Welcome to Gut Check, our column dedicated to the complex, ever-evolving relationship between food and our bodies. Whether you’re curious about mindful eating or want to understand what makes picky eaters picky, read on and let award-winning journalist Betsy Andrews answer all your burning questions. 

“Picky eater” is a label, not an explanation. There are many reasons someone might have more restrictive eating habits than another, food sensory issues among them. I thought the video, done another way that explored the reasons behind her diet, could have jump-started a real discussion about personal needs and wants in eating, and the compassion we should have for others around that. Don’t we all need to respect a “No, thank you” to food, just as we should respect it around anything else having to do with bodily autonomy? How does our negativity toward “picky eaters” affect them? 

Reading through the comments, I considered my own biases toward food restrictions. As a journalist, I go out to dinner a lot, and there’s always this question: “Any allergies or dietary restrictions we should know about?” I have to confess, when I respond, “Nope!” there’s a hint of pride in it, like I’m not one of those people whose difficult needs will inconvenience you. What a privilege it is to think this way, and how unfair. Like the negative commenters, I’ve been making value judgements, pitting my no-holds-barred eating against others’ limitations. I don’t know what it is like to live in a body with dietary restrictions, so why should I take pride in not having them? Determined to deconstruct my biases, I decided to talk to some folks who knew more about all this than I did. I started with my niece.

“I’m on the spectrum. That’s the biggest thing that affects my eating,” Rachel told me. Texture, smell—she’s sensitive to these. At 22, her diet is restricted to cheese pizza and a dozen other foods. She has been through intensive feeding clinics. She has tried, and sometimes succeeded, in adding new foods to her diet. When she does, like recently with buttered bagels, she is proud. That type of perseverance should be honored, but so should her needs around food to begin with. 

“I hate telling people I’m a picky eater or even on the spectrum because I feel like I’m going to be judged,” she says, “but if people want to go into depth, I will talk about it because people should have an understanding that it doesn’t matter what I eat. It’s my personality, what I do, who I am as a person that matters.” A senior in college, Rachel has found her community of support. “Some people are shocked but most understand. My friends are accepting of it. They don’t care.”

Who should? “How bad can it be that I have a daughter that is only extremely limited in her diet, but all her physical tests show that she’s healthy?” says my sister Jane. “Rachel’s an adult and in control. She makes it work. Why fix what’s not broken? That’s where we are.”

Morgan Blair, a licensed clinical counselor who writes the Psychology Today blog “Eating Disorders Among Gender-Expansive and Neurodivergent Individuals,” would agree with that approach. “If a person’s restrictive eating isn’t causing distress or impairment to the individual, then it doesn’t have to be a clinical concern,” she says. “My ultimate goal in treating neurodivergent individuals with eating struggles is to help them allow themselves to interact with their environment in a way that makes them feel content, happy, and fulfilled.” 

In other words, not everyone with food sensory issues has a disorder. Though there is a correlation between neurodivergency and eating disorders, there is also confusion among doctors, who might misdiagnose the eating style of a person on the spectrum as a disorder. Food sensory issues result from differences in processing sensations as well as a need for safety in a world made for neurotypical minds. Labeling people on the spectrum as “picky eaters,” says Blair, “creates an unfair and stigmatizing assumption that their struggles are superficial or created out of personal choice.”  

Rachel is fortunate. Her mother struggled with trauma-related bulimia as a teenager and is attuned to the difference between a disorder and a manageable sensory issue. “When Rachel was younger, I was constantly having to justify my child’s eating behaviors to other parents,” says Jane. “People judged me as being an enabler.” 

Stigma can follow people like Rachel throughout their lives. “I have seen time and time again neurodivergent individuals with food sensory issues be pressured, bullied, and stigmatized,” says Blair. People push them to eat, call them rude for not trying, or leave them out of gatherings around food. “I have also seen how this can then lead to the neurodivergent person suppressing, withdrawing, or masking their struggle to avoid those negative responses.” 

Yet, as anyone with a food allergy or intolerance can attest, neurodivergent people aren’t the only ones dealing with social pressures around food. A registered dietitian specializing in autoimmune conditions and eating disorders, Danielle Crumble Smith has suffered painful, food-related symptoms from Celiac disease, Lyme disease, SIBO (small intestine bacterial overgrowth), and hypothyroidism. “It can be quite a psychological burden. It becomes very isolating if people are not accepting,” she says. “At the same time, I’ve had people graciously try to make things for me to eat without fully understanding that that can be a stressor because I feel obligated to eat it.” Family members often push Smith’s patients with, “You can have a little bit.” But, though they might mean well, they are inadvertently causing problems. Even a bite or two of the wrong food can create inflammation in a body intolerant to it. 

