This episode includes discussion of eating disorders. We know these topics can be sensitive and even triggering. Please take care of yourself and feel free to pause or skip if you need to. If you or someone you love is struggling with an eating disorder, support is available in the US by calling or texting nine eight eight, or by visiting Nationaleatingdisorders dot org for resources.
I'm TT and I'm Zachiah.
And this is Dope Labs. Welcome to Dope Labs, a weekly podcast that mixes hardcore science with pop culture and a healthy dose of friendship. In today's lab, we're talking about something that hits close to home for many families, avoidant restrictive food intake disorder.
Or our fit. That's right.
For years, when we heard about someone who was a picky eater, it often felt like it was brushed off. It's just a phase or a personality quirk. But now there's growing awareness that for some this is a serious medical condition, and so ourfit is a relatively newer diagnosis, and it's important to understand that it differs significantly from typical picky eating.
Right.
URFID can have serious health and social impacts. We know that it often co occurs with other mental health conditions, and treatment for our FID is also much more intensive and requires a team approach, so a lot of folks to help you out, unlike just trying to encourage a child to eat their veggies. You know.
Yeah, it's way more than that.
And the conversation around our FID is gaining a lot more visibility, and part of that is thanks to personal stories that have been shared publicly, like that of reality TV star Emily Simpson discussing her son's diagnosis. But perhaps one of the most compelling and widely shared stories that has immerged on social media recently has been from Hannah bringing a new face to this disorder.
Yes, I originally stumbled on Hannah's TikTok page and she's this really adorable little girl who was trying different foods. And it's not like, oh, I'm trying sushi or I'm trying snails for the first time. It was basic things like oh, I'm going to try watermelon or I'm going to try cheese. And it really was surprising to me because I'd never seen anything like this before.
Yeah, you put Hannah on the map for me.
You shared her profile on Instagram because you know, I don't have a TikTok, and she has an account and it's.
Called my r fit Life.
In each video, Hannah is bravely sampling a single food and rates it on a scale from one to ten. She always pushes herself to eat at least three bites before saying she doesn't want to eat something anymore.
Sometimes there's tears.
Sometimes she is really pleasantly surprised and is able to add foods to her safe list.
And really her honesty and sharing this struck a nerve online and it was incredible for me to see, right, because I had no awareness of arfit, and within just six months her account exploded to like one point four million followers. Yes, and I think this is a beautiful example of science communication, right because we're seeing a personal story, yes, and we're seeing how on platforms like social media it can create a powerful wave of awareness and community for folks.
Yes. So to help us dive deeper into the science and human experience of our fit, we're joined by doctor Jessica Body, who works at the Pearlman's School of Medicine at the University of Pennsylvania. I am always on TikTok or Instagram chronically, and there was a few videos that had popped up on my feeds with this young girl and she was talking about how she was going to be trying like cheese for the first time, or trying a pickle for the first time in her life, or trying wheat bread.
And I was like, what's happening. I don't get it.
And so I looked at the hashtags, and one of the hashtags was ARFED, and so I clicked on it, and then I was introduced to this whole world of folks that are struggling with this avoidant restrictive food intake disorder.
And so it really just piqued my interest because it seems like it's mostly very, very small kids that are dealing with this, and so I thought it would be helpful kind of shine a light in this a little bit of a dark corner that people may not know exist, and if they do know it exists, to help them understand how this comes to be.
Yep, great, really relevant question.
I think if you pulled any parent at like a playground or a school, they would all spark a conversation about picky eating among their kids. Yeah, so it's like both common and then, Yet this arfied name sounds like a bug right, sounds like something. Where did this name come from? And it's relatively new, so it didn't get introduced in the Diagnostics Just manual until twenty thirteen, which is fairly new for an eating disorder, and it is
housed in the same category as bolimia and anorexia. But for most folks with ARFID, it's an anxious experience to be presented with a new food. It's really tough to see her eating those foods, and she really looks anxious and uncomfortable, partially disgusted, a little bit gaggy at times, so quite brave that she's recording it, quite brave that she's doing that exposure work. And it really is the recommended treatment for our FID. So I think people wonder,
is my kid just picky? Is my kid having this ARFID experience? Where is this diagnosis coming from? And I think it's so new even though it's been around for more than ten years, pediatricians are still getting new information about it and starting to recognize the severity of some kids with picky eating.
