Anonymous
Post 03/24/2016 07:09     Subject: Re:When does picky eating become abnormal or a eating disorder? 13yo
DD is picky, now she doesn't want to take vitamins! Sometimes she acts like I am poisoning her, unbelievable. During summer I am going to back off on asking her to eat breakfast but for school, I think it's important to eat breakfast. DD is 8, I hear all the girls talking about weight.
Anonymous
Post 03/23/2016 23:36     Subject: Re:When does picky eating become abnormal or a eating disorder? 13yo
Anonymous wrote:
Anonymous wrote:
Also, I understand that anorexia/bulimia/other serious eating disorders are a big deal and that picky eating isn't comparable to that. I didn't mean to make light of serious eating disorders by using the term (although it appears that in fact, selective eating is something that is considered by eating disorder specialists, so maybe not completely off-base?).



There's a range. Picky eating isn't considered an eating disorder. Extreme selective eating to the extent that the child isn't getting enough calories to gain and grow, or nutrition is otherwise impacted (and can't be remedied by a simple vitamin/mineral supplement) could be an eating disorder called ARFID (Avoidant Restrictive Food Intake Disorder). ARFID is a very serious eating disorder, as serious as anorexia nervosa. It can have similar bad outcomes and can last longer and be harder to treat.

But if your step son is able to get enough calories to maintain weight I don't think it rises to the level of being diagnosed as ARFID. Especially because it sounds like he's eating a good bit of meat. Now, if he ever drops the meat, you might find over time his pickiness solidifies even more. In my experience often kids get worse and worse when the go vegetarian. (Not that all vegetarian kids turn out to have problems eating -- not at all! But if you are a picky eater AND a vegan/vegetarian you are going to have a really tough time getting all your necessary nutrients in).


It's really not that hard. I've been a vegetarian since I was 4 years old and I've always managed to get enough nutrients in without that much planning.
It's been 40 years and I've had few problems and have plenty of energy for work and regular physical exercise. Sometimes Americans overestimate what they need to eat versus what they are used to eating.
Throw in some nuts, beans and good fats (avocado, cheese, ) every so often and you're doing ok.

Though for someone like me it's too bad all of the milk is pasteurized as that kills all of the B vitamins that naturally occur in milk.
Anonymous
Post 03/23/2016 23:30     Subject: When does picky eating become abnormal or a eating disorder? 13yo
Anonymous wrote:Hey, I wanted to get some feedback about my SS who is 13yo. He lives with his mom and visits us regularly. We don't have any other kids and while I don't think his eating is normal, maybe I don't understand the range of normal. We had assumed he would grow out of his picky eating but there hasn't been very significant improvement over the 7 years I've known him. And BTW,I am aware of the limits of my step-mom role -- basically I just advise/influence my H.

The kid eats approx 20 items in limited combinations.

Fruits: NONE
Vegetables: ONLY the following- Green beans, lima beans, corn, peas, tomato sauce/ketchup.
Dairy: Cheese and ice cream, milk only if it is flavored chocolate (NO yogurt, etc)
Meat: Mainly ground beef. Chicken in chicken nugget format ONLY. Will try slices of steak and pork, but won't eat much of that. NO eggs. NO fish/seafood. Nothing else.
Carbs: White flour stuff (bread, tortillas, pancakes) pasta, rice, oatmeal, popcorn, chips.

So anyway, obviously this limits what I can make for him when he's with us -- usually tacos, meatballs, cheeseburgers. I used to be more motivated about hiding veggies (making veg puree and putting it in the meatballs, for example) or making him try new things. BTW, "trying new things" isn't as exciting as it sounds. It seemed like a MAJOR WIN to us when he started liking pizza! Even though he was eating bread, tomato sauce and cheese already, he did not like it in combination until a couple years ago. And of course, no toppings.

I think stuff like: If he likes green beans and peas, he should def like edamame or sugar snap peas! But I give it a try and he will not even touch/look at the unfamiliar veg.

I find this frustrating and depressing ... Food to me is so much about family and relationships and love and special occasions, and it makes me sad we can never share food with him like that. Making dinner is a pain because my H and I don't want to eat cheeseburgers and meatballs, but we want to eat together so I do it anyway, or make different meals at the same time. Going to restaurants and ordering is often embarrassing to me (Please make sure no lettuce, pickle or tomato are on the plate. Please make sure no green herbs are sprinkled on the fries. Oh no. There are visible pieces of onion in this).

I used to spend more time on all this, but I got worn down! I keep organic mac and cheese dinners in the freezer and that will always do, plus I make sure he has one of the acceptable vegs on his plate for dinner every day. And there's only so much we can do over a summer or a week's break or a weekend. Sometimes there is some progress, like he ate and liked a bite of steak, but by the time he is back with us, maybe he has reverted and doesn't want to try it again. And we don't want to push it all the time, because we just want to have a happy time together.

