Some eating problems are behavioral in nature. Parents of young children often are concerned that their children are picky eaters, not eating enough or eating too much, eating the wrong foods, refusing to eat certain foods (see also Avoidant/Restrictive Food Intake Disorder), or engaging in inappropriate mealtime behavior (such as sneaking food to a pet or throwing or intentionally dropping food).
Most eating problems do not last long enough to interfere with a child's growth and development. Growth charts can help doctors determine whether a child’s growth rate is of concern. Doctors usually communicate this information to the parents at well-child visits.
Parents should consult a doctor if their children
Repeatedly voice concerns about their appearance or weight
Lose weight or stop gaining weight at an age when growth and weight gain are expected
Begin to gain weight at a faster rate than usual
Eating disorders, such as anorexia nervosa and bulimia nervosa, typically do not occur until adolescence.
Body dysmorphic disorder is a preoccupation with one or more nonexistent or slight defects in appearance. This disorder can result in significant psychological distress and impairment, which may include unhealthy eating habits that the child may feel are needed to maintain a certain appearance. Body dysmorphic disorder usually begins during adolescence.
(See also Overview of Behavioral Problems in Children.)
Undereating
A decrease in appetite, caused by a slowing growth rate, is common among children around 1 year of age. However, an eating problem may develop if a parent or caregiver tries to coerce or force the child to eat or shows too much concern about the child's appetite or eating habits. The extra attention children with an eating problem receive when parents coax and threaten may inadvertently reward and thus reinforce the child's tendency to refuse eating. Some children may develop additional food behavior issues, such as holding food in their mouth, spitting out food, or vomiting.
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Overeating
Overeating is another problem caused by many factors.
Overeating can lead to childhood obesity. Once fat cells form, they do not go away. Thus, children with obesity are more likely than children of normal weight to be obese as adults.
Because childhood obesity can lead to adult obesity, it should be prevented or treated.
Binge eating
Binge eating can be a problem in children and adolescents when they frequently eat a lot of food in a short time period and feel like they cannot stop. Over time, this can lead to obesity. This behavior can also lead to serious feelings of distress and make it difficult for children to continue performing everyday activities normally and may be a sign of a mental health condition called an eating disorder.
Children who repeatedly binge eat large amounts of food should be evaluated by a doctor.
Promoting Healthy Mealtime Habits
To prevent problems that arise from undereating, overeating, or binge eating, parents can help children establish healthy mealtime habits. Decreasing the tension and negative emotions surrounding mealtimes may be helpful to achieve these healthy habits.
Emotional scenes can be avoided by providing food for the child and removing it 20 to 30 minutes later without positive or negative comments about the food or the child's eating behavior. The child should be allowed to choose from among the foods offered at mealtimes. Young children should be offered 3 meals and 2 to 3 snacks each day.
Mealtimes should be scheduled at a time when other family members are eating. Distractions, such as television, digital devices, or pets, should be avoided. Sitting at a table is encouraged. Children should participate in cleaning up any food that is thrown or intentionally dropped on the floor.
Using these techniques balances the child's appetite, amount of food eaten, and nutritional needs.