So I think if it's sort of like picky eating.
Like an umbrella term right, you could talk about all people with ARFIT or picky eaters, but not all picky eaters meet criteria for our FA. There's probably a spectrum there, just like with somebody who's afraid of flying on airplanes. Right, you could say, oh, I'm a terrible fly er, I hate to fly, but you get on airplanes and you kind of white knuckle through it all the way up to people who are crying and having panic attacks, or people who will say I won't even book a flight.
Like same with picky eating.
You could have kiddos who need a lot of nudging to eat their vegetables, like you got to finish that before we have dessert, or you need to eat your fruit before we go play. Kids who respond to that contingency might be mildly picky, but they can get some eating off the ground. Right. Parents are successfully getting those bites in. I think there's parents at the playground who are getting advice from other picky parents and they're like, oh, you know, just.
Set out a veggie tray.
They'll graze on it, they'll eat what they want, just keep offering it. And the parents of the kids with ARFID are thinking to them like, that's pie in the sky. There's no way my kid's going anywhere near that cucumber. It's not going to happen, And so I think there's
this level of frustration. And even when they take these kids to the pediatrician and they say they're really picky, sometimes the pediatrician is looking at their weight saying their BMIs pretty typical, or they've stayed on their trajectory the whole time, and they're not expressing a lot of concern, which makes parents sort of walk away saying, either it's not that big of a deal, or I'm sensing something that's not quite right. They're not eating things from food groups.
They're really struggling. Every night's of battle to try to get them to eat the foods that the rest of
the family is eating, and they feel really invalidated. So the diagnosis is great that it's now in there, and we're starting to see more clinicians and pediatricians starting to represent that diagnosis in the eating disorder space, but treatment is sort of still like trickling through, and we're trying to get more and more families aware of what the treatment options are, which is exactly what Hannah Arfit and Handle is trying to do she's trying to show how she's doing exposure therapy.
Wow.
You know when you think about ten years, you could think like, oh, well that's a long time everybody should have a handle on this.
But I think you.
Raised such a great point about how things may present across different cases. That makes maybe progress and being able to quickly recognize things that could make it difficult. At what point does picky eating cross the line into our fit territory? So, even if you're a pediatrician is not informed, are there specific red flags that parents or even if they're pediatricians listening to this, that they should be looking for to inform their diagnosing.
Yeah, definitely.
Some of the main red flags that easily get you the ur FO diagnosis, or that you're so limited in what you eat or so avoidant or so restrictive in what you eat that you have a weight loss or a growth deficiency. So pediatricians can see this really easily on the growth charts. They can say, well, she was at twenty fifth percentile when she was like an infinittaller.
Now she's sort of fallen off the growth curve.
So things like failure to thrive or failure to meet those needs in gain and growth could be a huge flag.
However, when we did our research, a.
Colleague of mine, Catherine Dollsguard, who big shout out for doing the Picky Eating program at the Children's Hospital of Philadelphia for many years. When we looked at the data on the picky eating group, the BMI was actually quite high, and I kept asking, like, is that right we should this number?
Is that the right?
What happens with kids with pig eating is that they end up having a bimodal distribution, meaning that there's kids that are actually low weight underweight, but there's also kids that are in the overweight obese category because they're eating breakfast foods and pastas and goldfish crackers and snacking all day, right, because that's the limited food set that they're able to eat. So just weight alone isn't enough to sort of look
at whether a kid is picky or significantly picky. So things like nutritional deficiencies can be assessed for and we ask pediatricians to sort of run some panels on kiddos that we're about to start an outpatient therapy to make sure they're not missing anything, because you could have a
carb loving kiddo who's like at risk for rickets and scurvy. Right, they're not getting enough ingredients, and so we like to see kids with a protein that they're able to eat, an animal food of some type, and some sort of fortified carb. Then we feel a little bit better that they're not as much risk for nutritional deficiencies. But even like that weight is not necessarily the red flag. We might need to get them in and get some blood work done or some testing if a parent is concerned
they're not getting enough of various food groups. The nice thing about the ARPHID criteria that was written in by the people who developed the diagnostic criteria is that you can meet criteria for ARFID just on interference with what they call psychosocial functioning, meaning like, is it a pain to feed this kiddo? Is it hard to take them lunch to school? Is it hard for them to eat at restaurants? Is it hard to travel?
