The Picky Eater's Recovery Book: Overcoming Avoidant/Restrictive Food Intake Disorder

by Jennifer J. Thomas, Kendra R. Becker, Kamryn T. Eddy

Are you a picky eater? Do you worry that food will make you vomit or choke? Do you find eating to be a chore? If yes, this book is for you! Your struggles could be caused by Avoidant Restrictive Food Intake Disorder (ARFID); a disorder characterized by eating a limited variety or volume of food. You may have been told that you eat like a child, but ARFID affects people right across the lifespan, and this book is the first specifically written to support adults. Join Drs. Jennifer Thomas, Kendra Becker, and Kamryn Eddy - three ARFID experts at Harvard Medical School - to learn how to beat your ARFID at home and unlock a healthier relationship with food. Real-life examples show that you are not alone, while practical tips, quizzes, worksheets, and structured activities, take you step-by-step through the latest evidence-based treatment techniques to support your recovery.

Genres: Nonfiction, Self Help, Mental Health, Psychology

282 pages, Paperback

First published August 12, 2021

Reviews

[Monica Hills · Rating 5 out of 5]

I just want to say thank you to the publishers of this book. This book is written for adults who have ARFID. I read this book to try and help my 14 year old son. Although he has never been officially diagnosed he definitely has this eating disorder. His eating issues started when he was an infant. Doctors had no idea what was wrong with him. At that time ARFID was not a diagnosed disorder that people knew about. I felt so alone and could not understand why my son would not eat. I had one doctor tell me to just let him starve for 3 days and eventually he would eat. After trying for years and working with many different health professionals he still only eats 10 foods.

What I really liked about this book is they broke down the disorder and gave examples of real people who have struggled and gone through treatment. One of the profiles was almost identical to my son. The strategies they suggested are very similar to ones I have heard over the years but what the book gave me was some hope. It really broke it down as to how one could go about conquering their fear and how to approach food which is exactly what my son needs. I also like how in the book gave follow up advice for when you have gone through the steps. I just found this book very informative and helpful. This is not a disorder that is going to be cleared up in one day. It takes time but this book gave some great advice and strategies.

I received this book through NetGalley to review and I will be purchasing this book when it is published. There were many charts and worksheets to help you but I could not access them on the ebook copy I was given. I definitely think that a hard copy would be much more beneficial. I am hoping that this book will help guide my son and be helpful to him throughout his life so that this disorder will not isolate him and rule him in the future.

Thank you so much to NetGalley and Cambridge University Press for the advanced copy.

[Anna · Rating 4 out of 5]

I have many thoughts about this book, none of which I feel comfortable sharing. If you struggle with picking eating or other symptoms of ARFID, you should be aware that it exists.

[em · Rating 5 out of 5]

Overall, The Picky Eater's Recovery Book is an outstanding development in Avoidant-Restrictive Food Intake Disorder research and offers stellar recovery plans for individuals to work on their behaviors from the comfort of their home. I would say that even those who don't necessarily present as identical to the three common variations of ARFID but still struggle with selective/restrictive eating would highly benefit from the tools and resources in this book.

Thomas et. al. follow traditional cognitive behavioral therapy techniques, starting with an explanation of the eating disorder and recognizing how the individual presents, and then provides a plethora of useful resources and techniques to try. The CBT-AR techniques align with the chapters, giving the reader a good stopping point to practice the technique before proceeding. I read this book over the span of 4 1/2 months, pausing between chapters to put these techniques to work before moving forward. In particular, Worksheet 4.1, a self-monitoring record of food consumed, was helpful for me in identifying what my diet truly looked like. Table 5.1, a list of common nutritional deficiencies in ARFID, was beneficial when it came to grocery shopping and trying new foods as I could take it with me and highlight the nutrients I knew I wasn't consuming enough and look for foods I was willing to try from those categories.

