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Sep 09, 2015

More Than Just Anorexia and Bulimia

Anorexia Nervosa, Bulimia Nervosa and now Binge Eating Disorder have become common terms with the mental health field. However, what about other lesser known eating disorders such as Food Emotional Avoidance Disorder, Selective Eating and Functional Dysphagia. These are often considered childhood eating disorders but are not yet classified in the Diagnostic and Statistical Manual.

Food Emotional Avoidance Disorder (FEAD) was one I found out more about when I worked with an adolescent girl, who the psychiatrist felt met criteria for a diagnosis of Anorexia Nervosa. Her symptomalogy at the time and reports from the pediatrician did not support this diagnosis. Being that I was not comfortable with the diagnosis, I began doing some research and found she met criteria for Food Emotional Avoidance Disorder, or for DSM purposes Eating Disorder Not Otherwise Specified. This disorder is marked by food avoidance but not the fear of being fat. Actually, it is the opposite, these individuals acknowledge themselves to be underweight but have difficulty in gaining weight. Disorder can often be linked to somatization. This one particular client often would call home from school and complain of stomach and headaches until she was able to acknowledge that the symptoms were not physical in nature. The key is that the main diagnosis is anxiety. This client was diagnosed with Generalized Anxiety Disorder and the majority of her symptoms were unrelated to food. To treat the anxiety will help in treating the FEAD.

How many young children, especially those under the age of 5 may meet the criteria for Selective Eating? A high percentage may be likely. This disorder is marked by an extreme unwillingness to try new foods. Majority of these cases will resolve with age. One case of mine demonstrates this issue, a 3-year-old male who only likes chicken nuggets and fries. If ones looks at the family history of the client, the mother never introduced new foods to the child because when this occurred the child would have a temper tantrum and refuse to eat. To avoid the temper tantrum the child would only be given the food he likes. This has led to a case of selective eating in which now a system of introducing new foods with opportunities to be rewarded in being introduced to the family to help resolve the issue.

A lesser known and less common eating disorder is Functional Dysphagia. This disorder is marked by food avoidance, fear of swallowing, choking or vomiting with no abnormal cognitions or preoccupation regarding weight or shape. Again, another disorder linked to symptoms of anxiety.

Beyond those that are often discussed, the category Unspecified Eating Disorder encompasses a vast array of other disordered eating behaviors, some of which have been outlined above to help further educate those within the profession.
Rachel Collins, LPC is a clinical therapist working with children and adolescents in New Haven, Connecticut. Her specializations include eating disorders, self-injury and trauma related work. She has a history of writing articles, giving presentations and serving in leadership positions at the local, state, regional and national level.




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  1. 2 Food addicts 21 Sep
    Yes--there are so many kinds of eating disorders. I identify as a food addict. I was obsessed with food, my weight and my body for most of my life but was unable to stick to a diet or maintain a healthy weight. I eventually reached my top weight of 260lbs. I then found a free, 12-step program for food addiction ( and have freedom from my food and body obsessions! I have also maintained a healthy 125lbs for over 11 years. I am so grateful. 
  2. 1 Kamaria 24 Sep
    When considering eating disorders is it possible to diagnose as young as 5, or would that be too early to positively diagnose as it may resolve with age. Would early diagnosis help to resolve the issue sooner? I have found that pairing foods kids avoid with food they enjoy seems to assist with getting them to eat. Also when children are young they are more likely to copy parent behavior. Are there other tips to assist when children are reluctant to eat?


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