H's relationship with the mom is bad. Any inquiries get turned around into accusations and big to-do's, so H doesn't bring up anything unless he's really serious about it and ready to deal with crazy-making, life-upending, time-sucking drama. The mom seems to have low standards. She sends him to school with Lunchables most days, and gives him PopTarts or frozen waffles for breakfast. To me this is disgusting and ignorant (but I understand that it doesn't actually rise to the level of neglect or abuse).

The upside is: He is healthy and growing, his size is good for his age, he gets lots of exercise, his doctor appointments check out fine. We don't know if his mom thinks that food is an issue at this point. (I can say that I believe she thinks of him as being much younger than he is. For example, we find she is administering to him OTC medicines intended for toddlers when he is a teenager, and she seems to miss age-appropriate stuff like his need to have a basic understanding about sex. So maybe she thinks he is like 6yo and so picky eating is normal)

Also, I have a couple friends who have told me that they had extreme picky eating into adulthood, and they are fine. Although I have doubts that these friends' diets were as limited as SS's.

Thanks for thoughts or tips!




Damn, lady - the kid eats enough stuff, he is not 'disordered'. Do you really have to write a huge book about it?
You're into food , he's not. Just make him comfortable when he's with you and stop overanslyzing EVERYTHING under the sun.
If you don't want to feel like a short order cook teach him to make some simple meals himself to enjoy at the same time you are eating some complicated creation.

Pop tarts and Lunchables is not 'ignorant'. And frankly a 13 year old boy is not a baby so I assume he's there for some of the grocery shopping and he picks these things.
Anonymous
Post 03/23/2016 22:16     Subject: Re:When does picky eating become abnormal or a eating disorder? 13yo
Anonymous wrote:
Also, I understand that anorexia/bulimia/other serious eating disorders are a big deal and that picky eating isn't comparable to that. I didn't mean to make light of serious eating disorders by using the term (although it appears that in fact, selective eating is something that is considered by eating disorder specialists, so maybe not completely off-base?).



There's a range. Picky eating isn't considered an eating disorder. Extreme selective eating to the extent that the child isn't getting enough calories to gain and grow, or nutrition is otherwise impacted (and can't be remedied by a simple vitamin/mineral supplement) could be an eating disorder called ARFID (Avoidant Restrictive Food Intake Disorder). ARFID is a very serious eating disorder, as serious as anorexia nervosa. It can have similar bad outcomes and can last longer and be harder to treat.

But if your step son is able to get enough calories to maintain weight I don't think it rises to the level of being diagnosed as ARFID. Especially because it sounds like he's eating a good bit of meat. Now, if he ever drops the meat, you might find over time his pickiness solidifies even more. In my experience often kids get worse and worse when the go vegetarian. (Not that all vegetarian kids turn out to have problems eating -- not at all! But if you are a picky eater AND a vegan/vegetarian you are going to have a really tough time getting all your necessary nutrients in).
Anonymous
Post 03/23/2016 19:33     Subject: Re:When does picky eating become abnormal or a eating disorder? 13yo
Anonymous wrote:
Anonymous wrote:Lol that's certainly not an eating disorder. It's a teenager. Who cares. Let it go. It's not THAT bad.


+1


However, not allowing lettuce or pickles on the plate... That is abnormal at 13.

OP. I've learned to do things like cook one meal, but parts served separately, so the eggplant doesn't get tossed into the pasta until we are each at our place. kid can take a pass on eggplant. I do wonder if this kid gets enough fiber and would suggest a supplement if leaves and brown grains don't cross his lips.
Anonymous
Post 03/23/2016 19:22     Subject: Re:When does picky eating become abnormal or a eating disorder? 13yo
Anonymous wrote:Here's a really good blog post on the subject of selective eating, OP. It's written by the director of a highly regarded eating disorder clinic.

https://www.kartiniclinic.com/blog/post/selective-eating/


OP here. This is great!! Thank you. This definitely sounds like my SS.

Most of what I previously found on picky eating said that it was a little-kid phase and that they would outgrow it ... and since that hasn't happened by 13, I was concerned. This selective eating thing makes much more sense to me.

Anyway, I appreciate all the perspectives, although I don't really relate to those of you who seem to think I'm nuts for being concerned. I mean, he eats 20 things out of the 1000s of foods out there. It means he doesn't eat what his friends eat. It means that he doesn't eat one thing on a traditional Thanksgiving/Christmas/Easter menu, except for plain green beans. It has meant that when on vacation, visiting family, and in other countries and cultures, I have to make sure I find the specific foods he eats and prepare them separately because he will not eat what is being served (because we don't all eat burgers and chicken nuggets, right??). Food is a big part of life! His eating impacts his life, and I do consider that above my own inconvenience.