There were two major things I thought the book could have improved on. First, there is a brief mention of ARFID being accompanied by another mental health condition, stating more than half of people that experience the disorder had a lifetime history of a psychiatric disorder, usually an anxiety disorder. As someone who can relate to that research, I was hopeful for a chapter dedicated specifically to anxiety and how it relates to ARFID. We got some of that towards the end with chapter 7, Fear of Aversive Consequences, but for me it just wasn't enough. I would've liked to see a bit more of a touch on the anxiety part of eating.

Also, the use of BMI in the book is a little frustrating. The history of the BMI and research on it has proven it is not a useful tool for accurately measuring health. I personally am considered underweight according to the BMI but have maintained the same weight all of adulthood regardless of how much I present avoidant/restrictive eating behaviors. I have no health problems whatsoever and have never been told by a medical professional to gain more weight. The book only touched lightly on BMI, but it does ask you to calculate your BMI at one point and categorize yourself as underweight if you fall below a BMI of 18.5. This is a really fine line because we are discussing an eating disorder that involves avoidant/restrictive eating behaviors, and many ARFID patients probably do experience health problems as a result of being undernourished. But you can have a normal BMI and still be nutrient deficient. I would suggest to the authors a revision of this portion and consider different ways that readers can analyze the effects ARFID has on their health unrelated to weight. If a patient has recently lost a significant amount of weight, or has consistently experienced symptoms of nutritional deficiencies through life, that would be a better measure of how "unhealthy" ARFID is making them. The authors do discuss this immediately after the BMI paragraph and give explicit examples as to why a "healthy" BMI is not always true, which is highly valuable and should stay in the book, but I think we could do away with calculating BMI and still be able to measure our own individual experiences from home. I'm also a little on the fence about suggesting to readers to increase food consumption by 500 calories in a later chapter in an effort to increase the volume of food, as everyone should have their own personal goals when it comes to food volume intake. Generally speaking 500 is an okay number, but again it's a fine line that could certainly trigger readers to engage in unnecessary calorie counting.

I thoroughly enjoyed this book and all of its resources. It's an outstanding work towards ARFID research and I look forward to seeing what else is published by these authors in the future.

[Bookgrrl · Rating 4 out of 5]

The book does a good job of gathering together a lot of information on this disorder, and presenting each chapter with multiple real life cases of people who deal with this every day, and how they are working on it. Introduction of new and scary foods is of course a huge part of this. One thing that I wish were addressed more was when introducing new foods to try them in different forms (raw, lightly cooked, more cooked). I have sensory issues, specifically texture and taste (also a strong gag reflex). The foods that I’ve been able to introduce as an adult have been in varied forms of raw and cooked. For example, asparagus is one of my favorite vegetables now, but only roasted until dark and soft. I will not eat steamed asparagus or raw asparagus. Another example is applesauce – I cannot tolerate store-bought applesauce because it has a grainy texture to it, but if I make it from scratch and purée in my blender until 100% smooth then it’s great. But like I said earlier, I think this book does a good job of getting together a lot of information on this disorder and the steps to mitigate it.

Thank you to NetGalley & Cambridge University Press for this advanced reader copy. All opinions expressed in this review are my own.

[Riley Bayless · Rating 5 out of 5]

I was 18 when ARFID was added to the DSM as an official diagnosis, and 14 when SED (Selective Eating Disorder, the old and awfully ironic name) first became a possibility of what was 'wrong' with me. Prior to this addition of terminology to our world, me and my family had nothing to work with. Everyone could only speculate what was going on with me and I was too young to articulate the maze of complexities my body would give me in response to food. I won't belabor the difficulties of being a teenager with ARFID, but not even having a name to call this thing left me with a horrible feeling of the being 'the only one in the world' who was dealing with this. Totally alienated and confused.

So with that preface, it's hard for me to explain how grateful and excited I am that research has progressed so much in the ARFID field that now books like this one can exist. I hope it will help future generations feel less alone and help all of us in the middle get closer to our goals.

