Refusing all vegetables. Demanding hamburgers at every meal. Insisting on chocolate ice cream only. Avoiding crunchy foods. Complaining that green food tastes terrible. Toddlers and young children are notoriously picky eaters, and for some, this behavior continues into adolescence. But when is being a picky eater actually a sign of a teen eating disorder?
Fortunately, most kids grow out of their resistance to certain foods. For others, though, picky eating can turn into something more serious—disordered eating or a full-blown eating disorder that can affect their health and development. Understanding the difference between the two is important for parents of teenagers whose fussy eating has become noticeably restrictive.
Key Takeaways
- Picky eating is a common way that children assert their growing independence.
- If your child’s picky eating interferes with their daily life or negatively affects their growth, health, or well-being, they could be suffering from a restrictive eating disorder.
- Teens with restrictive eating disorders may limit their food intake because they have body image or mental health issues, or because they’re highly sensitive to food’s sensory qualities.
- Warning signs of restrictive eating disorders include sudden weight loss, restricting portion sizes, avoiding social events with food, and becoming anxious at mealtimes.
Why Are Kids Picky Eaters?
After 12 months of age, children don’t need as much food as they did when they were babies because their growth rate slows down. In addition, when they grow into toddlers, they strive for greater autonomy. One way to assert their independence is by expressing preferences—and food preferences are an obvious target.
Picky eating is therefore a normal phase of childhood development. It usually occurs between 18 months and 6 years old, though it can continue beyond this time frame. While it can make family meals frustrating, parents of young picky eaters shouldn’t worry too much. They usually outgrow it.
What Does Picky Eating Look Like for Kids?
Picky eating can look different from one kid to another. Some kids are mildly picky; others will only eat a few select foods. Extreme picky eaters might only have 25 foods or fewer in their diet. Others struggle with food neophobia, the fear of new foods. They might avoid tasting anything that looks or smells unfamiliar. Their reactions can include gagging, becoming anxious, or even leaving the table.
Some kids go on what’s known as food jags. They become hyper-focused on one or two specific foods at the exclusion of all others for days or weeks at a time. Alternatively, they may suddenly avoid foods they once enjoyed. They might love sweet potatoes one day, declare they hate them the next, avoid them for a week, and then begin eating them again. However, if picky eating habits continue into adolescence and also feel alarming, they could be signs of an eating disorder.
What’s the Difference Between Picky Eating and Disordered Eating?
Picky eating behaviors are less common in adolescence, but they can occur. Some teens are simply fussier about food than others. Picky eaters tend to eat specific foods, but they don’t usually avoid entire food groups. They may not eat asparagus, but that doesn’t mean they’ll refuse all vegetables. Furthermore, picky eaters don’t restrict portion sizes or how frequently they eat.
On the other hand, disordered eating can include avoiding certain food groups, restricting food intake, and keeping close track of food and calorie intake. Teens with disordered eating exhibit the same symptoms and behaviors associated with eating disorders. But they aren’t severe or frequent enough to meet criteria for a full-fledged eating disorder.
Disordered eating is very common. One study looked at data from 63,000 children and adolescents between 6 and 18 years old, from 16 countries. Researchers found that 22 percent of kids and teens exhibited evidence of disordered eating. Not surprisingly, those numbers were higher among girls. However, the prevalence of disordered eating doesn’t mean this behavior is healthy or safe. Without treatment, disordered eating can progress into a diagnosable eating disorder.
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How Is Being a Picky Eater Different from an Eating Disorder?
When picky eating is extreme enough that it interferes with a teen’s daily life or has a detrimental effect on their overall health, they may be suffering from a restrictive eating disorder. A restrictive eating disorder is a mental health condition that can have serious consequences on the body and the mind. Some teenagers with restrictive eating disorders may seem like picky eaters, even though they’re suffering from something more serious.
What Is a Restrictive Eating Disorder?
Teenagers with restrictive eating disorders limit their food intake. Not every teen who suffers from a restrictive eating is trying to be thinner. Still, body image issues are often at the heart of restrictive eating disorders such as anorexia nervosa and bulimia nervosa.
Adolescents with restrictive eating disorders might refuse to eat certain types of food like bread or cheese. They may abstain from an entire food group, such as sweets or dairy. Or they may cut an entire nutrient group from their diet, like carbohydrates, protein, or fats. In addition, teens with restrictive eating disorders often limit portion sizes, control how frequently they eat, and may overexercise—all in an effort to attain or maintain a specific weight or appearance. As a result, they may experience malnutrition and have difficulty functioning in daily life.
What Is ARFID?
ARFID stands for Avoidant/Restrictive Food Intake Disorder. It’s recognized by the DSM-5 as an eating disorder. While it predominantly affects children, it can also occur in adolescents and adults. One study found that just under 2 percent of young people between the ages of 11 and 19 met the criteria for ARFID.
Individuals who suffer from ARFID demonstrate more than picky eating behaviors. They severely restrict their food intake, but not because they’re concerned about their weight, body shape, or overall appearance. Instead, they are hypersensitive to food’s sensory characteristics, and thus may refuse to eat foods of a particular color, scent, or texture. Difficulty with swallowing or chewing may cause them to confine their diet to foods with a soft consistency. At mealtimes, they may appear disinterested in food, be reluctant to eat with others, or simply say they’re full.
