Forcing “picky eaters” to eat may not improve their attitudes or behaviors toward food. According to a recent study, creating a positive, supportive, and flexible approach to eating is more helpful.1
Researchers from Duke Health surveyed more than 19,000 American adults who identified as “picking eaters” or had symptoms of Avoidant/Restrictive Food Intake Disorder (ARFID). They were asked to recall whether certain parent feeding strategies helped with their eating habits.
The study found that 39% of helpful themes reported by the participants related to a “positive emotional context” around food. About 40% of the responses deemed mentioned that creating a “structure around eating” was helpful.1
On the other hand, the participants said that being forced to eat or feeling like they made their parents angry by avoiding certain foods didn’t help.
While the survey examined a large sample, the respondents were 75% female, 25% male, and 89% White.
“Unfortunately, eating disorders have long been associated as an issue limited to adolescent, white girls,” Megan Carlson, PhD, a licensed clinical psychologist within the multidisciplinary Eating Disorders Center at Children’s Mercy Kansas City, told Verywell. “But as we continue to learn, EDs truly do not discriminate between body sizes, types, ethnicities, gender identities, or social-economic statuses.”
Carlson added that researchers “need to better understand the nuances in presentation among diverse populations to improve screening efforts, diagnosis, and treatment for youth who may look different from what we as a culture think of as a ‘typical’ ED patient.”
The researchers wanted to use the study results to find strategies that could help people with ARFID, a fairly new eating disorder diagnosis. The condition was first included in The American Psychiatric Association’s 2013 edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).2 The diagnosis is used when a person has an “eating disturbance” that causes them not to get all the nutrients that their body needs.
ARFID is not the same as other eating disorders like anorexia nervosa or bulimia nervosa because people with ARFID are typically not concerned with their weight or body image.3
Carlson said that people with ARFID often restrict their food intake based on sensory sensitivity or fear of negative experiences like choking or becoming ill.
Although picky eating can look different in various cultural contexts, she added, many parents fixate on how kids have strong preference for or aversion against specific foods rather than their relationship with food in general. It’s especially challenging for parents to navigate a busy schedule when there are other children in the household.
But encouraging kids to establish a healthy diet is similar to potty training, Carlson suggested. “Feeding and eating is often a behavior that we can address with consistent expectations, positive reinforcement, and a good deal of patience,” she said.
Is Picky Eating Always a Concern?
Many toddlers display some signs of picky eating as they try to assert some form of independence, 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.
Signs of food avoidance at an early age aren’t always concerning, but strong food preferences can become a concern if they cause malnutrition, developmental delays, or mealtime stress, Reed told Verywell.
She recommended the use of the Satter’s Division of Responsibility in Feeding (sDOR), a tool that helps parents create a structure around feeding.4 The model suggests feeding a baby on demand to establish a more regular pattern before transitioning to a “meals-plus-snacks routine.”
While parents might not always see immediate changes in their child’s eating patterns, the researchers wrote, they can think of supportive feeding experiences “as planting seeds that will help build positive food memories, increase pleasure around eating, and decrease social isolation.”1