Okay, now for the details on the book:

The first section describes a couple folk's stories who deal with ARFID and about how it has affected their lives. I found this section wildly validating in how they discussed social difficulties when dealing with family/friends and workplaces and such. It also talks about where research is nowadays and some theories as to why it occurs in people (spoiler, you're probably not just a really 'picky eater.')

The rest of the book is about the strategy devised by the writers to help you go from tasting new foods to introducing them into your weekly diet. I've personally been using this, though not long enough for major changes, and have found it helpful. My one gripe is that it teaches you 'what' to do, but really doesn't teach you 'how' to do it. Like, at the end of the day one of the steps is to put the food in your mouth, and there is no expounding on how that is done. And gosh is it hard sometimes!!

One thing I really like about this book is that it often advises readers to stop reading and continuing progress until certain prerequisites have been met. For instance, don't start trying new foods until you have stabilized your health and weight. As a teenager I made some bad decisions because I reeeeally just wanted to be able to eat normal foods over everything and ended up introducing other eating disorders to the mix. The barriers that they add to the book are super important and should be heeded.

This book is a 5 star for me just because it exists and that means a lot to me. But I also will vouch for its helpfulness in making steps to add foods (once you are ready! Adding foods is not the end all be all!) to your palate. It isn't comprehensive to all the challenges of ARFID, and it certainly isn't a stand-in for therapy, but for folks who are ready to make a really big and difficult next step, this book is monumental.

[Maggie Buckhannon · Rating 3 out of 5]

This was an insightful read. I do feeding therapy with the pediatric population and I wanted to read this book to get some more insight for older teens. I appreciate this book because it gives me hope and I think many older children could benefit from it.
My biggest complaint about the book/ the research guiding this book is the discussion about concomitant disorders like anxiety, OCD, ADHD, and Autism. I feel that the severity of some of these diagnoses really inhibits good progress and even having any intrinsic motivation to begin with. Again, this book was written for adults who seem to have some intrinsic motivation or something socially that’s propelling them to want to change. I see many teenagers who have Autism or significant anxiety with no interest in food, no qualms with their restricted diet, and no motivation to change/ explore new food options. If there is a spark, I think this book can be helpful. It’s a long journey and I think many neurodivergent people should be given grace with how long this process can take.

There is a caveat at the end that states that the research for this type of CBT-AR is limited. So unfortunately we don’t know the long term affects of this type of therapy and that worries me as well.

[Erika · Rating 5 out of 5]

My mind has been blown. I was diagnosed with anxiety a few years ago and I have emetaphobia but after reading this, I related to all the avoidance behaviour with food! It was crazy to read but so helpful. I had CBT therapy a few years ago but recently felt like I was about to relapse again. I'm so glad I read this as it has so many good worksheets on how to get through things. Highly reccomend. I now know what it is I have, its a new term for me but it has a label now and I know that I can beat it.

[Britt · Rating 4 out of 5]

Thank you to Netgalley and Cambridge University Press for providing me with an ARC of The Picky Eater's Recovery Book: Overcoming Avoidant/Restrictive Food Intake Disorder.

This self-help book provides some nice information about Avoidant/Restrictive Food Intake Disorder (ARFID) and a lot of tips and worksheets to overcome it. I do not have ARFID myself so I cannot judge how effective these tips and worksheets are. However, I do think that for individuals with ARFID, especially adults, this book might be a great help. A lot of literature and self-help books surrounding ARFID and picky eaters are focused on children so it's nice that the authors chose to create a self-help book for adults with ARFID who face different challenges, for example, difficult social situations surrounding food (eating in a restaurant, on a date or with family).

Personally, I learnt a lot about ARFID in the first couple of chapters. I was not familiar with this eating disorder at all so I am glad that I got to learn about it. These chapters might be nice to give to loved ones so they can understand the person with ARFID better.

[Ava Courtney Sylvester · Rating 5 out of 5]

The Best Book for ARFID

If there's one book to read on avoidant/restrictive food intake disorder (or ARFID), this is it. In it, you'll learn about what the disorder is (and isn't), take screening tests to evaluate your symptoms and monitor your progress, meet patients who fall under the three main archetypes, and treat yourself through the authors' own adaptation of cognitive-behavioral therapy for ARFID.