Because we have to.
Track the restaurants that have the foods that they'll eat. But parents will know, am I making separate meals for this kiddo? Am I bending over backwards to pick off specs and retoast the toast that got to burn, right, Like, it's difficult for a parent and they know that it is, so it honors that difficulty.
In having that added to the criteria.
I think if you have a kiddo you're really struggling to get them to eat across food groups or expand their diet or eat what your other typical eating kiddo will eat, then you can actually meet criteria just based on that interference alone.
Wow.
I mean, I think that that's really great to have that type of nuance when we're talking about something like this, which is a very sensitive topic for a lot of people. You talk a little bit about how URFID a new diagnosis within the last you know, ten years, you said that it came to be. Can you talk about in the world of eating disorders, can you explain why OURFID was recognized as a distinct condition and what makes it different from older well known eating disorders like anorexia or bolimia.
Great question, And when we have a person in our office that we're assessing for URFID, we ask questions that to rule out those other conditions, because it's really important to make sure that we are identifying what we think we're identifying the treatment's going to differ based on whether someone meets criteria for URFID or anorexia, So super important to get that nuance right. And I should mention we talked about URFID presenting in kids. We see the teens
and adults as well. There's an arfid Andrew as well all over Instagram doing the adult version.
Of these exposures.
And if we had someone like him in our office and we're asking questions like what's behind the food avoid or the food aversion.
If it's not because of shape or weight like.
We would expect to see in anorexia, we're more confident that it's more about the aversion to the food itself. Within our FID, we think that there's probably subtypes of folks with our FID. So just like we would ask questions about binge eating or bingeting history, weight and shape concerns in anorexia, we can ask some specific questions to see even what subtype of our FOD someone might have.
So we see a subset of kids, teens and adults who just historically have had a lack of interest in eating. They're like the opposite of a foodie. So and it's a shame when you have a foody in a household. They don't always understand what it's like to have these like low appetite food apathy kinds of people, because they're like, what do you mean you don't appreciate a good stake,
and like they just don't get it. But these books sometimes they have a history of just never really having a strong hunger Q, never having a strong interest in the varieties and flavors of food.
It just falls flat.
Sometimes it can come from a history of having discomfort
when eating. We see kids with like chronic history of constipation, or folks that have had a lot of GI ups and downs or IBD where eating actually has a history of causing them some discomfort and pain, and that sort of association over time creates this learned fear of eating or disinterest in eating, because it just never feels the typical experience of somebody who's eating feels you feel hungry, you grab something to eat, you feel the food is
delicious and rewarding, and it reinforces that I should do that again when I get a hunger Q. For folks with ourfait, they might not necessarily get that strong sensation of hunger and the reward from eating.
So they're sort of tapped out of that entire system.
And when you add that fear layer on top of it, if their history, say you were lactose intolerant, but you wasn't recognized for a long time. Anytime you look at milk, it might sort of have this like, oh, yeah, I didn't feel great.
The last time.
Might have that milkshake, so it's not feeling as interesting to me. So there's that category of folks with arfod. Then you get folks who are really sensory bothered by food, so things like mushi textures, soft textures. If you think of like a bowl of blueberries and a bowl of goldfish crackers.
Every goldfish cracker is.
Very predictable in applewl, a bowl of blueberries super unpredictable, like.
The squashy mushy one.
The really our one, the really tart one, the release like it's a mixed bag. So in terms of it coming from this place of anxiety, I'm going to get a lot less of anxiety eating that predictable, crunchy, sort of smooth carb versus this really unpredictable set of experiences with typically fruits, vegetables, and meats. So those sensory kiddos,
I think they're really sensitive. So those types of things, we hear stories all the time, like a chicken nugget manufacturer changed their recipe and now my kiddo won't eat it anymore. Or we change toasters and now we keep burning these slight specks.
