Family Meals Focus
The Ellyn Satter Institute Newsletter
Children who are obsessed with food
by Ellyn Satter, Registered Dietitian and Family Therapist
Does your child eat a lot? Does he love to eat, think and talk about it, look forward to it, and/or eat fast and enthusiastically? If you are like a lot of parents in our weight-hysterical world, you may fear that such traits condemn your child to obesity. Not so. Follow the division of responsibility in feeding, and trust your child to know how much he needs to eat. He will only become an overeater if you try to curb his enthusiasm and make him eat less than he wants. That will shame him, he will be come even more preoccupied with food, and he will eat as much as he can, whenever he can.
Some children are just scary
Consider the toddler who is described by his mother as, from birth, “eating a lot, being a fast eater, and now being obsessed with food—always clearing his plate and pestering for food continuously, especially when he is upset or anxious. The pediatrician says his tests are normal.” Consider the preschooler who “eats until he throws up” or the preschooler who “moans when she eats and plans her next meal before she finishes eating this one.” In a Family Meals Focus issue about neglected children, we discussed adoptive twins who binge-ate enormous amounts and hoarded and stole food any chance they got.
The conventional wisdom: There is something the matter with them
- “Our Endocrine doctor says most of her outpatients aren’t able to regulate; they often eating until vomiting.”
- “My twins are the same way and just got diagnosed with sensory processing disorder.”
- Certain children are born with abnormally hearty heartier appetites (they are hyperphagic)1 and grow too fast.2
- Children who are born large are more likely get fat as they get older.3
The conventional wisdom causes the problem
The conventional wisdom, of course, is wrong. Children who have the support of Satter’s division of responsibility in feeding know how much they need to eat.
Look up the word iatrogenic: it is a disease caused by treatment. Here is how conventional approaches to feeding children and addressing child overweight cause the very problem they are intended to address.
- Some children are naturally big or fat and grow just consistently at a high percentile. Conventional thinkers go by the 85th or 95th percentile cutoff points for pronouncing a child to be too fat and impose food restriction.
- Some children have hearty appetites and/or are enthusiastic about food. Conventional thinkers miss children’s innate wisdom with eating and assume these qualities to be synonymous with overeating and obesity. They impose food restriction, especially of highly appealing food.
- Some children are said to be born lacking the ability to regulate food intake. This might be a child with special needs, endocrine problems, or developmental disabilities. Having made this assumption, conventional thinkers impose restriction on food intake.
- Children who are afraid of going hungry become food obsessed, may eat until they throw up, and constantly beg for food, especially when they are upset or anxious. Parents might restrict children’s food intake, be too strapped financially to buy enough food for everyone, or be so disorganized that the child can’t depend on getting fed. Conventional thinkers miss the cause and go straight to even more food restriction.
Children know how much they need to eat.
The conventional wisdom, of course, is wrong. Children who have the support of the division of responsibility in feeding know how much they need to eat. They only become overeaters when, for whatever reason, they are made afraid of going hungry. Despite what you read in the literature and hear on the grapevine, the principle that children know how much they need to eat applies to these children, provided their parents follow sDOR:
- Large infants. Big babies might stay big (but not necessarily fat), or they might slim down over time. They grow in the way that is right for them.
- Children who need to eat a lot, have hearty appetites, and/or love food. Even though appetite is compelling, it can be satisfied. Children know how much they need to eat.
- Children who have endocrine problems (e.g. diabetes, very slow growth, thyroid dysfunction). Children with diabetes regulate. Those who grow slowly eat what their bodies tell them to. Children with thyroid under-activity may eat little and grow slowly until the thyroid dysfunction is addressed. There are no endocrine disorders that explain child obesity.
- Children with sensory issues—who are unusually sensitive to tastes, textures, and smells. These children manage their own sensitivity and regulate food intake as long as parents follow sDOR, which gives children opportunities to learn and no pressure.
- Children who eat a high proportion of starches, processed foods, and even sweets. Poor food selection doesn’t make children fat. Poor feeding practices can. While too many sweets can unbalance the diet, they don’t make children fat as long as they get them at structured meals and snacks rather than being given unlimited access and/or random food handouts.
What to do about “food obsession?”
Establish the division of responsibility in feeding. Given the child’s fear of going hungry, parents must be scrupulous about maintaining structure and absolutely faithful about letting the child eat as much as s/he wants at structured, sit-down meals and snacks. At first, the child’s so-called food obsession becomes more pronounced. However, soon the child begins to trust parents to let him eat as much as he is hungry for at structured meals and snacks. Then he can get in touch with his internal cues of hunger and fullness and eat more like any other child at his age and stage of development.
- Fisher JO, Cai G, Jaramillo SJ, Cole SA, Comuzzie AG, Butte NF. Heritability of hyperphagic eating behavior and appetite-related hormones among Hispanic children. Obesity (Silver Spring). Jun 2007(6):1484-1495.
- Llewellyn CH, Trzaskowski M, van Jaarsveld CH, Plomin R, Wardle J. Satiety mechanisms in genetic risk of obesity. JAMA pediatrics. Apr 2014; 168(4):338-344.
- Cunningham SA, Kramer MR, Narayan KM. Incidence of childhood obesity in the United States. N Engl J Med. Jan 30 2014;370(5):403-411.
For more about withstanding the convention wisdom about child eating and overweight, read Ellyn Satter’s Your Child’s Weight: Helping Without Harming.
Related issues of Family Meals Focus
- Child overweight: are current guidelines helpful? do they do harm?
- Court-ordered placement for child obesity: what can you do to help?
- Dieting and mental health
- Do children lose the ability to self-regulate?
- Helping without harming with child overweight
- Overweight kids are not gluttons
sDOR addresses child obesity
- To prevent child overweight and obesity from birth, support parents in following sDOR.
- To treat child overweight and obesity at any age, restore sDOR and trust the child’s own homeostasis to restore appropriate growth.