ARFID is characterized by significant weight loss, failure to achieve optimal weight, stunted growth, nutritional deficiency, need for supplementation, and/or negative psychosocial effects.
What Causes Restrictive Eating Disorders?
The precise cause of restrictive eating disorders isn’t fully understood. Experts suggest a combination of biological, behavioral, psychological, social, genetic, and environmental factors are at play. While ARFID is more common among children and young teens, anorexia and bulimia are more likely to occur during adolescence or young adulthood. Here are some of the causes of restrictive eating disorders:
External Stressors
For example, research shows that the number of teens with eating disorders doubled during the stress of the COVID-19 pandemic. Another study found that young people with chronic health conditions are at higher risk for all types of eating disorders. Kids or teens who’ve been bullied because of their weight may also develop eating disorders.
Neurodiversity
People with ARFID may have neurological conditions that lead to avoidant/restrictive food intake. Teens with autism spectrum disorder and ADHD are more likely to experience ARFID.
Mental Health Disorders
ARFID often co-occurs with obsessive-compulsive disorder and other anxiety disorders, as well as other mental health issues. In one study, 45 percent of the 74 children and adolescents in the sample met criteria for a current psychiatric diagnosis.
Traumatic Food-Related Experiences
Some children or teens are severely impacted by a traumatic experience in childhood in which food caused them or someone they care about to choke or vomit violently. Kids who’ve experienced this type of trauma may be reticent to eat almost anything.
A Tendency Toward Perfectionism
Teens with anorexia or bulimia may be unusually restrictive about their food intake because their perfectionism extends to trying to look “perfect.” Hence, they struggle to meet society’s idea of an ideal body type.
Family History of Eating Disorders
Teens are more likely to develop an eating disorder if they have a family member who struggles with eating or body image issues. According to some research, genetic factors determine 40 to 60 percent of a person’s vulnerability to developing an eating disorder.
10 Eating Disorder Warning Signs
Not everyone who’s suffering from an eating disorder exhibits the same warning signs. If you’re concerned your child’s picky eating could be a restrictive eating disorder, look for the following signs in your teenager:
- Sudden weight loss
- Skipping meals, restricting portion sizes, or saying they’re full after just a few mouthfuls
- Talking about food, weight, and body shape frequently
- Avoiding social events with food
- Exercising excessively
- Developing nutritional deficiencies, such as anemia
- Eating the same meals repeatedly
- Menstrual irregularities
- Extreme sensitivity to the texture, smell, or temperature of certain foods
- Becoming anxious at mealtimes
What Should You Do if You Think Your Teen has a Restrictive Eating Disorder?
Even though broaching the topic of a restrictive eating disorder with your teen may feel awkward, it’s important not to shy away from the subject. If you think your teen could really suffering from one, addressing it is important. Some strategies include:
Be Prepared for the Conversation
Learn as much as you can about restrictive eating disorders before you initiate a dialogue with your teen. And think about what you want to say before you say it. If you rehearse, you’ll feel less anxious. Also, don’t bring up the topic at mealtimes or when your child is emotional. Approach your teen when they’re relaxed.
Ask Open-Ended Questions
If you hop into lecture mode about the dangers of eating disorders, your teen is likely to shut down. Instead, ask open-ended questions about their feelings. “How have you been feeling lately?” or “How did the party go?” might lead your teen to open up. Then you’ll have a more natural segue to talk about their eating behaviors.
Avoid Shaming
Accusatory language gets you nowhere. Saying, “You’re not eating enough” or “You’re looking too thin” only makes your child defensive. Instead, remind them that there’s no shame in admitting that they’re struggling. Explain that eating disorders are common and there are ways to get help.
Express Compassion
While your goal is to support your teen, refrain from jumping into fixing mode right away. What your child needs most is to know you feel for them. Let them know you’ll do whatever you can to help. Listen to what they say. Explain that adolescence is a challenging time. Tell them you care deeply about their well-being. Overall, create a safe container in which they feel free to share what’s going on.
Get an Eating Disorder Assessment
If your conversation leads you to believe your child is more than just a picky eater, reach out to a registered dietitian, mental health counselor, or doctor to schedule a formal assessment. A professional can help you understand what’s going on and take the next steps.
Eating Disorder and Mental Health Treatment at Newport Academy
At Newport Academy, we realize that each adolescent is unique. With that in mind, we tailor our eating disorder treatment plans to meet each teen’s individual needs.
Our MDs and nurses provide medical and psychiatric care to ensure their health and safety. Registered dietitians check in with teens regularly and facilitate weekly nutrition groups. And we address co-occurring mental health issues with individual and group therapy, using modalities including Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, and Acceptance and Commitment Therapy. We also offer experiential modalities like kayaking, hiking, yoga, and meditation to enable teens to get in touch with their bodies and boost their self-image.
Because we see the family as central component of eating disorder treatment, we also utilize Attachment-Based Family Therapy (ABFT) to help repair fractures in the family system. As families heal longstanding wounds and rebuild trust, they’re able to connect in deeper ways that serve the recovery process—not just for the teen but for everyone.
Contact us today to find out how we can help your teen develop a healthy relationship with food, with others—and most of all—with themselves.
Frequently Asked Questions
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