A 10-year-old boy is brought by his parents for evaluation of severely restricted eating. He eats only five specific foods — plain white rice, chicken nuggets, plain pasta, crackers, and apple juice — and has done so since age 3. He refuses all other foods based on their texture, reporting they make him gag. He has fallen to the 3rd percentile for weight, and his pediatrician has documented nutritional deficiencies in iron and vitamin D. He expresses no concern about body weight or shape and states he wishes he could eat more foods but 'they feel disgusting in my mouth.'