SED is now ARFID

The DSM-V (Diagnostic & Statistical Manual of Mental Disorders, 5th edition) published by the American Psychiatric Association, has now recognised SED as an official disorder. However, it now calls is "Avoidant/Restrictive Food Intake Disorder (ARFID)". Quite what was wrong with the far easier 'SED' I don't know, but putting that aside the DSM V also suggests some reasons for the development in this disorder.

One mother of a child with SED was greatly distressed by reading "…in the DSM-IV, a difficult parent-child relationship is emphasized as a potential factor in the development of this feeding disorder. For example, parents who present food or respond to a refusal to eat inappropriately may contribute to an infant developing a general uneasiness around eating. Additionally, the DSM-IV suggests that infants with feeding disorders are more likely to have unpredictable, intrusive, and over-stimulating mothers, who are also more likely to have mental illnesses such as depression or an eating disorder compared to infants without feeding disorders (Chartoor et al., 1998; Lindberg et al., 1996)."

My reply to her was as follows:

"Hmm… bossy, interfering mothers are the cause of SED? In that case where I live in North West London, a notorious hotspot for bossy, interfering high pressure, tiger mothers, there should be a veritable pandemic of SED. Sorry, but if anything I have fewer clients from this area than other places.

In my experience I tend to find that children who develop SED invariably tend to be very wilful, headstrong (I.e. stubborn), or to put it more accurately, their subconscious minds are (their conscious minds are exasperated).

Stubborn personality traits + trauma around food = SED.

More to the point, I have also seen numerous parents who are certainly not bossy. They say they never pressurised their kid because it would backfire if they did.

Over the years I have hears parents bemoan that they have variously tried the carrot, the stick, good cop bad cop, no pressure, pressure, bribing, threatening, fighting, guilt trips etc.. all to no avail.

Conclusion: its not one variable any mother did that caused this. SED is based on a trauma around food, regardless of the mother or father's personality type, combined with a natural headstrong personality trait of the child.

Felix Economakis

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