The medical community should be driving public understanding, says Smith, but despite the estimated 20 percent of people who suffer food intolerance, physicians have long failed to examine the problem. “Doctors would say, it’s in your head, you’re stressed, you’re picky,” Smith says. With new research into the microbiome—the microorganisms living in our bodies that profoundly affect our health—“doctors are starting to see that these reactions are real,” says Smith. The paradigm shift is seeping from medicine into the wider culture. “It’s easier nowadays. I can call restaurants and ask specifically what I can have and how it’s prepared.”

Social media, says Kate Scarlata, can be both harmful and helpful. A registered dietitian and author, Scarlata specializes in the low FODMAP diet, a regimen of elimination and reintroduction of foods rich in short-chain carbohydrates that many bodies can’t digest. The bulk of her clients suffer from IBS, irritable bowel syndrome, a group of painful intestinal symptoms. Affecting up to 16 percent of people, IBS can be so debilitating that one survey found patients would sacrifice 25 percent of their remaining life for relief. But research on it is underfunded, says Scarlata, perhaps because it mainly impacts women.

“There has been a fair amount of medical gaslighting and stigma,” she says. “There’s embarrassment. They feel alone. ‘I’m having diarrhea. Pass the nachos.’ It’s not exactly cocktail party conversation.” In response, she started the hashtag #ibelieveinyourstory. Sufferers DM her, and she shares the science with them. “Part of my job is advocacy, giving them tools to talk to friends, neighbors, doctors, whoever.”

Social media campaigns like hers are making IBS a hot topic. “The poop emoji has been a star in breaking the taboo,” she adds. But as the “picky eater” video illustrates, social media is a double-edged sword, and its dangers go beyond intolerance to have a negative influence. “With eating disorders, increased social media use is a risk factor, and people with food-related special diet needs are at higher risk for developing disordered eating.” That does not mean your friend on a low-FODMAP diet is at risk for anorexia. “If you’re concerned your friend’s diet is so limited they can’t meet their nutritional needs, and it’s affecting their psychosocial functioning, that’s when you encourage them to get help,” Scarlata advises. 

It's an entirely different thing, though, to pressure someone with food intolerances to have just one bite, or worse, to deride their diet. In a survey of food-allergic people in which 93 percent were children, nearly a quarter reported being bullied, teased, or harassed for their allergies. The bullies are spreading a culture that’s intolerant of food intolerance. “Parents say, ‘I wish we could just have peanut butter at the party.’ Kids hear that and may project it onto the kid with the allergy in their class.”

As our understanding of restrictive eating evolves, my niece Rachel clocks increased awareness. “It’s been a while since someone has interrogated me,” she says. That gives her breathing room to talk about more than her dietary habits.

I wish I’d had the wisdom to give such breathing room to my son, Harper, when he was little. A kid from Maine, Harper’s favorite food was clam chowder—until he was diagnosed with a shellfish allergy at nine. In the year that followed, he refused to eat restaurant food. I fretted over this. I’m a food writer. Dining out is what I do, who I am. How could my partner and I just stay at home and cook for this kid forever? Months later, a psychologist put things in perspective when he reminded us that Harper’s response was rational. “The wrong food could kill him,” the therapist said.

That sunk in. Before my kid was diagnosed, I was one of those parents who rolled their eyes at the school’s no-nuts policy, the type of behavior that might make my child think his allergic classmates were weirdos. Because of my own need for control around food—to eat whatever I want wherever and whenever and to have those around me join in—I resented others’ food restrictions. Writing this story has helped me realize: I’m still evolving that mindset.

What I’m saying is, if you’ve had your own moments of ambivalence over “picky eating,” I can relate. Food is a vessel for our physicality, our experiences, and our feelings. That could include some negative feelings over someone else’s relationship to food inconveniencing you. But maybe we should all take a note from Rachel. After all, she’s been nothing but respectful and patient with us non-picky eaters all these years. At family gatherings, she sits gracefully, usually not eating but happy to be there. Personally, I’d like to do unto others as Rachel does us.