On the pizza.
Now my kid won't eat it anymore. So they're super sensory sensitive and they're really in tune with that. And then the last type of folks with our fad that we will ask more about when we have these folks in our offices are people with folks that have a fear of choking or vomiting or gagging on the food.
So the way I like to think about this is if.
We were in Thailand together and we were walking around open air market and there's skewers of crickets and scorpions and meal worm burgers, and a guide says these are great, like this is a delicacy here, you gotta try it. I don't know about you, guy, but if you were offered a skewer of crickets, your reaction might not be as positive, even if the person is saying they're great. They're delicious, everyone loves them. Our reactions might be I don't know if that texture will go down well. I
don't know if I would vomit or gag. I don't know what that would do to my GI system. We would have the same sort of reaction that a picky eater would have to like a slice of pizza.
So you get that category too.
So when people are coming into offices, we're asking do you have any of these other subtypes and can we rule out some of those other bigeating disorder or anrexia.
Tit and I just talked about this. I ate something recently.
It did not treat me well, and we were texting each other and she says, I hate when food betrays me.
That's what she wrote to me.
And I can't imagine what it must feel like to have all of these things betray you. I think about how much of our day to day life. I'm just thinking about if I were scrolling on Instagram or what as I see on television. Food is everywhere. I'm curious about some of the psychosocial impacts. How does arfit affect someone's social life or friendships. And we've talked a little bit about family dynamics. But I'm particularly interested for teens
and adults. You know, as food is such a central social nexus for all of us, what does that look like.
Yeah, the amount of shame and anxiety that people with our fit experience in those spaces is really strong, and I think for some people it leads. There's this misnomer in picky eating that kids will grow out of it, right, And I think it comes from the fact that a lot of kids do so some of those like nudge to eat your vegetable. Folks with mild picky eating do
grow out of some of those rigidities. And when the folks that are sort of getting passed in the toddler years, elementary school years, middle school years and they haven't expanded their diet, I've had teens say I'm so embarrassed by my toddler lunch. Right, I have an apple sauce pouch and a peanut butter sandwich and I've been doing this since I was five. They're embarrassed. And now I have some adults on my caseload. They talk about going to
restaurants and having panic attacks. Someone had I think onion put on her salad and she went to the bathroom and cried full panic attack.
And cried, and she's feeling like I know this.
Cognitively, I know this shouldn't be such a big deal, but physically it's like the cricket on the plate. It's like it's such an anxiety response and so embarrassing to feel that way and to have to then advocate for kind of clos have the salad remade without onions, or to be facing the consequence of eating something aversive in public, which is the other part of that fear. I think people worry about social judgment for making faces or for struggling to eat something.
What if I gag or choke in front of somebody as.
I'm trying to get down a new food, because imagine, like it one thing to eat crickets with your friends, it would be another to like be in a job interview and be expected to sort of keep this food down. So the amount of anxiety that people are experiencing is quite high, the good news being that it does respond
well to graduated treatment. So I think for some folks who are motivated enough, that's where that's where some of that interference can be turned into a motivator, because it can be the thing that makes me try to Okay, fine, fine, I'll try to down the crickets, which for them could be like I'll try to eat a salad in front of my work colleagues, because that's always offered at the beginning of a business meal, you know. And so with some graduated practice, people can do well looking at least
more tolerant of those foods. So our motto is that you get more comfortable being uncomfortable.
And you can even see it in Hannah Arfid's video.
