AP Photo/Bernadette Tuazon Saltines: A staple of some picky eaters' diets.

NEW YORK --  Fotini Strakaris eats hamburgers. Carefully.

The meat patty has to well-done, or "burnt," as she sometimes requests. No lettuce, tomatoes or onions. No condiments, but plenty of salt.

She will have French fries, with ketchup. In fact, Strakaris will use almost the entire bottle of ketchup.

But she won't put ketchup on the burger, because that'd become the third ingredient in the dish, and the art student from Maspeth, N.Y. doesn't eat anything that combines more than two food items.

In this age of increasingly diverse palates and fusion cuisines, Strakaris and other hyper-picky eaters face a daily battle to find chow that they can swallow without gagging.

PICKY, BUT NOT LONELY

Though they're stuck in their ways, some are seeking help.

Three years ago, Bob Krause started PickyEatingAdults.com to help others with what he calls "our strange eating disorder." He also runs a Yahoo! e-mail group with over 1,000 members.

Krause, a Virginia Beach small business owner, hopes that an open dialogue about symptoms will help parents and young children recognize the problem early and start treatment before pickiness settles in. He started the support group because he couldn't find help or solace among friends or the medical community.

"I lived most of my life thinking it was something to hide at all costs," he said.

His daily meals usually consist of waffles, peanut butter and crackers or potato chips, French fries, and a grilled cheese sandwich.

"Sort of a 4-year-old's dream diet," he said. Krause just turned 60.

DIAGNOSIS: PICKY

Picky eating isn't an officially recognized eating disorder, like anorexia or bulimia. But some psychologists say it's either a phobia or a form of a compulsive behavior.

Marcia Pelchat, a psychologist at the Monell Chemical Senses Center in Philadelphia who specializes in the influence of food, led a study in 2002 of about 500 people. Twenty percent identified themselves as eating a very limited range of foods or having food neophobia, the fear of trying new foods. Pelchat said the picky eaters had signs of obsessive compulsive disorders and depression.

"It's possible that picky eating is, in fact, a type of OCD," Pelchat said. "But we have a long way to go before we can actually establish that."

Despite their limited diets, picky eaters are fairly healthy, with many taking vitamin supplements to make up for their eating habits, she said.

She found that male adult picky eaters tended to be slightly overweight because they're most comfortable eating familiar, high-calorie foods like macaroni and cheese, fries or plain hamburgers.

In clinical studies, some adult picky eaters have tried desensitizing therapy, the type used for treatment of phobias. But most picky eaters aren't interested in being cured at all, Pelchat said: "It's like saying to them, would you like to try a pill that makes it possible for you to eat feces?"

WHEN CHILI BECOMES MANURE

Picky eaters often have issues with the texture of foods. Krause, for example, thinks a bowl of chili looks and smells like "dog crap."

"I can become ill just being in the same room with someone eating it," he said.

Andrea Juele, 23, of Astoria, N.Y., won't eat condiments like ketchup, mayonnaise or mustard because their slightly thick, slightly runny quality induces nausea.

On a trip to Chicago when Juele was 5, her great-uncle refused to let her into a McDonald's PlayPlace until she finished her hamburger. He'd forgotten to order a plain burger for her, so she held her nose while forcing it down, crying the whole time.

Many adult picky eaters are disgusted by joining certain flavors. Though he loves chocolate and loves peanuts, Krause can't stand them together, describing the combination as "bad chocolate with dirt in it."

HARROWING RESTAURANT VISITS

Nils Noren, a chef who overseas the curriculum at The French Culinary Institute and its student restaurant L'Ecole, has seen an increase in business meals where at least one guest requests an off-the-menu dish.

"He will ask for plain salad, nothing else, for example," Noren said. "I don't think they're disrespectful, but I think they're missing out."

On a recent hot July day, Strakaris was ordering a late lunch at her favorite restaurant in New York's SoHo neighborhood. Although the menu has a variety of Mediterranean and Greek specialties, she's only ordered two items in all her visits: a lemon chicken broth similar to the one her mother makes, and a small rectangle of feta cheese.

Strakaris warily describes a personal challenge: She's hoping to eat roasted chicken sometime this summer.

"I don't know, though," she said, looking a little green.

Amanda Kwan is an AP staffer in New York.