Erin Graham refused to eat meat, vegetables, pasta or salad and was even choosy about desserts last year, but now the 9-year-old from Kansas City has made major strides in her eating habits after undergoing an intense "picky eater rehab" program.
Erin is an extremely picky eater. Most kids love pizza, chicken nuggets, hamburgers, hot dogs and cheese, but before entering "rehab" at Duke University School of Medicine Center for Eating Disorders last year, the list of foods Erin would eat was brief. She enjoyed breakfast foods like French toast, some fruit, grilled cheese sandwiches -- only with American cheese -- chips, French fries, crackers and lots of peanut butter, but only a specific kind.
Now, a year out of the program, where Erin underwent a range of therapies and physical tests, she's has added a litany of new foods.
"Yeah, I like cheeseburgers, calamari, onion, onion rings ... bacon," Erin said.
She's also added fried chicken, celery, carrots, and her mom's pumpkin pancakes.
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It may not seem like much, but for an extremely picky eater like Erin, it's a huge breakthrough. But it hasn't been easy. This year, the Grahams have recorded each and everyone one of Erin's 1,433 bites.
Erin treats it like a game.
"When I take a bite of a food," she said. "I get six points. Like one bite equals six points. And then ... at the end of the food adventure, my mom adds up like all of the sixes that we've done."
"It's exhausting," said Amy Graham, Erin's mother. "My husband Eric does all the tracking. He keeps everybody's spreadsheets."
The young girl suffers from what doctors call "food neophobia" -- essentially a fear of trying new foods. It is a relatively new field of study for researchers. They have no idea how many people suffer from it. It hasn't even been officially classified a disorder by the medical field, but it's starting to more serious than previously thought.
Erin used to be so afraid of trying new foods that she was on the verge of being hungry all the time. Every meal was a stressful family battle.
For Amy Graham, cooking meals at home for her three children was a daily nightmare, especially when she had to follow Erin's strict food demands.
"Do you ever like the dinner I make?" Graham asked her daughter last year.
Erin's answer? An emphatic "no."
Graham believed her daughter has been a picky eater since birth. Erin had acid reflux as a baby which made every bite painful.
The Grahams' other two children, 11-year-old Ella and 7-year-old Freddie, don't share the same eating habits as their sister.
Erin went to several doctors, all of whom gave her mother advice that ranged from "she'll outgrow it" to "just starve her," meaning not letting Erin have a choice of what's on her plate.
"I tried to say, 'This is what's for dinner, you gotta eat. ... If you're hungry enough you'll eat,'" said Amy. "People just think I'm specially making a meal for her all the time and it's my fault, and if I showed her who was boss, she would eat. And the fact of the matter is, no, she won't."
So last year, in a last ditch attempt, Amy and Eric Graham brought their daughter to see Dr. Nancy Zucker, who runs Duke's Center for Eating Disorders. The center studies food-neophobia and how someone who might suffer from the condition reacts to new foods.
Zucker heads an intensive five-day program with the center -- a picky eater rehab of sorts.
"We would look at [a] plate of food and say, 'Oh, look at this lovely food adventure, I wonder what this would taste like,'" she said. "They would look at a plate of food and be like 'DANGER, DANGER.'"
When Erin first heard about the Duke program, she pushed her parents to enroll her. Even at her young age, she knew her difficulties with food were affecting her social life.
"I'm hungry when we go out for dinner and there's nothing I like," she said. "Or at birthday parties, I don't have something to eat because they mostly serve pizza."
Her father added, "The fact that she recognizes that it's not normal and she wants to get better is really the big reason why we're here."
For some picky eaters, new foods will make them physically ill, and for others, the food simply tastes bad to them. For Erin, it was both.
Zucker said that when kids are picky eaters, meals become stressful for the whole family.
The first two days of Erin's "rehab" were spent trying to change her thinking about new foods and testing her anxiety levels. The program also evaluated Erin's sense of smell and counted her taste buds to see if she was hyper-sensitive.
"The work with Erin has been about kind of retraining her experience with food," Zucker said, "giving her tools to relax her body and relax her mind and not let her thoughts get in the way of what she does."
Throughout the week of treatment, Erin, who never mixes foods, was asked to try different combinations of foods and experiment with different tastes. Her first breakthrough came when she ate a small piece of turkey bacon. This was a huge step for a young girl who refused to eat meat.
"That went better than what I would have expected, by far," said her father, Eric Graham.
Armed with new lessons from the program about how deal with Erin's picky eating habits, the Grahams headed back to Kansas City to continue working with her at home.
When they first arrived home, "She was a mess emotionally. I think that we were all drained," Amy Graham remembered. "But Dr. Zucker really kept in contact through emails and she would sometimes call Erin. And Erin just loved Dr. Zucker. [That] really kept her going."
Through the year, they've also learned a bit more about Erin's food choices.
"She likes onions," said Amy Graham. "And I think Dr. Zucker says what she really likes are strong tastes. We called her picky but she has a very fine palette, apparently."