She showed one recently of like she's eating honeydew melon for the very first time. She's almost in tears. She's like, this is awful. It tastes like cucumber. It's really disgusting. They show her a year later she hasn't even tried honeydew melon that much in the intermediary year, and she says she's eating it. She's eating it pretty quickly, and she's like, it's not great, it's not my favorite. But you can tell what the intermediary factor is that she's
gotten better at eating things she doesn't like. So for a lot of parents, we have them take liking off the table altogether. So the immediate thing when a picky eater tries something new is to say, okay, so did you like it? And all parents follow victim to this, right, did you like it? I usually try to get people
out of it because it's a double bind. If I say yes a picky eater who has ten foods or something really restricted, the parent's going to go out and buy Pasco sized portions of that and they're going to be like, so saye. Saying yes is like, Ooh, I don't know that I want to commit to that. So the urge is to say no. And then saying no means that I've signed up for my parent not only not presenting it again, because I've sort of trained them in this avoidance cycle, but then I've identified I'm not
a person that eats honeydew melon. I'm not a person who eats those granola bars and it stays stuck. So I tried to get parents out of the liking dilemma. Altogether, you can tell by their face whether they like it or not, and in the treatment, it's not the goal anyway. The goal is actually to get you practice eating things that you don't like. So instead my response is, oh,
I know that one was a tough one. Keep going, you got this, keep those bites down, and if they kind of seem like they like it, then there's like the thought that we could keep gradually introducing it, not costco size introducing it.
I'm definitely one of those parents who does that where I'm like, oh, he likes it, get We're going to eat it every day. That's what we're eating every day.
And then he gets sick of it, and I'm like, uh oh, but we have more. So now we're.
Eating blackberries for the next few days just to get through it before they we have to throw them all in the trash.
Yeah.
When I think of people who have this disorder, we don't exist in a vacuum. There's so many other things that are going on out And you were talking about the anxiety and the fear and the shame that's wrapped up in all of this, and it started to get me thinking about how having this type of disorder and other types of disorders like anxiety, how that could impact a person, and how the overlay of these multiple complicated diagnoses can really interfere with each other and sometimes hold
someone back. There was some research that suggested that our fit often coexists with conditions like autism, ADHD or anxiety. Can you talk about how these overlaps complicate diagnosis and treatment and what should a parent and clinicians be aware of.
We see comorbidity across those diagnoses, and there's actually a good amount of meta analyzes out now that sort of have done that number crunching. It's the norm for there to be an eating disorder among folks with autism, or at least eating interference. It's so common for those kiddos to struggle, ARFID being one subtype of how that can present sensory preferences and some of the nonverbal kiddos having difficulty describing what's hard about a food.
So that's the norm.
The good news is across all of those comorbidities is that the interventions work well for all of those kids. So there's been quite a few pilot studies of eating interventions for kids with autism and ARFID, and they look great when they're responding to that slow graduated food introduction. So a parent will typically give up giving a food after three to five rejections, but the data suggests that
even for folks without sensory sensitivities. You need at least ten to fifteen tries of a food to even start to accept it into this is safe a poison berry, it's a safe food.
To eat category.
So getting those folks with autism to do multiple tries it can take a big behavioral motivational reward lift for parents to do it, but I think for the kiddos that have more significant eating interference, it's worth it. And the protocol works the same in kiddos with autism, So that's the good news. And then there's other comorbidities where the actual anxiety condition might have to be addressed first.
So someone who has choking phobia or vomit phobia, not eating is part of that picture, but they might need specific exposures that address the choking fear or the vomit fear. We have a lovely set of vomit exposures that involve photos and pictures and videos and sensation you know, spitting into the toilet, gagging with your duke brush that get that kiddo all the way ready to eat non preferred foods because the fear of vomiting might be just part of that, or the fear of getting so full that
I threw up might just be part of that. We also see a decent chunk of OCD comorbidity with harfit and picky eating. We often with OCD try to get to the core fear of what is what am I afraid it is that the contamination of the food. Is it that the food touched my brother who's contaminated. We had a kiddo recently who said, I'm afraid of root vegetables because they grow in the ground, and you don't know what kind of contaminant they could have absorbed by
growing in the ground. Right, So there you have to kind of get to the underlying logic, start doing exposures that address the absurdity of that OCD and throw in some eating exposures on top of that.
So it just complicates the picture. But luckily the treatment's very much the same.
That root vegetable when I don't know, it doesn't feel absurd to me.
I have a quick follow up question because I'm a two year old who eats what I feel like, eats everything except except vegetables. He did eat them when he was a very very small baby. For a parent who feels like, oh my child is refusing this type of food, Could you give like an age range where you should start really paying strong attention and can you talk with a little bit more granularity when it comes to the plate when we present it.
