Eating behavior in children
Parents are often quite concerned when their children are being too picky around food. Does my child eat enough? Does he get enough nutrients? Approx. 20% of all children are said to be "picky eaters". Most of the time, they do not want to eat vegetables, and hardly any salad or fruits. Parents then often resort to promises ("you'll get some dessert after your meal") or to threats ("if you do not eat up, you can't go outside afterwards") in order to make their child finish their meal. Many children, however, do not eat much, and if they do, would rather choose French fries, pizza or white noodles.
Parents should not try to force their children to eat healthier food. Also, it would not be very helpful to prevent the child from eating sweets in order to make him eat other foods. It is also advisable not to exhort the child to eat less. Basically, parents decide what comes on the table, while the children decide what they will eat. A wide variety of food as well as the example set by the parents are often the most determining factor. Ideally, family mealtimes should take place in a relaxed and enjoyable ambiance. Also, sweets and dessert should not be served at every meal, but rather occasionally. Most children develop a taste for various foods when growing older, and the selective eating habits disappear with time. When a child is rather thin but developing normally according to his age and to the standard curve, the parents have no reason to be concerned about their child's eating behaviour. However, should they have a concern, it would be advisable to have the child be examined by his paediatrician, to make sure every thing is ok. Should a child eat only small quantities of fruits and vegetables, it wouldn't be very useful to let it escalate to a conflict, as the child would most likely refuse to comply. Instead, it would probably be more helpful to give the child a vitamin preparation and see how the situation evolves.
When the child develops an eating disorder
Should the child loose weight or not grow according to the age-based norm, it would be advisable to have him checked by the paediatrician. Is the child suffering from an eating disorder? Even before reaching puberty, some children develop so-called atypical eating disorders, in which the child does not eat sufficiently because of emotional issues. In such cases, a psychotherapeutic treatment is advisable. In some other cases, children may develop an anorexia disorder well before the beginning of puberty. Despite their young age, these children have already surrendered to the pressure of having to be thin. They refuse to eat in order not to put on weight. Here too, psychotherapy may prove to be necessary.
My child eats too much, what should I do?
Often, the parents are worried when their child eats too much. They are concerned that their child might become overweight. They try to put a stop to this urge to eat. In fact, parents should be concerned only if the child's weight is markedly above the age-related standard curve. A child whose parents try to make him eat less or lose weight might only get the impression that his parents find him actually too fat. This can have a detrimental effect on the child's self-esteem. Often, this will in fact trigger the opposite effect, and the child might even eat more. For the child to maintain a healthy weight, self-esteem is crucial. The child should also go out and meet other children, and have fun moving around or eating food. Most of the time, children do not put on excessive weight when they have a good self-esteem and move around sufficiently.
Whether or not the parents should intervene if they suspect their child to be dealing with eating disorders depends mostly on the weight progression. As long as the child's weight is normal and corresponds to his age standard, there is no reason to be concerned. Some few children develop eating disorders with serious weight loss even before the onset of puberty. In such a case, psychotherapy should be provided as soon as possible. If in doubt, the parents should ask for professional advise from the paediatrician.
Text: Dr. D. Pauli, chief physician, hospital director at Zurich Psychiatric University Clinic – 02/2018