Is My Teen A Picky Eater, or Does My Teen Have An Eating Disorder?
The line between picky eating and eating disorders can be quite confusing for both parents and teenagers alike.
If you’re a parent and you suspect that your teenager’s picky eating is really an eating disorder in disguise, you’re not alone.
Who can be a picky eater?
Picky eating typically occurs during early childhood development around the ages of 2 - 6 years old. Picky eating habits during this time period are considered a normal part of development. Toddlers are gaining independence and learning how to make decisions. It’s estimated that 1 in 5 children are picky eaters! Often, these patterns of developmental behavior are reflected through eating and food.
Although most picky eating ends after the 2 - 6 year old period, it can extend into late adolescence and sometimes even adulthood. The truth is: anyone can be a picky eater, even a teenager!
What does picky eating look like for kids?
Picky eating can look different from person to person, but typically it can involve the following:
Food jags - Has your child ever seemed to have a hyper-fixation on a specific food? A food jag is when someone identifies a food that they particularly like and fixates on that specific food, often requesting a particular food daily or multiple times a day and refusing to eat anything else. This can go on for several days or sometimes weeks at a time.
Food neophobia - Food neophobia is the “fear of new foods”. This type of feeding disorder involves a “persistent reluctance to eat new foods, avoiding tasting unknown products and unwillingness to accept newly introduced flavors or unknown consistencies of food”.
Sudden avoidance - Has your child ever loved a food one day, and hated it the next? Picky eating often involves a sudden, unexpected avoidance of a food or foods that were once accepted and liked. This could look like your teen loving ice cream one day, and claiming to hate it the next day.
How is picky eating different from an eating disorder for teenagers?
While it can become difficult to distinguish between the two, picking eating is not the same thing as an eating disorder! Eating disorders are “serious health conditions that affect both your physical and mental health” including problems in how you think about food, eating, weight and shape, and in your eating behaviors”. Picky eating can often be confused with two genres of eating disorders: ARFID and restrictive eating disorders.
What is ARFID?
ARFID, or Avoidant Restrictive Food Intake Disorder, was recently added to the DSM-5 and recognized as an eating disorder. ARFID involves extreme limitations in the amount of food and types of foods consumed due to the following:
Hypersensitivity to taste, texture, and smell
Lack of interest in food
A traumatic experience with food during childhood
Such as vomiting or choking
While those with ARFID do experience limited intake of food, ARFID doesn’t involve any stress about weight, body shape, or appearance.
What are restrictive eating disorders?
Food restrictive eating disorders also involve a limiting intake of one’s food and are classified as anorexia nervosa, bulimia nervosa, OSFED, orthorexia, and binge eating disorder. However, unlike ARFID, restrictive eating disorders are often associated with concern over body image, weight, and appearance. Food restriction in the context of restrictive eating disorders involves restriction of:
Entire food groups (i.e. sweets & desserts, fruits, meat, dairy, etc.)
Types of foods (i.e. pasta, bread, milk, cheese, etc.)
Entire macronutrient groups (i.e. carbohydrates, protein, or fats)
Portion sizes
The frequency of eating
How are ARFID and restrictive eating disorders different from picky eating for teens?
Those with ARFID often struggle with an underlying issue that causes a severe limited intake of food. Most often these underlying issues are sensory characteristics, difficulty swallowing and/or chewing, or a traumatic experience with food. Sometimes, individuals with ARFID can even have an underlying medical condition that causes them to limit their intake of food to avoid symptoms, such as constipation or irritable bowl syndrome (IBS).
Additionally, individuals with ARFID often have certain neurological conditions that affect their eating behaviors, such as ADHD, intellectual disabilities, and autism spectrum conditions. While this is not always the case, there is significant research supporting strong correlations between ARFID and neurological conditions.
As mentioned before, food restriction involves severe limited intake of food due to individuals avoiding entire food groups, types of foods, portion sizes, and frequency of eating. While those that are picky eaters avoid certain foods, they often don’t restrict entire groups of foods (like sweets) or entire macronutrient groups (like carbohydrates or fat).
Picky eaters usually only avoid certain specific foods. For example, a picky eater may not like cake, but that doesn’t necessarily mean that they avoid eating all desserts. Additionally, picky eaters don’t reduce portion sizes or the frequency of eating. Because of this, picky eaters are rarely at risk for malnutrition or failure to grow.
Individuals with ARFID and restrictive eating disorders experience severe distress and anxiety, and often have such a severe limited intake that they are at risk for malnutrition, macronutrient and micronutrient deficiencies, and failure to grow properly especially for kids and teens
Unlike restrictive eating disorders, picky eaters don’t restrict or limit foods out of concern over weight or bodily appearance. Picky eating has very little to do with distress over body shape or size. Additionally, picky eating is a normal part of childhood development. Usually, picky eating ends during childhood. With that being said, picky eating can sometimes extend into late adolescence and adulthood, though it’s rare.
Click image to download the infographic that demonstrates the difference between picky eating and eating disorders in teens
What are the causes of picky eating in teenagers?
