Childhood Picky Eating Linked To Depression and Anxiety

Having a child in the house who is a picky eater can be frustrating, but new research suggests it can also have serious implications for your child’s health. A new study published in journal Pediatrics shows moderate to severe picky eating habits may also be tied to serious childhood mental health issues such as depression and anxiety.

Researchers from Duke Medicine found over 20 percent of 3,433 children between the ages of 2 and 6 were selective eaters. Of those, 18 percent were classified as ‘moderately’ picky, and another 3 percent were classified as ‘severely’ selective. According to the researchers, severe selective eating is characterized by being so restrictive their food intake limits their ability to eat with others.

“The question for many parents and physicians is: when is picky eating truly a problem?” said lead author Nancy Zucker, Ph.D., director of the Duke Center for Eating Disorders. “The children we’re talking about are not just misbehaving kids who refuse to eat their broccoli.”

Most notably, the study showed that both children with moderate or severe selective eating habits were significantly more likely to show symptoms of anxiety and other mental conditions. The study also noted that children who had selective eating behaviors were almost twice as likely to have increased symptoms of generalized anxiety at follow-up intervals.

“These are children whose eating has become so limited or selective that it’s starting to cause problems,” Zucker said. “Impairment can take many different forms. It can affect the child’s health, growth, social functioning, and the parent-child relationship. The child can feel like no one believes them, and parents can feel blamed for the problem.”

The study also linked moderate and severe selective eating with increased symptomology for depression, social anxiety, and generalized anxiety.

Interestingly, the study did not link moderate picky eating with an increased rate of formal psychiatric diagnosis, it did show children with severe selective eating were more than twice as likely to be diagnosed with depression.

Due to the findings, the researchers say moderate and severe selective eating can be diagnosed as a formal eating disorder of its own. The team says the childhood behavior meets the criteria for a disorder called Avoidant/Restrictive Food Intake Disorder (ARFID), a diagnosis recently added to the Diagnostic and Statistical Manual of Mental Disorders (DSM5).

The report also indicates that picky eating habits can be a source of conflict in the home that rarely leads to the child eating. Zucker says new tools are needed to better address the issue.

“There’s no question that not all children go on to have chronic selective eating in adulthood,” Zucker said. “But because these children are seeing impairment in their health and well-being now, we need to start developing ways to help these parents and doctors know when and how to intervene.”

Zucker also gave several theories for why picky eating may develop in some children. He says some children may potentially have heightened senses, which make some smells, textures, and tastes overwhelming and unappealing, leading to aversion. It is also possible some children associate some foods with bad experiences, which would contribute to anxiety when trying new foods or being forced to eat the offending food again.

“What’s hard for physicians is that they don’t really have data to help predict which children will age out of the problem and which children won’t, and so they’re trying to do the best they can with limited information and interventions,” Zucker said.

If the cause of selective eating is tied to anxiety or bad previous experiences, therapy may help demystify or decrease the anxiety through exposure. However, traditional methods do not exist for addressing children with sensory sensitivities.

Zucker does find one upside to the findings, though. Since picky eating is an easily identifiable behavior, it could be a good tool for finding children who may benefit from anxiety or depression screening.

“It’s a good way to get high-risk children into interventions, especially if the parents are asking for help,” he explained.

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