HealthEncourage your kids to eat a variety of food

Encourage your kids to eat a variety of food

If mealtime is a constant battle between you and your little one, you’re not alone. Picky eaters wage war at dinner tables around the world, leaving fields of frustrated and defeated parents in their wake. Is there a way to bring peace to the food fight, or will parents of picky eaters strategically hide peas in macaroni and cheese until their kids leave home?

In my years as a psychologist and anxiety specialist, I’ve met with many parents of picky eaters. Whether it’s simply a distaste for anything green or a more extreme form of picky eating known as Avoidant/Restrictive Food Intake Disorder (ARFID),1 I’ve discovered a few effective methods that can remove stress and anxiety from mealtimes and get those picky eaters to try something new.

Marcus, the Picky Eater

One picky eater I met through my work was an eight-year old boy named Marcus. He was brought in for a psychological evaluation by his exasperated parents. They came in with this initial question: “Does Marcus have an eating disorder or an anxiety disorder?” And then, more urgently, “How do we get him to eat?!”

It’s not that Marcus didn’t eat, it’s that he didn’t eat most things. As a toddler, he was slow to try new foods and even slower to accept them. His parents noticed that he was pickier than his older brother had been at that age. They worried that he wouldn’t ingest enough calories, so they grew accustomed to feeding him his preferred foods and rarely tried to get him to eat something new.

They hoped he would grow out of it, but Marcus only became more selective. He ate almost the exact same meals every day: dry cereal for breakfast, a cheese sandwich for lunch, and chicken fingers or macaroni and cheese for dinner. Marcus became “extremely anxious to the point of screaming and throwing a tantrum” if presented with a food that was new or not part of his usual menu. His parents noted that this behavior made sense in the context of his personality: a sensitive boy who had always been a bit fearful about trying new activities or being in unfamiliar social situations.

Marcus was a bit overanxious, but didn’t meet full criteria for any anxiety disorder. His extreme picky eating, however, was compromising his nutritional health, his daily functioning, and his parents’ sanity. To answer his parents’ first question, Marcus did meet criteria for an eating disorder, specifically Avoidant/Restrictive Food Intake Disorder (ARFID)

Eating Disorder, Anxiety Disorder, or Just Picky?

Does your picky eater have an eating disorder or even an anxiety disorder? Selective eating can be an eating disorder, but it is not an anxiety disorder. That said, selective eating does often exist simultaneously with anxiety. A recent study of ARFID youth found that 58 percent also met criteria for an anxiety disorder.2 Hence, if your child is losing weight or expressing exaggerated fears of vomiting or choking, two significant steps are recommended: evaluation and treatment.3 Seeking evaluation from a trusted psychologist with experience in treating eating disorders could result in more effective and personalized treatment for your little one.

How Can You Get Your Picky Eater to Eat?

It doesn’t matter if it’s medicine or dentists or broccoli, kids will try to avoid anything and everything they don’t like. Allowing them to skip vegetables at every meal, however, isn’t going to bring them any closer to diversifying their palette. Instead, what I call “repeated exposure”—i.e. continuously motivating them to take one or two bites of that broccoli in their bowl despite their objections—can help encourage children to open their minds to new foods. Parents can support healthy eating by insisting that their child take small steps to confront and overcome their stress of eating new things and reward them each time they do.

6 Ways to Bring Peace to the Table

    1. Don’t be afraid to reward: Many studies show that rewards motivate children to eat new foods. Give children a nightly reward (such as access to screen time) for eating a challenge food at dinner. And, dole out tokens as a reward for brave eating outside of the home.
    2. Your children don’t have to like the food. They just have to eat it: Eventually, with enough practice, they will even tolerate the food. That counts as a win.
    3. Encourage challenging foods right off the bat: Placing a new or “no way” food on your child’s plate and telling him he will “sit there until he eats it” is a strategy that typically backfires. Your child will wait you out, and will eventually need to go to bed. Instead, introduce the challenge food at the beginning of the meal and set a timer for a few minutes. If he eats the food before the buzzer rings, be generous with smiles, high fives, and specific praise, like “Great job finishing that before the buzzer!” “Great brave eating!” “Those were rockstar bites!”
    4. Don’t indulge or entertain poor behavior: Picky eaters will whine, cry, scream, and flat-out refuse. Paying attention to these behaviors will only make them more likely to continue. Instead, continue a pleasant dinner conversation with the rest of the family.
    5. Keep calm and upbeat: It’s important to get the message across that new foods are safe. Anxiously reassuring your child or making mealtime a tense battle is a surefire way to make them more adamantly opposed to trying new things.
    6. Practice patience. This is a marathon, not a sprint. Your child has had years to practice picky eating and by now, it is a deeply ingrained habit. Plan on lots and lots and lots (months! a year!) of practice.

While these tips can help both parties raise their white flags at mealtime battles, there is no absolute way to get your child to start eating every meal you place in front of him over night.4 However, many of us who treat selective eaters believe that the habit of picky eating is maintained, if not encouraged, by only offering kids the foods that they like. Instead, consistently placing new foods on their plate, despite their whining and complaining, may help picky eaters expand the number of different foods they will comfortably eat. In my own practice, I advise parents to repeatedly expose their child to new foods and educate them on good mealtime hygiene (eating at the table, at about the same time, without distractions like the TV or electronics) and effective reward strategies such as access to screen time and praise for brave eating. With these methods, I’ve seen miracles happen. Marcus, for instance, now eats whatever the rest of the family is eating at dinner. Occasionally, he even says he likes it.

Sources

1. Bryant-Waugh, R. (2013). Avoidant restrictive food intake disorder: An illustrative case example. International Journal of Eating Disorders, 46, 420-423.

2. Fisher, M., Rosen, D., Ornstein, R., Mammel, K., Katzman, D., et al. (2014). Characteristics of avoidant/restrictive food intake disorder in children and adolescents: A “New Disorder” in DSM-5. Journal of Adolescent Health, 55, 49-52.

3. Eddy, K., Thomas, J., Hastings, E., Edkins, K., Lamont, E., et al. (2014). Prevalence of DSM-5 avoidant/restrictive food intake disorder in a pediatric gastroenterology healthcare network. International Journal of Eating Disorders.

4. Bryant-Waugh, R. (2013). Feeding and eating disorders in children. Current Opinion in Psychiatry, 26, 537-542.

Cognitive-Behavioral Therapist at University of Pennsylvania

Katherine K. Dahlsgaard, Ph.D., is a licensed clinical psychologist with expertise in Cognitive Behavioral Therapy for children, adolescents, and young adults. Dr. Dahlsgaard received a Bachelors of Arts in Psychology from Bryn Mawr College and later earned her Ph.D. in psychology from the University of Pennsylvania. She specializes in the treatment of anxiety disorders, particularly selective mutism, social anxiety disorder, obsessive-compulsive disorder, phobias, agoraphobia, and generalized fears. Dr. Dahlsgaard also frequently treats individuals with disorders that commonly present comorbidly with anxiety, such as tic disorders, food selectivity, and body-focused impulse control disorders (trichotillomania).

Dr. Dahlsgaard is a frequent lecturer and guest speaker and is published widely on the topics of child development, psychopathology, mental health, and human virtue. She serves as Lead Psychologist at the Anxiety Behaviors Clinic (ABC) and as Director of the Picky Eaters Clinic in the Department of Child and Adolescent Psychiatry and Behavioral Sciences at The Children’s Hospital of Philadelphia.

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