Common causes of picky eating in teens are:
Desire for control and autonomy
Taste and texture preferences
Sensory issues with textures or tastes
Taste buds change over time
Early childhood traumatic experiences
Such as tube-feeding, vomiting, choking
Anxiety around trying new things
Limited variety of foods during early childhood
Picky eating can be an indication that something is wrong! While picky eating is different from an eating disorder, picky eating can potentially tell you that your teenager is struggling with eating behaviors and patterns. For instance, if your teenager was not a picky eater during childhood, but recently has become more restrictive with their diet, this may be a sign of disordered eating or an eating disorder.
As a parent, you should be concerned that your child/teenager may have an eating disorder if:
Your child has sudden changes in weight - If you notice that your teen suddenly gains or loses weight this may be an indication that your teen’s eating patterns and behaviors have dramatically changed in some way and this should be taken seriously even if the child “looks healthy”.
Your child starts wearing big, loose, clothing that sometimes is inappraiote for the temperature and season. It’s very common when teenagers are engaged in the eating disorder to try to hide their body behind clothes. And, when a teenage body is undernourished, it gets colder fastest. For example, this can lead to things like long sleeves and pants in the summer time.
You notice your teen has sudden health issues - If your teen suddenly begins passing out, complaining of low energy, a delayed onset of their menstrual cycle or complete loss of their menstrual cycle, or becomes noticeably distressed at the dinner table, they may be suffering from an eating disorder. Teenagers will also begin to sleep a lot more than usual (teens do need more sleep than adults; however, if your teen has a sudden shift in sleep patterns, it likely means that something is going on). Sudden health issues can also mean that your teen has vitamin and/or mineral deficiencies due to not getting enough food or enough variety of foods.
Your teen begins expressing symptoms of other mental illnesses - Eating disorders often coexist with other mental illnesses and eating disorder often arise as a way for your teen to cope with the symptoms and experiences of dealing with a mental illness. If your teen begins exhibiting signs of anxiety, obsessive compulsive disorder, depression, post-traumatic stress disorder, it’s important to be aware of sign and symptoms of eating disorders too so that you’re able to address any issues as they arise.
Your teen begins restricting more than just certain types of foods - If your teen’s restriction extends beyond certain foods and they begin restricting portion sizes and their frequency of eating, it’s likely that your teen may be suffering with disordered eating or an eating disorder.
Others begin commenting on your teen’s food intake - Although unsolicited comments on another person’s food intake is never appropriate, these comments can sometimes give insight into your teen’s behavior outside of the home. Teens spend the majority of their time at school, sporting events, or other extracurricular activities, meaning they often eat outside of the home. This can make it challenging for parents to really observe their teen’s eating patterns and behaviors. If other’s begin to notice that your teen is restricting their food intake, showing signs of distress around eating, or simply avoiding eating all together, it may be worth noting and discussing with a professional.
What can you do as a parent if you suspect your kid, teen or adolescent’s picky eating might be an eating disorder?
1.Ask your child questions
It’s okay to get curious and ask your teen about their food preferences! Try to get a more information about the root causes of your teen’s picky eating. Ask your teen why they avoid these foods, what they dislike about these foods, or what they look for in foods that they enjoy and wish to eat. If your teen begins mentioning weight concerns or body image concerns, this is a sign that they are likely struggling with some disordered eating or an eating disorder. Teens often use the phrase “I like to be healthy” as a way to disguise their disordered eating behaviors. While it’s important as a parent to acknowledge your teen’s independence and desire to live a healthy lifestyle, it’s crucial to intervene when your child’s desire to eat healthy interferes with their nutrition status and daily life.
2. Obtain an eating disorder assessment
It’s never too early to try and help your teen, even if there is a chance that it really is just picky eating and not an eating disorder. In other words, it can’t hurt to get your teen assessed for an eating disorder. It only means that if your teen is struggling with an eating disorder, they receive help sooner! Even if it isn’t an eating disorder, you become more informed, educated, and you gain peace of mind. Reach out to a registered dietitian who specializes in eating disorders, or a doctor or mental health therapist.
3. Educate yourself
It’s important as a parent to learn about the signs and symptoms of eating disorders and disordered eating in teens so that you can easily recognize them in your home. If your teen does start showing signs of an eating disorder, you’ll have the knowledge to identify these behaviors and get your teen help.
4. Don’t use food as a reward or punishment
Though it’s a tempting and popular parenting strategy, using food as a reward or punishment can be incredibly harmful to kids and teens. For example, saying to your teen “If you eat ____, then you can have ____.” or “If you don’t ____, then you can’t eat ____.” This method disrupts your teen’s ability to sense hunger and fullness cues, and it doesn’t solve the main issue or concern at hand. If you want to help your teen and their eating behaviors, it’s best to avoid using food as a means of rewarding or punishing your teen.
When should you seek professional help for picky eating in teenagers?
It’s never too early for you to seek professional help for your teen! If you’re concerned that your teen’s picky eating may be an eating disorder, trust your parental instincts. You know your teenager best, and if you’re worried that something may be wrong, there most likely is something wrong. Trust your gut as a parent, and take action sooner rather than later!
It can be incredibly difficult as a parent to gauge your teen’s eating behaviors and distinguish between picky eating and an eating disorder. The good news is: you don’t have to do it alone!
You’ll also love…
Should You Be Eating In Moderation?
Dear Diet Culture: Stop Targeting Parents and Caregivers
5 Common Overlooked Signs of Eating Disorders
What Is Virtual Eating Disorder Nutrition Therapy and What Is It Like?