For Amy Graham, cooking meals at home in Kansas City for her three children is a daily nightmare, especially when she has to follow the strict demands of her young daughter, Erin. Even breakfast is far from simple.
"Mamma, make French toast ... Can you cut it?" said the seven-year-old, and then after her third slice, "I want more!"
It's not unusual for a growing girl to want a big breakfast, but for Erin, this will probably be her last full meal of the day. Erin is an extremely picky eater, and suffers from what doctors call "food neophobia" -- fear of trying new foods. French toast is one of the very few things Erin can stand to eat.
"Do you ever like the dinner I make?" Graham asked her daughter.
Erin's answer? An emphatic "no."
Food neophobia is a 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.
Most kids love pizza, plain chicken breast, chicken nuggets, hamburgers, hot dogs, and cheese. Erin won't eat any of those, except American processed cheese. In fact, Erin won't eat any meat, vegetables, pasta or salad. She is even choosy about desserts.
The list of foods she will eat is brief: waffles, pancakes, some fruit, grilled cheese sandwiches -- with only American cheese, of course -- chips, French fries, crackers and lots and lots of peanut butter, but only a specific kind.
Erin's fight with food has her parents constantly intervening. Her father, Eric Graham, tried in vain to reason with his daughter at the dinner table on spaghetti night, usually another kid favorite, but Erin's plate remained empty.
His tactic was to make a deal with her: he would give her a piece of bread if she would eat half a cherry tomato in exchange.
"Erin, just do it and be done, and after you're done, you can have a piece of bread, okay?" Graham pleaded.
Erin struggled with the tomato and could barely keep it down. This is a typical night at the dinner table for the Grahams.
Amy Graham believed her daughter has been a picky eater since birth, saying that Erin "always had a different relationship with food." The Grahams' other two children, nine-year-old Ella and five-year-old Freddie, don't seem to share the same eating habits as their sister.
The Grahams Try Desperately To Break Erin of Her Picky Eating Habits
Erin has been to several doctors, all of whom have given 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,'" Amy said. "I don't want to be this way, 'cause she's hungry."
Some people might not understand why the Grahams have such a hard time getting their young picky eater to try new foods, but Erin's mother knows how serious her daughter's demands are.
"People just think I'm specially making a meal for her all the time and it's my fault," Graham said. "And if I showed her who was boss, she would eat and the fact of the matter is no, she won't."
Erin's peculiar eating habits are not a unique case. Bob Krause, 63, is a lifelong picky eater and founded a website called PickyEatingAdults.com. Within a few weeks of its launch in May 2003, the site had 1,400 members. Today, it has over 7,000.
Krause's food preferences, as well as those of many who participate on his website, are very similar to seven-year-old Erin's.
A typical lunch for Krause includes Lance peanut butter crackers or a bag of potato chips, and a glass of milk. For dinner, it's a grilled cheese sandwich and French fries.
For very picky eaters like himself, Krause said trying different foods doesn't make sense.
"The intelligent side of my brain will tell me that it's food, but the side of my brain that's going to accept me eating something that I really don't have a control over will say, 'You can't eat that' ... it doesn't look appetizing to me," he said.
At the grocery store near his home in Virginia Beach, Va., Krause tried a new food, a croissant. He immediately gagged. "That's an example of what happens when I try [new foods]."
Sometimes, there's a visual component to Krause's fear. "Spaghetti might look like a plate full of worms to me," he said.
Don't think that picky eaters are being snooty about their palates. Adults well into retirement, who struggle to feed themselves because of their fear of foods, put heavy strains on their bodies and their relationships -- even marriages. Two, in Krause's case.
"It wasn't the only reason the marriages didn't last, but it was certainly part of the reason for the failure," he said.
Picky Eaters Associate Bad Feelings with Eating New Foods
Dr. Nancy Zucker is an assistant professor at Duke University's School of Medicine, and runs its Center for Eating Disorders. The center is just beginning to study food neophobia and how someone who might suffer from this condition reacts to new foods.
Zucker said, "We would look at [a] plate of food and say, 'oh look at this lovely food adventure, I wonder what this would taste like. They would look at a plate of food and be like 'DANGER, DANGER ... This could be way too much stimulation, this could be awful.'"
These bad feelings associated with food are far from the average kid wanting their favorite peanut butter and jelly sandwich day in and day out.
"That's just normal. That's just exploration and sort of finding your preferences, but you know, a picky eater is one for whom that variability just doesn't shift," Zucker said.
For some picky eaters, new foods will make them physically ill, and for others, the food simply tastes bad to them. Trying desperately to break Erin of this intense reaction, the Grahams took her to see Dr. Zucker for an intensive five-day program -- a picky eater rehab of sorts.
When Erin first heard about the Duke program, she pushed her parents to enroll her. Even at her young age, she knows her difficulties with food are affecting her social life. "I'm hungry when we go out for dinner and there's nothing I like at, 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."
Zucker explained 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.
"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."
"If we're eating pizza by Friday, we've done good," she added. Pizza was Erin's goal for the week, because it's the food served at most of the birthday parties she attends.
'Rehab' for Picky Eaters
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 is a huge step for a young girl who usually refuses to eat meat.
"That went better than what I would have expected by far," her father Eric said.
The Grahams said they were shocked by what they learned about their daughter's eating habits: Erin is hungry almost all the time, and it mostly stems from her nervousness about food.
Last day of her treatment was the pizza test. A special slice of cheese pizza, no sauce, was prepared just for her at the center.
Nervous, Erin tried a tiny piece of cheese from the slice, and declared that it tasted "okay." She wasn't ready for a whole slice just yet, but these are baby steps in the right direction in her fight against food phobia.