Understanding Childhood Eating Disorders - Blog of the children's educational center

Unhealthy eating habits in childhood, such as overeating, undereating, or limited diet, can lead to serious conditions like Anorexia or Bulimia.

Establishing a healthy relationship with food is crucial for all children, as eating is a fundamental part of life.

Disordered eating can take different forms, from forgetting to eat to being excessively selective about food textures and presentations.

Common Manifestations of Disordered Eating

Restricting or binging: Not eating enough or overeating
Purging: Inducing vomiting after eating
Selective eating: Rejecting certain foods
Junk food eating: Consuming unhealthy foods exclusively
Sensory sensitivity and eating: Being overly sensitive to food attributes
Picky and argumentative eating: Demanding multiple meal options
On-the-go eating: Eating on the move
Missing sensory cues: Ignoring hunger signals
Body shaming: Criticizing one’s body leading to unhealthy eating patterns
Obsessive calorie counting: Constantly tracking calorie intake and restricting food based on numbers
Compulsive exercise: Exercising excessively to burn off calories consumed
Secretive eating: Hiding food consumption from others
Meal skipping: Intentionally avoiding meals to control weight

Factors Contributing to Disordered Eating

Anxiety: Seeking control through eating due to anxiety or insecurities

Poor body image: Body image issues leading to eating disorders, with some individuals not recognizing their thinness

Sensory differences: Sensory sensitivities impacting eating habits, as seen in Autism Spectrum Disorder

Trauma: Emotional trauma manifesting in food hoarding or refusal to eat

Medical complications: Certain medical conditions affecting appetite and nutrient intake

Activity level: High activity levels or ADHD influencing eating behaviors

Rigid behavior: Resistance to change or trying new foods resulting in limited eating habits

Self-esteem: Low self-esteem leading to restrictive eating patterns

Tips for Addressing Mild Eating Issues

Try these strategies if mild eating concerns are noticed:

Relax and avoid being too controlling
Make mealtimes enjoyable
Offer food choices
Reward trying new foods
Ensure availability of healthy snacks
Encourage a positive attitude towards food
Involve children in meal preparation
Set a good example by eating a variety of nutritious foods

In addition to psychotherapy and play therapy, nutritional counseling and medical monitoring are often key components of treatment for eating disorders. It is important for individuals with eating disorders to work with a team of professionals, including therapists, doctors, and dietitians, to address both the physical and psychological aspects of the disorder.

Families and caregivers also play a crucial role in supporting individuals with eating disorders. Providing a supportive and non-judgmental environment, encouraging healthy behaviors, and helping with meal planning can all be beneficial in the recovery process.

If you suspect that a child is struggling with an eating disorder, it is important to seek help as soon as possible. Early intervention can lead to better outcomes and a quicker recovery. Remember, eating disorders are serious mental health conditions that require professional treatment.

Resources in Colorado

[2] Kay A. Toomey PhD Individual Practitioner, Feeding Specialist Denver Colorado

[3] Star Institute Occupational Therapy, Denver https://www.spdstar.org/

[6] Kaiser Permanente Eating Disorders Program. Eating disorder program (outpatient) at Highline Clinic and Hidden Lake Clinic in Westminster.

Most children aged one to five who refuse to eat are healthy and have appropriate appetites for their age and growth rate. Unrealistic parental expectations can cause unnecessary worry, while threats or punishments may worsen a child’s refusal to eat. Conducting a thorough assessment is essential to rule out acute and chronic illnesses.

Keywords: Picky eating, Poor eating, Refusal to eat, Toddler, Unrealistic parental expectations

It is important for parents and caregivers to be patient and understanding when dealing with children who are picky eaters or refuse to eat. Offering a variety of healthy foods, involving children in meal preparation, and maintaining a positive mealtime environment can help alleviate eating concerns. Seeking guidance from feeding specialists or occupational therapists, such as Kay A. Toomey PhD and the Star Institute Occupational Therapy in Denver, can provide valuable support and resources for addressing children’s eating issues. Additionally, programs like the Kaiser Permanente Eating Disorders Program at Highline Clinic and Hidden Lake Clinic in Westminster offer outpatient services for children struggling with eating disorders. By taking a comprehensive approach and seeking appropriate help, parents can help their children develop healthy eating habits and overcome any challenges they may face.

Common Challenges in Toddlers and Preschoolers

About 25% to 35% of toddlers and preschoolers are described as poor or picky eaters by their parents. Feeding problems in children often lead to conflicts with parents but most children have appropriate appetites for their age and growth rate. Healthcare providers can offer guidance to parents to prevent mealtime battles and reinforce positive feeding behaviors.

In addition to picky eating, common challenges in toddlers and preschoolers may include difficulty transitioning from breast milk or formula to solid foods, refusal to try new foods, mealtime tantrums, and food jags where a child only wants to eat the same few foods over and over again.

It is important for parents to remain patient and consistent when dealing with feeding challenges in young children. Offering a variety of healthy foods, modeling good eating habits, and creating a positive mealtime environment can help encourage children to develop healthy eating habits for life.

Growth Patterns and Eating Behavior

Children experience significant growth in their first two years, with weight gain and height increase slowing down between ages two and five. Picky eating is often a result of parental pressure, and efforts to force children to eat more can backfire.

Investigating Food Refusal

A detailed history and physical examination are necessary to determine the cause of food refusal. Sudden appetite changes may indicate underlying conditions, and accurate measurements are vital for proper assessment.

It is important for parents to model healthy eating habits themselves, as children often mimic their parents’ behavior. Encouraging children to try new foods and involving them in meal preparation can also help develop their taste preferences.

A balanced diet should include a variety of foods from all food groups, such as fruits, vegetables, whole grains, lean proteins, and dairy products. Limiting sugary snacks and beverages can help prevent dental cavities and promote overall health.

Eating together as a family can create a sense of routine and connection, as well as provide an opportunity for parents to monitor their child’s eating habits. It is also important to praise children for trying new foods and making healthy choices, rather than focusing on what they refuse to eat.

Further Recommendations

This information has been reviewed by the CPS Community Paediatrics Committee.

CPS NUTRITION AND GASTROENTEROLOGY COMMITTEE

Members: Dana L Boctor MD; Jeffrey N Critch MD (Chair); Manjula Gowrishankar MD; Daniel Roth MD; Sharon L Unger MD; Robin C Williams MD (Board Representative)

Contact Persons: Jatinder Bhatia MD, American Academy of Pediatrics; Genevieve Courant NP, MSc, The Breastfeeding Committee for Canada; A George F Davidson MD, Human Milk Banking Association; Tanis Fenton, Dietitians of Canada; Jennifer McCrea, Health Canada; Jae Hong Kim MD (past member); Lynne Underhill MSc, Bureau of Nutritional Sciences, Health Canada

Primary Contributors: Alexander KC Leung MD, Valérie Marchand MD (previous Chair), Reginald S Sauve MD

This document’s recommendations do not prescribe a single treatment plan. Adjustments may be necessary based on specific circumstances. The Canadian Paediatric Society reviews all position statements and practice points regularly. For the most up-to-date versions, please visit the CPS website (www.cps.ca).

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Paediatrics & Child Health articles are made available here with the permission of Oxford University Press.