Also, I understand that anorexia/bulimia/other serious eating disorders are a big deal and that picky eating isn't comparable to that. I didn't mean to make light of serious eating disorders by using the term (although it appears that in fact, selective eating is something that is considered by eating disorder specialists, so maybe not completely off-base?).

And about being embarrassed ... people are judgmental! Family members are judgmental. Waiters in restaurants are judgmental. I myself am judgmental (and have kinda blamed his mom for this). So I am now seeing this as an opportunity for understanding and growth for me. Ha.


Anonymous
Post 03/23/2016 19:05     Subject: When does picky eating become abnormal or a eating disorder? 13yo
You are not required to make him food he likes every day. He is 13. My 7yo can make his own sandwiches. Your SS can fix himself something if he doesn't like what's on the table, and he can make his own plate if he doesn't want the offensive veggies on it. Stop catering.

Also, why doesn't your husband make the special meals? It's his kid.
Anonymous
Post 03/23/2016 16:55     Subject: Re:When does picky eating become abnormal or a eating disorder? 13yo
Anonymous wrote:And, her follow up post is here.

https://www.kartiniclinic.com/blog/post/selective-eating-revisited/

You will see more parent descriptions of children's eating that will sound a lot like your step son.

There aren't a lot of treatments that have evidence behind them (i.s. studies have been carried out with controlled variables, etc., and published in medical journals) to treat this disorder. There are people trying to treat it using trial and error -- Duke University seems to have a good program in my experience. But if your step son is actually gaining weight and is healthy and has energy, I don't think you'd want to invest that kind of time and money. The people who do that usually have kids who don't eat anything AND are failing to thrive.

There's a good book out there but more geared to younger children:

http://www.amazon.com/Helping-Child-Extreme-Picky-Eating/dp/162625110X


I love these blog posts, thanks for linking to them.

I have a selective eater who is almost 13. He's been this way since we introduced solids, basically. No matter how many times we presented a food, it was usually rejected. As the blogger notes, he would happily starve himself rather than eat something that wasn't in his repertoire. Every once in a great while, he will consent to try the smallest of nibbles, and even more rarely, that small nibble leads to a new food being added to his list. Yet he is of normal height and weight and appears to be glowing with health.

One way he differs from the kids described in the blog post is that his repertoire isn't composed mostly of junky foods. He will eat most meats, chicken, and salmon, but never sauced or mixed with other foods, and often not if it was cooked by someone other than me or DH, and not if it somehow looks or smells unfamiliar. He eats clementines (but not oranges), applesauce (but not apples), pears, pineapple, grapes, strawberries, bananas under duress (but likes them in smoothies). He eats green peas fresh or frozen, green beans and sugar snap peas from our garden only (not frozen, not canned), and steamed broccoli and cauliflower (fresh not frozen). He drinks soy milk, won't touch cow's milk. Loves a yogurt smoothie, but won't eat yogurt. Will eat a cheese quesadilla with a minimal amount of cheddar cheese, but no other cheese passes his lips. He will eat black beans and pinto beans. He eats plain white bread, wheat bread if it is toasted. No butter on anything, ever. He loves all manner of desserts and munchies, especially (go figure) hot salsa (?) and tortilla chips. Will not eat any type of pasta or rice. He may be the only child in America who has never had mac & cheese in any form.

So all in all, it's a pretty good diet. But in order to feed him, I generally have to make sure our meals are a plain form of protein and plain broccoli, cauliflower, or peas (or that they can be deconstructed into this form) (and unless it's summer and I have garden beans), and a starch on the side (for the rest of us; he gets a slice of bread). It drives my older child, who is something of a foodie, stark raving mad, LOL. BUt we usually do okay at home and we have some restaurants we know are "safe." The hardest thing is eating at other people's houses. He gags and vomits if forced to eat something he doesn't want, but feels bad/guilty if he doesn't eat what the host prepares.

All this is to say: OP, your SS is fine. Really. Let it go.
Anonymous
Post 03/23/2016 16:43     Subject: When does picky eating become abnormal or a eating disorder? 13yo
Let it go. He's well within normal limits and even eats vegetables. We parent - and stepparent - the kids we have not the ones we imagined.
Anonymous
Post 03/23/2016 16:34     Subject: Re:When does picky eating become abnormal or a eating disorder? 13yo
Anonymous wrote:Here's a really good blog post on the subject of selective eating, OP. It's written by the director of a highly regarded eating disorder clinic.

https://www.kartiniclinic.com/blog/post/selective-eating/


Wow this is great stuff and just like my dd who I posted about who likes crab legs but won't eat fruits and veggies. I particularly like these lines. It describes it perfectly.

