If you’re the parent of a picky eater, you’ve probably experienced a range of emotions — from worry that your child isn’t getting enough nourishment to frustration that your efforts are in vain. You may have tried everything from pleading and bribing, to enforcing “clean your plate” rules. Still, you might be wondering which tact is best to take.
A large national study by Duke University researchers offers an answer: No matter how annoying or hopeless it might seem, staying positive and encouraging will get the best results.
More than 19,200 people (75 percent female and 25 percent male) who struggled with food avoidance issues before 2013 when they were formally classified as the psychiatric condition known as Avoidant Restrictive Food Intake Disorder — or ARFID for short — took part in the study.
The study was aimed at adults who self-identified as picky eaters and began more than a decade ago. Based on the degree of their food avoidance, participants were classified as either likely having an ARFID diagnosis or not.
Using food to teach cultural or nutritional lessons, being flexible about the approach to food, providing plenty of “safe” foods, helping with food preparation, and offering choices from a variety of food groups were all found to help.
Other than being extremely picky eaters, those who are diagnosed with ARFID have very little interest in eating food. They consume a limited variety of preferred foods, and this can lead to poor growth and poor nutrition. For many, the eating disorder includes fear of pain, or anxiety over choking or vomiting when they eat. ARFID can all cause social and emotional problems when meals become a source of friction, conflict or shame. More boys than girls suffer with the condition, unlike other eating disorders.
Participants were asked to characterize how they perceived the helpfulness of their parents' feeding strategies when they were growing up. Then the research team applied an algorithm to interpret the meaning and/or sentiment of their survey responses to characterize the approaches as either helpful or not helpful.
The most successful strategies involved a positive emotional approach. Using food to teach cultural or nutritional lessons, being flexible about the approach to food, providing plenty of “safe” foods, helping with food preparation, and presenting choices from a variety of food groups were all found to help.
“Figuring out the best way to feed a child with severe food avoidance can be exhausting and stressful for parents,” co-author, Nancy Zucker, a professor in Duke’s Department of Psychiatry & Behavioral Sciences, said in a statement, “so providing guidance is essential to improve the social and emotional eating environment for their children and reduce that distress that both parents and children have at mealtimes.”
Additional signs of ARFID, according to the National Eating Disorder Association (NEDA), include:
- A dramatic restriction in types or amount of food eaten
- A willingness to eat only certain textures of food
- Lack of appetite or interest in food
- A list of preferred foods that is extremely limited and becomes narrower over time.
If your child is experiencing some of these picky eating issues, speak with your pediatrician. You can also contact the National Eating Disorder Association on their toll-free helpline at 1- 800-931-2237.
The study is published in the International Journal of Eating Disorders.