Ewww…That’s Gross! Food Avoidance In Children.

Many children I know would happily live on a steady diet of macaroni and cheese and boycott anything green on their plate. Picky eating is a normal part of development especially seen in toddlers and preschoolers. We know that strategies like nagging, bribing, pressuring, and forcing do not win the dinner table battle over food. A recent study, published in Appetite (2015), showed an effective strategy to combat your young child’s food refusal. Results showed that parents who repeatedly exposed a child to a certain food (repetition), ate if first and showed them how good it tastes (role modeling), and then praised their child for trying the food (rewards), positively changed their child’s attitude and willingness to the food. The children in this group ate significantly more vegetables and reported liking the previously disliked vegetable.

Most children grow out of their picky eating. However, for some, food avoidance and restriction develop into a persistent pattern and serious condition. To account for this problem, the Diagnostic and Statistical Manual 5^th edition (DSM-5), now includes Avoidant/Restrictive Food Intake Disorder (ARFID) as a diagnosis. To get the diagnosis, the individual must have a lack of interest in eating or food, concerns about the negative consequences of eating, and avoid food because of sensory characteristics of food. Additionally, the person must not meet nutritional or energy needs and/or experience marked psychosocial stress due to their eating habits. For children and teens, AFRID can have serious social consequences because much of their social interactions with peers involve food. They may not be able to sleep over at a friend’s house or go on the school camping trip due to their worry and fear involving food. Unlike other eating disorders, such as anorexia or bulimia, individuals with AFRID do not have a distorted body image or a desire to lose weight. Research is currently underway to better understand this new diagnosis and effective treatment options to treat it.

Clare E. Holley, Emma Haycraft, Claire Farrow. ‘Why don’t you try it again?’ A comparison of parent led, home based interventions aimed at increasing children’s consumption of a disliked vegetable.Appetite, 2015; 87: 215 DOI: 10.1016/j.appet.2014.12.216