What is Food Neophobia?

What is food neophobia?

Food neophobia is a term which has gained currency recently as a tool for understanding difficulty with feeding and eating. It refers to an overwhelming fear of new or unfamiliar foods; ‘neophobia’ refers specifically to fear of new.

This is distinguished from picky eating because the fear for someone with food neophobia lies in the items being new or unfamiliar. Someone who is a fussy eater often avoids common foods they are very familiar with.

Where is the line drawn? Many people have narrow food preferences and would rather eat food they know than try something they do not. Food neophobia describes a condition when preferences are overwhelming, phobic and likely to have a social impact (avoiding meals and situations with unfamiliar food) and a dietary impact.

Common causes of food neophobia

There is a recognised association between autistic spectrum disorder (ASD) and food neophobia. Individuals with ASD commonly struggle with flexibility of thought and can be more resistant to change, therefore initial fears of trying new foods are likely to last longer.

Research has also found that individuals with ASD are more likely to have rigid preferences for specific food textures, colours and tastes, which could maintain their neophobia. Genetic factors are also recognised as a cause of food neophobia, together with psychosocial influences: if parents have food neophobia themselves, there is an increased risk of the same condition in their child.

Symptoms and signs of food neophobia

Some degree of food neophobia is common and expected in early childhood as part of normal development, particularly ages three to seven. It does follow that food aversions reduce from the ages of eight or nine onwards and it is unusual for them to persist through adolescence and into adulthood. The symptoms and signs of food neophobia include:

  • Refusal to eat new foods persisting beyond early childhood into adolescence
  • Fear of new foods is overwhelming
  • Food neophobia has a social impact: key activities such as parties and school trips are avoided because of the fear of having to eat new food
  • There is a psychological impact: the fear of unfamiliar foods causes significant distress and anxiety

Diagnosing

A Food Neophobia Scale (FNS) developed by Pilner and Hobden is used for diagnosis: participants answer these statements, grading them numerically (7 strongly agree to 1, strongly disagree) to gain an overall score. The higher the score the more neophobic an individual is. Items with an asterisk are reverse scored.

  • I am constantly sampling new and different foods. *
  • I don’t trust new foods.
  • If I don’t know what is in a food, I won’t try it.
  • I like foods from different countries. *
  • Ethnic food looks too weird to eat.
  • At dinner parties, I will try a new food. *
  • I am afraid to eat things I have never had before.
  • I am very particular about the foods I will eat.
  • I will eat almost anything. *
  • I like to try new ethnic restaurants.

A specific Child Food Neophobia Scale (CFNS) has also been developed with questions framed for children and answered by their parents.

Treatment and support

Food neophobia treatment can encompass one or more of the following approaches, depending upon individual diagnosis and needs:

  • Desensitisation through graded exposure to new foods in a supportive way
  • Modelling behaviour: parents and other significant family members can model normal eating and positive response to new foods
  • Cognitive behavioural therapy and techniques
  • Relaxation therapy and techniques

Is there are link between anorexia nervosa and food neophobia?

Food neophobia is known to be linked to Avoidant Resistant Feeding and Eating Disorder (ARFID), with both having common themes of selective eating and overwhelming fear of certain foods. It is also known that Food Neophobia has a high prevalence with young people on the autistic spectrum. Because there is also a link between anorexia and autistic spectrum disorder (ASD), there is some interest in how the three could interrelate: food neophobia, ASD and anorexia.

Could ‘picky eating’ in early childhood predispose an individual to anorexia during adolescence? One study suggests picky eating resulting in a lower calorific intake during childhood could be a predisposing factor, although other studies found the types of food avoided by children with food neophobia are most likely to be fruit, vegetable and protein and less likely to be sugary carbs; therefore, weight gain is more likely to be a problem for those affected. This is an interesting area of research with ongoing studies but no clear conclusions emerging at this stage.