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Key points to remember

  • A new study by researchers at Duke was one of the first to identify strategies parents can use to help their children with avoidant / restrictive food intake disorder (ARFID).
  • Researchers surveyed over 19,000 “picky eaters” and found that positive, flexible, and structured eating strategies were more helpful than being forced to eat.
  • The majority of study participants were Caucasian and female. Future studies are needed to determine if the results would be consistent in a more diverse population.

Forcing “picky eaters” to eat may not improve their attitudes or behaviors towards food. According to a recent study, it is more useful to create a positive, supportive and flexible approach to eating.

Researchers at Duke Health interviewed more than 19,000 American adults who identified themselves as “pick eaters” or who had symptoms of avoidant / restrictive eating disorder (ARFID). They were asked to remember if certain parenting strategies helped them with their eating habits.

The study found that 39% of the useful themes reported by participants were related to a “positive emotional context” around food. About 40% of the judged responses mentioned that creating a “structure around food” was helpful.

On the other hand, participants said that being forced to eat or feeling like angering their parents by avoiding certain foods did not help.

While the survey examined a large sample, the respondents were 75% women, 25% men and 89% white.

“Unfortunately, eating disorders have long been associated with a problem confined to white adolescent girls,” Megan Carlson, PhD, a registered clinical psychologist at the Multidisciplinary Center for Eating Disorders at Children’s Mercy Kansas City, told Verywell. . “But as we continue to learn, emergencies really don’t distinguish between sizes, types, ethnicities, gender identities or socio-economic status.”

Carlson added that researchers “need to better understand the nuances of presentation among diverse populations to improve efforts to screen, diagnose and treat young people who may appear different from what we as a culture see as a patient.” ‘typical’ in emergencies.

Disorderly eating

The researchers wanted to use the study’s results to find strategies that might help people with ARFID, a fairly recent eating disorder diagnosis. The disease was first included in the 2013 edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of the American Psychiatric Association. Diagnosis is used when a person has an “eating disorder” that prevents them from getting all the nutrients their body needs.

ARFID is not the same as other eating disorders like anorexia nervosa or bulimia nervosa because people with ARFID usually don’t care about their weight or body image.

Carlson said people with ARFID often restrict their food intake based on sensory sensitivity or fear of negative experiences like choking or illness.

Although difficult eating may look different in various cultural contexts, she added, many parents focus on how children have a strong preference or aversion to specific foods rather than their relationship to food. in general. It is especially difficult for parents to navigate a busy schedule when there are other children in the household.

But encouraging children to eat healthy is similar to toilet training, Carlson suggested. “Feeding and eating is often a behavior that we can respond to with consistent expectations, positive reinforcement, and a healthy dose of patience,” she said.

Is picky eating still a concern?

According to Amy Reed, MS, RD, a pediatric dietitian at Cincinnati Children’s Hospital Medical Center and spokesperson for the Academy of Nutrition and Dietetics, many toddlers show signs of difficult feeding as they try to assert some form of independence.

Signs of food avoidance at an early age aren’t always a cause for concern, but strong food preferences can become a concern if they cause malnutrition, developmental delays or stress around feeding time, Reed told Verywell.

She recommended the use of the Food Responsibility Division of Satter (sDOR), a tool that helps parents build structure around food. The model suggests feeding a baby on demand to establish a more regular pattern before switching to a “meal plus snack routine”.

Although parents do not always see immediate changes in their child’s eating habits, the researchers wrote, they may view supportive feeding experiences “like planting seeds that will help create positive food memories. increase the pleasure of eating and reduce social isolation “.

What this means for you

If you or a loved one has symptoms of ARFID, contact the National Eating Disorders Association (NEDA). Visit or text or call (800) 931-2237 to connect with a volunteer who can offer support. The NEDA website also includes resources specifically for the BIPOC community.