Rarely will such a child eat just any old white bread or any old peanut butter—no, it has to be from a certain place and cannot be altered or improved in any way.

Selective eaters may “burn out” on certain foods they formerly favored and find new (equally appalling) substitutes

“just make her sit there, she’ll eat when she gets hungry enough”. Oh no she/he won’t. Absolutely not.

At the risk of having to be quite graphic, I need to leave those of you who believe such children can “branch out” if they “have to”, with this thought: what would it take to convince you to eat dog excrement? See what I mean? Likely if you were forced to, you would gag and vomit—exactly what many of these children do when presented with food outside their range.
Anonymous
Post 03/23/2016 16:31     Subject: Re:When does picky eating become abnormal or a eating disorder? 13yo
As a parent of a teen with a real eating disorder, all I can say is that you have it easy. He does not have an eating disorder. But, given that you hate how he eats and get embarrassed in restaurants (which I think is pretty weird since there is nothing embarrassing about someone expressing preferences about how their food is presented), it doesn't make sense for you to continue to try to bond over food. Apparently he doesn't care about food. Why wouldn't you decide to try to find common ground instead of trying to change him.

One other thing. I have never heard of toddler medicine. There is children's medicine, which is fine for 13 year olds. And, given that an accidental overdose of something like Tylenol is a big deal and can cause health issues, it makes sense that his mom would supervise its administration. That's not babying.
Anonymous
Post 03/23/2016 16:12     Subject: When does picky eating become abnormal or a eating disorder? 13yo
My dd is 10 and a picky eater. She tends to expand her list of acceptable menu items when we go out to eat. For example, one time we went to a seafood restaurant for my birthday. She ate chicken tenders, and I ordered crab legs. I didn't know it at the time, but she was intrigued. The next time we went, she said that she wanted crab legs too. Now she absolutely loves crab legs, and will happily eat over a pound any time she gets the chance. Of course, it's expensive, but she gets to eat them 3 or 4 times a year.

She also likes salmon and steak. She appears to have an expensive palate. She also recently picked out a cookbook and picked the recipe for grilled chicken out of it, and she loves eating that recipe.

I am so glad she has expanded her list of items in this direction because she had previously announced she was a vegetarian which I would have no problem with if she actually ate fruits and veggies.

Here is her list of acceptable foods: spaghetti with spaghetti sauce (on the side), crab legs, steak, salmon, grilled chicken, cheese pizza, cinnamon rolls, occasionally scrambled eggs, also pancakes, milk, ice cream, tortilla chips, cup cakes, cheez its, and occasionally potato chips. Then in her list, she is picky about only one kind of spaghetti sauce, only one kind of tortilla chips, only a specific kind of potato chip. It is very annoying. She does not eat fruits or vegetables.

What does not work is trying to force/persuade her to eat a bite or two of a food that she doesn't want to eat.

Also, a food will be a favorite for awhile, then go on the won't eat a bite of list. Like she used to eat sliced cucumbers with ranch dressing, green apples, and salad with italian dressing. All of these are now on the won't eat list.
Anonymous
Post 03/23/2016 09:02     Subject: Re:When does picky eating become abnormal or a eating disorder? 13yo
And, her follow up post is here.

https://www.kartiniclinic.com/blog/post/selective-eating-revisited/

You will see more parent descriptions of children's eating that will sound a lot like your step son.

There aren't a lot of treatments that have evidence behind them (i.s. studies have been carried out with controlled variables, etc., and published in medical journals) to treat this disorder. There are people trying to treat it using trial and error -- Duke University seems to have a good program in my experience. But if your step son is actually gaining weight and is healthy and has energy, I don't think you'd want to invest that kind of time and money. The people who do that usually have kids who don't eat anything AND are failing to thrive.

There's a good book out there but more geared to younger children:

http://www.amazon.com/Helping-Child-Extreme-Picky-Eating/dp/162625110X
Anonymous
Post 03/23/2016 06:02     Subject: Re:When does picky eating become abnormal or a eating disorder? 13yo
Here's a really good blog post on the subject of selective eating, OP. It's written by the director of a highly regarded eating disorder clinic.

https://www.kartiniclinic.com/blog/post/selective-eating/
Anonymous
Post 03/22/2016 19:23     Subject: When does picky eating become abnormal or a eating disorder? 13yo
DD has a similar menu she finds acceptable and eats from. She has severe anxiety and it's a way to control her environment. We're working on CBT with her to try to expand her palate. She has issues with taste and texture, as in oatmeal (and many other foods) makes her vomit. She had to want to do it for it to be effective. We're several weeks in and we still haven't added any new foods to the menu, although she can eat a blueberry without gagging now. We'll take whatever progress we can get.