Normally, I'd be quite hesitant to read, let alone use or recommend, anything that came within a mile of a self-help book, but the authors here are quite clear when self-implementation is and is not warranted. Moreover, as an 11-year-old diagnosis that's rather rare, there are precious few practitioners with the experience to treat ARFID. For medically stable people who are not undergoing life-threatening eating disorder pathology, this book may be the best treatment option, in concert with medical supervision for signs of nutritional deficiencies and underweight if necessary.

[Kristy · Rating 5 out of 5]

Explains the decade-old (relatively new) classification of eating disorder called ARFID and how to overcome. Written for adults wanting to help themselves, but will be helpful in my work too. ARFID manifests as restrictive eating due to extreme picking eating (sensory-focused), fear of choking/vomiting, or disinterest in eating. It has nothing to do with restriction due to body image. The restriction has to be causing a problem to be diagnosed, such as malnutrition, cardiometabolic risks, social or activity avoidance, relationship or work limitations, etc.

The sensory-focused picky eating is seen in children as well, to the frustration of their parents. Parents are advised to get professional help earlier than later to address this correctable problem before nutrient deficiencies cause health problems, stunted growth, or more permanent habits.

[Sara · Rating 5 out of 5]

I bought this book because at least one and probably two family members now have ARFID (Avoidant/Restrictive Food Intake Disorder). This disorder has only had this name for about 9 years now so it's very new in terms of being diagnosed and treated It's a bit different than the more well-known eating disorders (bulimia, anorexia nervosa). This book has been super helpful to read. It is laid out with a 4 step treatment plan with worksheets. I don't like to write in books, but you can request a download of the worksheets from the publisher who responded quickly to my request. I am very thankful for this book so I can learn more about this disorder.

[Marie · Rating 4 out of 5]

This is a really useful book, even if you don’t have AFRID. My favorite bit of advice was picking five new food items per week and trying them out, and I figured I could try that, or even just one and try cooking it different ways.

However, and I’m sure this is no fault of Cambridge University Press, but there were so many formatting issues that it was nearly impossible to read the advance copy I got through NetGalley that I had to give up reading. I still got some useful information from the book, but wow, it was frustrating.

[Taylor McCarthy · Rating 4 out of 5]

As a therapist working with eating disorders, I found this book very helpful. While I am already familiar with ARFID, I think this is a must for providers who are not sure what the diagnosis actually is. I believe this would be informative for clients and loved ones as well. While it is set up as a self-help book, I do believe it would be most effective if working with providers. Of course, I am biased in this. Overall, I recommend just make sure you get support if needed/wanted.

[Allyson · Rating 5 out of 5]

After years of feeling crazy because of my eating habits (or lack thereof), I finally feel seen. Not only that but I finally feel like I will be able to help myself. Soon, the feeling of my throat closing up when I try a new food will be gone. Soon, my variety will expand beyond the 12 variations of food I eat.

[Tasha Turner]

Have only gotten a couple chapters in but this has been very validating and helpful in understanding my picky eating is likely an eating disorder that was only recently recognized in 2013. I’ve begun using advice on the first steps to take in overcoming or adding new safe foods to my small list. I’m taking this slowly and not reading ahead to keep from getting overwhelmed.

[Danni · Rating 4 out of 5]

I learnt a lot from this book about food. There were tips and worksheets to go through which helped. It was nice to have a book to read about this as it made it feel like I wasn't the only one who was a picky eater.

[Becky Douthit · Rating 3 out of 5]

Really helpful recommendation for individuals who want to treat their ARFID without therapy. As a therapist, Id stick to the manual as its essentially the same thing. But 10/10 recommend for clients/patients struggling with food issues or individuals who discontinue their treatment early

[Marcela · Rating 5 out of 5]

Very informative outlining the nature of this condition and including specific exercises to help the reader improve their diet.

[Ro · Rating 5 out of 5]

Good