I think everybody feels that who's parented a toddler before, and what you're hitting on is actually really developmentally normative. So I wouldn't be worried yet, because what happens in evolutionary terms is that when we go from infant breastfeeding and into the early pures, kids are pretty non specific and might be sort of dictated by what they were fed in utero. So we see moms who are eating spicy foods, their kids are more tolerant of spicy foods.
Moms who are drinking bitter coffee during pregnancy, their kids are more tolerant of bitter food. So there's been some breast milk research from the Monell Center and Philly that's confirmed some of those findings. So, but those early pures are often pretty widely accepted. So he was eating like braccli puree and all the weird green bean smelling pures.
What happens when kiddos get to age one or two, they start to walk and so evolutionarily, this was a dangerous time period because these kiddos could walk off and eat fistfuls of poison berries, So human development fascinating. We were able to sort of queue these kids to say, maybe you should be cautious with how much you're putting in your mouth when you're one to two, and you should make sure that it's not too bitter. So things like veggies, which are quite bitter, spark that like, but
is it a poison berry concern for these kids? And so it's normal for across the spectrum those little walkers to start to look more picky. So it's up to parents to sort of keep pushing the contingencies. And you're right on track for thinking like, how do I get him to reapproach These bitter foods are the ones that just have that slimy I mean, carrots can be too
crunchy or too hard to chew down. These things that have unusual presentations that might be less predictable than the goldfish cracker or more bitter than some of the other foods that they eat. So in the what to do category, it's funny I joked about the veggie plate before because the severe picky eaters won't do it. But in typical development, when we can catch kids when they're hungry, the veggie
plate is an awesome strategy. So something like the kids coming home, they want a snack, you know they're gunning for like the granola bars and the mini bites, and like, you know that that's what they want. We can put a contingency in place. Certainly you can have mini bites just as soon as you eat these three carrot bytes, and we could start with something that's like the least aversive of those things.
We get them really accustomed to.
Every time I ask for one of those snacks during the hungry period, Mom sets out the apple tray with the carrots on it, and I know, I sort of graze on that before I'm able to get the real thing.
There's a book called French Kids Eat Everything.
I Love for like a guide through that, because it's essentially it is about offering and modeling and having those opportunities, but it has to hit when they're hungry, and for some kids they might need more of a nudge than just having it out. So for my four year old, I was a picky eater when I was little. There's a high genetic load for picky eating. I passed it
on to my four year old. Despite being a picky eating expert, I have to give him a ton of nudges to get him eating some of these veggies.
And so nudge is meaning we.
Might have to have a specific cucumber eating party which he's doing his bites and he's getting a reward afterwards.
How that's set up for parents can really differ.
So it could be like the full round of cucumber has to be eaten and then we can go pick out a Pokemon card from your bin.
It could be points towards something. It could be.
Special time with parents, which is free and lovely, but the heavier lift of the reward might have to happen if just setting out the food isn't that interesting. Screen time is also lovely for this, So pushing pause on a show and saying, oh, finish your cucumber bite and then we can push play again.
That's how we do it in some of the feeding clinics.
So even the feeding clinic over at Chop will do very specific bite for bite rewards. Like we are sitting across from the kiddo, we put the piece of carry it down. We say eat your bytes, and then we can play. As soon as they're chewing, we get back into playing whatever little toy or game we're playing with.
The next bite gets set out.
If they're refusing, we sort of turn our attention away and wait for them to do the bites and then we go back to reinforcing the eating with playing in that way, So there's some strategies you can start to employ.
Again.
The folks with really significant ARPD will laugh at you for saying my kid won't eat for a Pokemon card.
But that's a different protocol.
Yeah, we.
See ourfit kind of gaining popularity and people are talking about it. I'm curious about how you see social media as a tool for people with ARFIT. Do you think it's helpful or does it add pressure or is there any kind of stigma.
