What a Case of Picky Eating Might Really Mean

Have a child who will only eat mac and cheese and white bread? You may want to read this.  

picky-eater-girl
Photo by GI/Jamie Grill/Getty Images

If your preschooler will only eat the same three meals every day, he or she could be more than just a picky eater. According to a new study from the Duke University Medical Center, picky eating may signal higher risk for anxiety and depression.

For the study, published in the August issue of Pediatrics, researchers screened 3,433 children between the ages of two and six for selective eating habits (a.k.a. picky eating). Of those screened, more than 20 percent had selective eating habits. And of those, 18 percent were “moderately picky” and three percent were severely selective to the point where it interfered with their ability to eat with others. Though those on the autism spectrum can be especially sensitive to tastes, smells and sights, they were excluded from the study.

Children with selective eating behaviors were nearly twice as likely to have increased symptoms of generalized anxiety at follow-up interviews during the study. Those with moderate and severe selective eating had significantly elevated symptoms of depression and social anxiety, too. But don’t panic: A case of picky eating doesn’t necessarily mean there’s a medical problem—the majority of standard picky eaters didn’t have problems in their health and well-being.

Yet some children in the study were so selective that their parents acted as short-order cooks or brought prepared meals when dining out at restaurants. These eaters met the criteria for a newly diagnosed eating disorder called Avoidant/Restrictive Food Intake Disorder (ARFID). Though the diagnosis is a new name to an old problem, it carries with it a different approach—tying it not only to anxiety, but also to sensory overload from textures, smells, and tastes.

“Once parents have a diagnosis that’s recognized by the medical and mental health community, they have something to hold onto while communicating with their pediatrician, and insurance,” Nancy Zucker, Ph.D., lead study author and director of the Duke Center for Eating Disorders, says.

Zucker recommends changing the framework for parents dealing with children with selective eating habits. Rather than focusing on whether a child likes or dislikes certain foods, she suggests helping that child be a “food detective.” Having them investigate a new food with their “sensory superpowers” helps them explore their senses and re-contextualize disgust in the service of health. “It’s like a parent who has to change a lot of dirty diapers,” she says. “They’re not thinking about it being gross or not gross, they’re thinking about what they need to do for the child they love.”