment training - self-hypnosis to support therapy

• other topics

• Additional therapy options

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Classification of weight according to WHO:

BMI = Body-Mass Index, describes the relationship between height and weight, corresponding percentile curves apply to children and adolescents, the BMI cannot simply be applied to this age group.

BMI and interpretation: BMI: body mass index

Formula: Body weight in kg : (body height in m) 2 (gives the unit kg / m2)

Underweight: <18.5, children: <25th percentile

Normal weight: 18.5 - 24.9

Overweight = pre-obesity: 25-29.9

Obesity grade I: 30 - 34.9

Obesity grade II: 35-39.9

Obesity grade III:> 40 = per magna

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Classification of underweight (source: Federal Association of Eating Disorders eV, 2019)

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BMI 17 - 18.5 slightly underweight

BMI 16 - 17 moderately underweight

BMI <16 severely underweight (grade 1 and 2)

BMI 15 - 16 severely underweight

BMI <15 extremely underweight

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A multimodal therapeutic approach is essential for eating disorders:

One is important  multimodal approach. ie for example nutritional therapy advice in combination with psychotherapeutic & hypnotherapeutic treatment. A self-help group may be able to offer support. In the case of severe forms of the disease, it can be used in parallel to nutritional therapy and psychotherapeutic therapy. Antidepressants may support the therapy.

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Medical classification : Colloquial term / ICD-10 code / diagnosis

The American Psychiatric Association recognizes SED as a disease that is very difficult to diagnose. Sometimes it is still very unknown and therapeutic approaches are rare. Many parents who seek help from eating disorders specialists often get the answer that they can only treat anorexia and bulimia. Parents often only seek help when their child is already massively underweight.

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Classification: Psychosomatic highly selective eating disorder (SED)

- Eating disorder / F50 / eating disorder

- Other eating disorders / F50.8 / Other eating disorders / F50.9 Eating disorders, unspecified (= mixed forms)

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Nutritional therapy

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• Anti-inflammatory diet as a basis adapted to the current weight & jointly defined goals

• Holistic therapy - do you have any comorbidities that need to be taken into account during the consultation?

• Avoid micronutrient deficiencies and mineral deficiencies & possibly counteract them with nutrient preparations

• Prevent protein deficiency

• Which nutrients do I need in which ratio?

• Consume fiber according to the respective level (low fiber or high fiber)

• Sufficient fluid: total fluid per day: 30 - 35 ml per kg body weight and day. Attention, this is not just a drinking liquid. The liquid from food (approx. 500 - 800 ml) must still be subtracted from this so that a quantity of> 2 l drinking liquid is created.

• add valuable anti-carcinogenic (anti-cancer) secondary plant substances

• A selection of foods tailored to your needs with cooking and technical information (for breakfast, snacks, lunch, dinner)

• Do you like to eat your warm meal in the evening? I am happy to cater to your individual situation and we will create a plan on how you can implement your wholesome diet into your everyday life.

• Overall fat selection, how should it be designed?

• which oils are good for me? What should I watch out for in relation to the anti-inflammatory diet?

• How much fat spread (butter / margarine / vegetable fat) can I use and which products are recommended?

• Get enough Omgea-3 fatty acids and essential fatty acids

• How can I boost and support my metabolism with natural foods?

• Coordinate sensible meal frequency for your individual case - meal allocation

• What do I have to look out for when choosing animal foods?

• How many animal foods (e.g. meat products, milk and dairy products, cheese, fish products, eggs) are recommended?

• Define the desired weight stabilization / normalization & the estimated period for this

• what should be considered with beverages and alcoholic beverages?

• How does exercise affect your body and thus also your diet?

• Avoid blood sugar fluctuations

• Sweetening foods - sweeteners, glucose, fructose, sugar and sugar substitutes, what can I use and in what quantities? How high is the respective sweetness of the different products?

• what should be considered when baking and cooking?

• what are cheap snacks / main meals

• Eating out - what should you watch out for?

• Vacation, boat trip or hospital stay, what should be considered?

• Flatulence, bloating, diarrhea, constipation, vomiting, heartburn, loss of appetite, pain related to eating, what can I do about it?

• Daily plans as an example for practical implementation in everyday life

• Enjoyment training

• Optimizing your eating situation

• long-term maintenance of a jointly defined weight

• Strengthen the stomach and intestines with natural foods

• Additional therapy options

• Dietetic products in support of nutritional therapy

• Food supplements - under certain circumstances, a supplement can be useful

• and other topics

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Any questions? I look forward to your call or email. To contact form

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Assistance:

1. ANAD eV Supply Center for Eating Disorders

2. Overview of clinics / residential groups that treat eating disorders. To the directory of the address list

3. Federal Association for Eating Disorders

4. Appointment within 4 weeks with a specialist / psychologist: Dial the telephone number: 116117 (also possible via app 116117), you need a transfer with an urgency note so that you can get a faster appointment within 30 km of your place of residence.