A Five-Year-Old & Food Anxiety

Our five-year old girl has always been two things; a good eater and a good communicator – from birth! She has always loved avocado, strawberries, broccoli, beans, tomatoes, and her carbs: macaroni and cheese, pasta, rice…about a month ago, she started requesting fruit/vegetables only for dinner and sometimes even throughout the day. One night while in a rush we offered to stop at McDonald’s, a very rare treat, she started hysterically crying, explaining she needs to eat healthy. We asked where she got this from, she insisted she made it up, “it’s my own thought.” We explain balance, drew a food pyramid; we see some improvement and then have a set back. Since this started she has refused to eat anything at times, and/or says she is hungry but she doesn’t know what she wants. We haven’t seen a doctor yet, only had blood drawn that came back all good. We’ve spoken to two pediatricians, one said therapy ASAP while the other wanted to see her if things didn’t improve over the weekend (this was last week) – which they did.

While she certainly doesn’t eat like she used to, she has abandoned the “healthy eating” opinions and is open to eating ice cream and other treats (requesting them more than ever in her little life) we are currently only having issues at dinner time but this has had many phases. That could change for better or worse today, tomorrow. At it’s worst, she asked for a hot dog, when I gave it to her, she went hysterical, hot dogs are bad for you, I know, I just know. Channeling the exorcist to get her point across. At it’s best, fruits and vegetables throughout the day, sometimes for dinner, but lately no dinner at all.

I hoping you can provide some insight. We are struggling watching her food refusal and at times obvious anxiety from being offered food. While we don’t want to bring attention to it or add pressure/stress it is a challenge putting her to bed without dinner, or trying to understand what is going on in her head and why she won’t eat?

I really appreciate you taking the time to read our story and offer any input. Thank you so so much.

Cheers and so much Thanks,
C

Ooof, anxiety in little kids is so hard to witness, and even harder to get to the bottom of.

So I see two main challenges here:

1. One being the food-related anxiety itself, and this belief she’s internalized about “healthy” eating being more about an ongoing war between “good” foods vs. BAD BAD EVIL WRONG foods. Where did that come from (typical food-related talking points from preschool? Preschool TV shows?) and how can you help her process and work through it without these high levels of emotional distress?

2. The second, of course, is the day-to-day challenge of getting your child to EAT on a regular basis without it spiraling into a meltdown over a hot dog.

Now on to some advice: 

1. Your child should see a therapist

For the first challenge, I actually agree with the therapy recommendation. These are not normal levels of anxiety, and I do worry that left unchecked, it could lead to disordered eating or OCD-like behavior (if not OCD itself) as she attempts to self-manage her anxiety by controlling and restricting foods she’s deemed to be “bad” or “wrong” in her head. I’ve been where you are, by the way, with a super-anxious child (though his anxiety had different triggers), and I can’t stress enough that a good therapist who specializes in childhood anxiety can be the MOST important resource for both her AND you.

2. Some things to try yourself

I am NOT a therapist who specializes in childhood anxiety, obviously, so I don’t want to dive too deeply into coping strategies and advice for the second challenge, beyond two very top-level things that popped into my head while reading your letter.

First: A book recommendation I’ve found super helpful, Freeing Your Child From Anxiety by Tamar Chansky. It’s a super-comprehensive look at childhood anxiety, panic disorders, OCD, phobias, you name it.

Second: It sounds like she is given a LOT of choices throughout the day regarding food, and is pretty much allowed to set her own dinner menu and decide exactly what she wants to eat. Try stopping that. Stop asking her what she “wants” to eat altogether. This might be triggering this mental tug-of-war (and thus, rising anxiety levels) over the fact that she really DOES want a hot dog, but feels like she shouldn’t want a hot dog.

3. Don’t be a short-order cook

Don’t short-order cook for her at dinner (i.e., she rejects what you’ve made, you rush back into the kitchen to get her an all-fruit plate or other “acceptable” food), and simply make the same “healthy” food choices for her that you do for your own dinner. If she doesn’t want to eat the family dinner, that’s okay. (AKA the Satter Division of Responsibility.) No pressure. “You don’t have to eat but please stay here and talk to us, okay?” And then you and your partner/spouse model healthy eating habits where you openly enjoy what you’re eating without guilt. 

4. Help her limit her choices

The same goes for the other meals and her snacks — don’t interrogate her into making a decision between ALL THE FOOD OPTIONS, but try making more food decisions on her behalf for awhile and see if that takes some of the mental pressure off of her. You make the food and offer it at set times throughout the day (no more “are you hungry? do you want a snack now? what about now?”), she decides if she wants to eat it. If she decides she doesn’t, don’t immediately run through your fridge contents in hopes of finding something else. (And thus, forcing her back into a stressful mental place where she feels compelled to evaluate each and every offering as “healthy” or “unhealthy.”)

5. Consider a Healthy Snack Drawer

If the mere act of offering her food/meals/snacktimes continues to seem SUPER stressful for her, you could also try giving her a designated “healthy snack drawer” in the fridge. Empty out a produce drawer and fill it with wholesome, healthy snacks like fruit, cut-up veggies in portioned baggies or containers, yogurts, milk boxes, cheese, homemade granola, any kind of finger food or portable snack you can think of. (Including stuff she maybe hasn’t tried before!) Tell her that you will make sure that everything in there is yummy and healthy and she is free to help herself whenever she is hungry. (Although I would still hold firm that dinner is the same as what the grown-ups eat, but at least if she rejects it you can rest easy knowing she can get a little something in her tummy in the form of a good pre-bedtime snack from the drawer.) This might help her self-regulate with less stress, with the bonus of making food/snacks kind of “fun” because it’s all completely self-serve and DIY.

But again, ask your doctor for a therapist recommendation. I think that will really help, and I hope you guys get some excellent solutions soon.

Photo source: Depositphotos/azaza

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