I think it helps a lot because I think people there is like a scoffing with what do you mean you don't like that food? Or I think if I asked everybody, are there certain foods you don't like? I think a lot of people would have a few. And even when we look at the you see sort of distressed ratings of people's foods. You probably have a pretty average rating for most foods, and then there's a spike
around something like tomato, cucumber. These are like commonly hated foods or like cilantro, right is the funny one out right, And so there's this really strong dislike for those types of foods, and people think they understand what it means to not like a food. And I think that's the risk, right that if you start dating someone and they're like kind of picky, you think I get that because I don't like cilantro, But you either muscle through it or you just don't order it. And so that's a simple
solution for someone without our FID. For someone with URFID, they're like, my everyday meals are tricky because of this, and powering through it is a lot harder for me than it is for you. So it's it's almost like the semblance of understanding that gets us in trouble a little bit there. And I think social media when they're showing someone like Arfid Andrew who's gagging and like he's just eating cheese right right, He's eating, you know, and a banana for the first time, and it looks really
distressing to him. I think that's helpful to sort of see it's not just your run of the mill aversion to something. He's really struggling with the sensory experience or the taste experience, and it's different for him. So social media can be helpful there. I think there's also we mentioned it being multidisciplinary. I think there's multiple influencers out there that are now speaking to the platform.
Which is great.
So you have speech pathologists who are talking about how to like quickly quickly chew the food and get it down, or manipulate the food in your mouth so that you can swallow it quickly. Some folks work with occupational therapists because they can help you sort of touch the squishy blueberry. And kids who are super super avoidant who would throw a tantrum if a blueberry is anywhere in sight, they can start doing ot with those folks and start touching blueberries,
smelling blueberries, et cetera. We tend to see the best symptom relief when we get full bites to happen, so like touching and playing with foods will only give us so much symptom relief. But like you mentioned, getting someone with a psychologist, a licensed professional counselor, or a social work er. Somebody can do graduated food exposures. That's going to be great. I think the more people who are out on the platform advertising that or talking about how
they are therapeutically helping people get through, that's great. The folks that are showing their food bites I think are the bravest, right.
They're both being vulnerable.
In those moments eating those foods, being able to be how could you not like cheese? How could you have that reaction to cheese? They're at the whim of all the comments, and I think they're also modeling for what parents can sort of expect to sort of get out of an exposure protocol, both that it's hard at first and then like with Arf and Hannah, she's looking awesome. She's looking much more tolerant of foods than ever before.
Yeah. I think one of the great things about one highlighting this disorder that people might not know much about and the experience of it on social media is that it shows that one these folks exists. It gives them a voice, and then it also shows that there is life like during your struggle in life after you're struggling and the process of living a life, a full life, even though you have this disorder that you're working through. It really humanizes folks and it really helps with people's
understanding and empathy. So the next time maybe you sit down with a friend who is picking tomatoes out of their burger or sending it back and asking for a fresh one, maybe you'll before you say, oh my gosh, that's ridiculous, you say, okay, yeah, I've seen people with similar types of aversions to types of food, and so you won't comment on it, or you say if they're feeling like I can't eat this, you're encouraging like, hey, it's okay, you can send it back, ask them to
make you a new one. You could say you're allergic or something like that, so that they, you know, really come back with something fresh. And that's one of the things that I've really loved about watching Hannah and some of these other kids that deal with it, is that even with my own child, I'm not I don't feel like I pressure him so much to like, you have to eat this, you have to eat this, because I'm like, you know, it might be a wrong dislike and I
don't want to traumatize. I don't want him the negative association with sitting down and having dinner with his parents. And so that's one of the things that I love. Prior to social media, I know that there was probably some common miss or even still now common misconceptions that you want cleared up about our FID, whether it's among
parents or teachers or even healthcare professionals. Can you talk about some of those misconceptions and kind of like where they come from and clear them up for us?
Yeah?
Sure, I think you tapped into one, which is sort of like that tussle between do I force them to eat this? How do you even force somebody to eat something? Are we like to clear the plate kind of family or.
Are we not? And that struggle?
So how do I advocate for their independence and that this might be one of those foods that spikes dislike for them or like you often get a one parent in the household who says, like, I don't know, just tell them to eat it, like the put the foot down, punish, go the harsh way path And really it's not glamorous.
It's this day in day out. We gotta be.
