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Wednesday, August 5, 2015

Is Picky Eating A Sign of Anxiety, ADHD, Depression, or Family Problems?

Forbes published an article yesterday: http://www.forbes.com/sites/johnmcquaid/2015/08/03/study-ties-picky-eating-in-preschoolers-to-anxiety-depression-adhd-and-family-problems/av

The way the Forbes article is written is misleading, and bound to create anxiety in some parents. The article says that picky eating "...can be a threat to health and development. And now, a new study says, it is linked to significant psychological problems including anxiety, depression, and attention-deficit/hyperactivity disorder."

For starters, "Picky eating" IS NOT A CAUSE of any mental health problem, and it is NOT A SYMPTOM of any mental health problem. But the article will probably cause some unnecessary anxiety for many parents. Readers should not confuse picky eating with other dietary changes related to various mental health problems. For example, when people are mildly depressed, they may eat more, and when they are severely depressed, they may lose their appetite; people with anxiety problems may lose their appetite at one point in the day and get it back later; people with a fear of getting fat (anorexia) may show all kinds of inconsistent restrictive eating patterns until it becomes severe; people with bulimia may sometimes or always be in a binge-purge pattern. These problems should not be confused with picky eating in children. If you are concerned about childhood depression or anxiety, please have your child evaluated by a licensed mental health specialist who has experience with children.
It's very important for children to learn to associate eating with feeling calm.
Parents should be learn to have realistic expectations and, in most cases,
parents should avoid arguing or lecturing children during meals.

Back to the article: according to Forbes, in this new study, 6 of the 917 children studied presented with "severe selective eating." But the definition of picky or selective eating may be problematic. It's not clear from the article how thoroughly eating habits were observed and explored. For example, did these six children have health exams, and if so, were they found to have health problems that were directly related to picky eating (for example, failure to thrive, mineral deficiencies, or other health problems)? What was the eating environment like? How long had the problem been going on? Was this just a parental report of the child's eating habits? There are many variables, and they weren't all made clear.

Picky eating probably needs to be addressed if there are health problems directly related to it. If there are none, then it probably should not be considered a clinical matter in and of itself. It is certainly worthwhile to have your child evaluated by a licensed mental health provider if you think that their eating habits are problematic; however, trying to compare you child to other children might not be the best way to determine what is normal, since every child is unique. There might be an underlying emotional problem or other factor that can be addressed to improve their eating habits.

Child behavior is complicated by many factors: parental actions and reactions, calorie needs related to childhood growth patterns, emotional reactions of children to parental interventions, a child's particular temperament, and many other trait and environmental factors. The behavior problem of picky eating will probably wax and wane for many reasons, and it may change from day to day, or even within the same day. Some school age children are too anxious to eat in front of other kids, while others may avoid breakfast and lunch out of fear of getting stomach aches in school. Stomach aches are a common side effect of anxiety, but many a time they are misinterpreted by children as a sign that they could vomit or have diarrhea.

If your child has signs of anxiety, depression, or other problems, or if you find that you are often fighting with your children about eating, it is in your best interest and theirs to seek help from a licensed mental health practitioner who specializes in child developmental and behavioral problems. Starting with a psychiatrist will probably not be necessary, since they tend to be too quick to diagnose children with serious mental health problems such as ADHD and bipolar disorder, both of which are grossly over-diagnosed and over-treated. Because of this, psychiatrists often prescribe unnecessary medications.

A behavioral specialist can evaluate the situation using behavioral theory, which is a well-developed and very effective way to analyze childhood behavioral problems and figure out where, when, and how to make changes. Too often, anxious parents will yell at their children to eat more food out of concern that they aren't eating enough. Many parents will see a child's picky eating as defiance and yell or punish the child. Although some kids will respond to these reactions and cooperate with their parents' directives, some children's eating habits will become worse.

Most children that I have worked with have had some problems with their diet. These problems are often around textures or certain types of foods that most kids have difficulty with, such as veggies. There are few good options for getting kids to eat healthfully once they have developed poor eating habits, so, like most problems, prevention is the best approach. New and expecting parents can limit or exclude refined sugars from a child's diet until at least age two, while at the same time, feed the child vegetables from a very young age. I think the Super Baby Food book by Ruth Yaron may be the best one out there when it comes to ideas for preparing health foods for babies in order to shape their palette. Yaron also published a Super Baby Food cookbook, and has a website called superbabyfood.com.





Mental Health Advice Disclaimer: The information included in this post and blog is for educational purposes only. It is not intended nor implied to be a substitute for professional mental health treatment or medical advice. The reader should always consult his or her mental health provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a mental health or medical condition or treatment plan. Reading the information on this website does not create a therapist-patient relationship.


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