Help! My child is struggling with food, what can I do?
AUTHOR: HADLEY GORDON, MS, RDN, (SHE/HEr)
If you’ve found yourself here, it is likely that you are feeling overwhelmed and concerned. The fact that you are reading this indicates that you have what it takes to help your child through this difficult time with food. Rest assured that in this blog, you will find some tangible steps that you can take to provide the support that your child needs to find peace with food (and to allow you to take a deep breath that you very much deserve).
Why do children struggle with food?
Childhood and adolescence is a time of rapid growth and development, oftentimes involving many new experiences, life stressors, and increasing independence. There are many factors that can contribute to a child struggling with food, including the following:
Pressure to meet societal standards of beauty:
Children and adolescents are commonly focusing on one major challenge throughout this time: fitting in. Because we live in a society that idolizes thinness and “beauty”, children and adolescents experience a large amount of social pressure to look and act a certain way in order to make friends and be liked by others. Although they may be receiving positive messaging in the home regarding accepting who they truly are and appreciating diversity, society and social cues are oftentimes telling them something completely different.
Additionally, because childhood and adolescence is a time of rapid growth and development, your child is likely experiencing confusion around their body shifting and changing outside of their control. The general perspective that society has on food and nutrition is directly related to dieting and maintaining a body size and shape that is socially acceptable, which can lead to children or adolescents learning that they can use food to gain control over their changing body.
The desire to fit in is an innate part of being human that allows us to have community and protection through a sense of belonging. That said, manipulating our bodies is not the way to sustainably achieve that valid need to be accepted.
[Of note: if you suspect that your child is seeking love and/or attention through their apparent struggle with food, it is never a wrong move to ask them how you can make them feel more loved.
Using food (or the control of food) to cope with stressors:
Life stressors for children and adolescents require time, experience, and advice in order to be appropriately tolerated. If there is stress that a child is unable to tolerate, they may turn to controlling food intake or relying solely on the pleasure received from food to cope, absent of other coping mechanisms. While this commonly leads to a feeling of dysfunction within your child, it is also a sign that they are adapting to stressful situations in the only way they know how to at that point in time. Coping with food and desiring control are not “bad”, we just need more tools in the toolbox in order to maintain a positive quality of life.
Sensations or fears related to the eating process:
Has your child been a “picky” eater? Have they struggled with listening to their hunger and fullness? These may be signs that your child struggles with food based on their ability to process sensations appropriately.
Your child may even struggle with what is known as Avoidant Restrictive Food Intake Disorder, where they can not meet their energy requirements needed to grow appropriately due to the sensations brought on by eating and/or fear of complications arising from eating (ie. choking, nausea, vomiting, pain, or swallowing complications).
Other coexisting conditions that may be impacting their appetite or ability to eat:
Children can be dealing with an array of mental health or medical conditions that can impact their ability to nourish their bodies appropriately. Medications, digestive issues, co-existing conditions, trauma, and more can all contribute to your child’s struggle with food.
Signs that your child is struggling:
There is no single prototype for what “struggling with food” looks like in a child or adolescent. For some, it can be extremely obvious, and for others, it can be something that has been well hidden for a while. Some signs that your child may be struggling with food can include:
Sudden changes in their growth and development
Decrease in appetite or eating frequency
Increased concern regarding ingredients or nutritional facts of various foods
Refusing foods that they have previously enjoyed
Avoiding experiences involving food
Mood or sleep changes
Change in menstrual function
Tension around mealtimes
Increased judgment of their own meals or other people’s meals
Sudden change in school or sport performance
Sudden change in socialization habits
Change in pace of meals
Increased secrecy around meals or snacks (noticing food wrappers in their room or noticing foods rapidly disappearing from pantry/fridge/freezer)
Anything else that prompts you to think about if they are struggling with food
What can I do?
While there are tangible steps that can be taken to get your child the appropriate help that they need, the first step to supporting them is to trust that you are capable of doing so. You know your child better than any expert on nutrition, medicine, or psychology ever could -- and that is worth something. First, trust your intuition, give them love, and ask them questions compassionately about how you can best help them. Next, you can take a look at the following options and figure out what may be best for you and your child.
Note: not all of the following is necessary for addressing your child’s struggle with food. Sometimes children just need to be given familial support and a listening ear in order to move through their struggle with food in an impactful way. However, if you feel that your child needs more support, listen to your gut!
Be a role model and provide adequate and frequent nutrition in a calm and compassionate environment
While you are figuring out what is best for your child, you cannot go wrong with modeling a positive relationship with food for your child to observe in the home. Additionally, encouraging or providing adequate, balanced, satisfying, and nourishing meals and snacks for your child in an environment that is suitable for eating without stress is a great way to help your child nourish their body. If you struggle with doing either of these things, this indicates that a registered dietitian nutritionist would be beneficial for you and your child.
Find the right providers for your child’s needs:
If you find that your child would benefit from expert support, the following providers may be helpful. Note: finding providers that have experience with eating disorders is crucial in preventing further harmful messaging from well-meaning but uninformed providers.
Primary Care Physician (PCP): It is always recommended to have a PCP as a part of the care team for your child in order to monitor their vitals, labs, growth curve, medications, and medical concerns. Having a PCP that you trust is an excellent place to start with easing your concerns or finding out more information about what your child is experiencing.
Registered Dietitian Nutritionist (RDN): If your child is struggling with food in any way, for any reason, an RDN is an incredible place to start. RDNs can help empower you while assessing the appropriate path to take to help your child. RDNs can specialize in a multitude of domains, so it is important that you find one that is a good fit for your child’s needs and has experience working with children struggling with food.
Therapist: Your child is likely experiencing distress around their struggle with food. A therapist can be extremely supportive in helping your child cope with this distress as well as address any other mental health concerns that may be co-existing. Therapists can specialize in many different areas, including (but not limited to): art therapy, animal therapy, play therapy, and an array of psychological philosophies and modalities. It is important to find a therapist that specializes in an area that you feel would best help your child, while also making sure that they have experience with working with children struggling with food.
Occupational Therapist (OT): If your child’s struggle with food is likely related to sensory processing, an OT can be beneficial in helping your child move through the sensory experience in a positive way.
Psychiatrist: If your child is struggling with co-existing mental health concerns and would benefit from medical management of the symptoms, a psychiatrist can be really beneficial for prescribing medication that may make your child’s situation feel more manageable.
Schedule appointments and ask for financial support if needed
When scheduling appointments, it is important to ask questions about your specific needs in order to make sure that providers are the best fit for your child. Additionally, treatment can be expensive; however, many providers offer sliding scale fees, accept insurance, or can offer scholarships to reduce the financial burden. Medical complications of an unaddressed struggle with food can oftentimes exceed the cost to address it in the here and now. Consider your family’s circumstance, and do what you are able to. It is the system’s fault if treatment is inaccessible to you and your family -- not the fault of your family in any way.
Find support for yourself, too
Parents frequently feel the burden of their children’s hardships in equal measure. It is essential that you tend to your own needs and feel supported while you are figuring out how to be there for your child. You are never alone in your circumstance and there is always someone who can be there to remind you of that fact.