Practicing foods just like you would have with a kid with diabetes, right, sorry, dude. Other kids don't have to do the blood stuff that we do or the insulin stuff that we do, but you have a condition that makes things different. We have to stick to this protocol, and no one likes that. Even teeth brushing, right, We don't say would you like to brush your teeth tonight?
Would you like to do that?
We know it's aversive, but we also know that you can do it, so we try to apply that level of confidence to the protocol. And then parents sort of get in their groove, and once they start seeing games, they get really happy with the protocol. And then we get all the pictures of like kids eating crab legs.
And one of the things that you've brought up that I thought was spot on was just about the each house has its own culture, yes, and creating a culture inside of your house so that kids understand, because I think me and my husband we grew up with two different cultures inside of our houses. His house was the clean plate club was a big thing. You clean your it's like you're part of the clean plate club. But in my house, it was like eat until you're full
if you don't want anymore. You stop eating and if there's stuff left over, that's okay. And it was never a big deal. When we started dating and I had food left on my plate, He'd be like, you're not gonna be in the clean plate club and I was like, I don't know.
What that is, and why should I care? Like I'm full?
And so I think that culture that we had in our separate houses, bringing that into our house and trying to find a new culture that works for our home with these things in mind arms us with the terminology, with the mindset that we need to create a healthy food culture, whether it's you know, our child eats everything or our child is really struggling with different textures, but just knowing that we can set the tone and that none of this is permanent and we can really help
mold them into having a better relationship with food. I mean, all of this has been really illuminating and just so how even if you don't have a child who's suffering from a specific disorder, having that in mind, those tools can help you in your household. It can help you with lots of different things, like if you have a child that you feel likes have too much screen time, or if you have a child that you that is struggling with anything. Really, all of this is so it's.
Like creating a bravery culture.
And I have a friend who says, like, anxiety plus bravery equals confidence, and that's really what we're aiming for it. So I often say, if anybody's going to kill a reward program or an exposure program, it's the parent because we're so busy and trying to sort of manage so many things. But if we can do this mundane day in day out, we're doing.
This brave stuff.
It creates a culture of achievement from bravery rather than from luck or from just that I happen to like this food. It comes from this place of oh, I don't like that food yet, but if I keep working at it, I can create some practice and confidence for myself. It's how I want kids to approach academics and social appearances that are reverse and world in general.
So totally true.
That's perfect.
This lab has been such an eye opener for me tt me too, Me too. We've talked about the importance of food in society and culture, and we've even covered food accessibility when it comes to like urban planning and food deserts. However, I don't think we've stopped to really address the lack of accessibility to so much of our society through the lens of eating disorders.
Oh my gosh, it's such a good point, and it really makes me look at all of our past episodes a little bit differently. It's really difficult to navigate, and we learn just a little bit about various factors that are at play, and this is a reminder that we could all be a kinder. We could be more empathetic, Like when we notice little things, we can say, oh, this person might be struggling. We can be more tolerant and more understanding about what people might be going through.
It's such an important lesson to learn and something that we need to really be conscious about in like actively practicing in our day to day lives to just tell ourselves, I don't know what this person is going through, I don't know what they're thinking in their minds, I don't know what's going on in their households, and taking that into account into every interaction that we have. Yeah, And I really feel like if you can't do that at
a minimum, practice mine of your business. And I think that's the polite Southern way to say it, I would say something else, Oh my goodness, bless her heart.
To learn more about therapy for pickie eating, or to join a parenting group, it www dot Doctorjessica Bodi dot com. You can find that link in our show description, along with links to Arford, Hannah and Arfred Andrew accounts.
You can find us on X and Instagram at Dope Labs podcast, tt.
Is on X and Instagram at dr Underscore t Sho.
And you can find Takiya at Z said So.
Dope Labs is a production of Lemonada Media.
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Dope Labs is sound design edited and mixed by James Farber. Leimonada Media's Vice President of Partnerships and Production is Jackie Danziger. Executive producer from iHeart podcast is Katrina Norvil. Marketing lead is Alison Kanter.
Original music composed and produced by Taka Yatsuzawa and Alex suji Ura, with additional music by Elijah Harvey. Dope Labs is executive produced by us T T show Dia and Kiah Wattley