1. Parents’ use of emotional feeding increases emotional eating in school-age children

    May 6, 2017 by Ashley

    From the Society for Research in Child Development press release:

    Emotional eating — eating when you feel sad or upset or in response to another negative mood — is not uncommon in children and adolescents, but why youth eat emotionally has been unclear. Now a new longitudinal study from Norway has found that school-age children whose parents fed them more to soothe their negative feelings were more likely to eat emotionally later on. The reverse was also found to be the case, with parents of children who were more easily soothed by food being more likely to feed them for emotional reasons.

    The findings come from researchers at the Norwegian University of Science and Technology, King’s College London, University College London, and the University of Leeds. They appear in the journal Child Development.

    Understanding where emotional eating comes from is important because such behavior can increase the risk for being overweight and developing eating disorders,” according to the study’s lead author, Silje Steinsbekk, associate professor of psychology at the Norwegian University of Science and Technology. “If we can find out what influences the development of emotional eating in young children, parents can be given helpful advice about how to prevent it.”

    When children eat to soothe their negative feelings, their food tends to be high in calories (e.g., sweets) so they consume more calories. If they emotionally overeat often, they are also more likely to be overweight. Emotional eating is also tied to the development of later eating disorders (e.g., bulimia and binge eating). This study sought to determine why children eat emotionally and is the first research to consider the issue in school-age children.

    Researchers examined emotional feeding and eating in a representative group of 801 Norwegian 4-year-olds, looking at these issues again at ages 6, 8, and 10. They sought to determine whether parents involved in the study (mostly mothers) shaped their children’s later behavior by offering food to make them feel better when they were upset (emotional feeding), and whether parents whose children were easily soothed by food (those who calmed when given food) were more likely to offer them more food for comfort at a subsequent time. Parents were asked to complete questionnaires describing their children’s emotional eating and temperament (how easily they became upset, how well they could control their emotions), as well as their own emotional feeding. Approximately 65% of the children displayed some emotional eating.

    The study found that young children whose parents offered them food for comfort at ages 4 and 6 had more emotional eating at ages 8 and 10. But the reverse was also true: Parents whose children were more easily comforted with food were more likely to offer them food to soothe them (i.e., to engage in emotional feeding). Thus, emotional feeding increased emotional eating, and emotional eating increased emotional feeding. The findings held even after accounting for children’s body-mass index and initial levels of feeding and eating.

    Moreover, higher levels of negative affectivity (i.e., becoming angry or upset more easily) at age 4 increased children’s risk for emotional eating and feeding at age 6. And this contributed to the bidirectional relation between emotional feeding and emotional eating.

    “We know that children who are more easily upset and have more difficulty controlling their emotions are more likely to eat emotionally than calmer children, perhaps because they experience more negative emotions and eating helps them calm down,” notes Lars Wichstrøm, professor of psychology at the Norwegian University of Science and Technology, who coauthored the study. “Our research adds to this knowledge by showing that children who are more easily upset are at highest risk for becoming emotional eaters.”

    The authors suggest that instead of offering children food to soothe them when they are sad or upset, parents and other caregivers try to calm youngsters by talking, offering a hug, or soothing in ways that don’t involve food. “Food may work to calm a child, but the downside is teaching children to rely on food to deal with negative emotions, which can have negative consequences in the long run,” adds Steinsbekk.

    The authors caution that because the study was conducted in Norway, which has a relatively homogenous and well-educated population, the findings should not be generalized to more diverse populations or to cultures with other feeding and eating practices without further study.

  2. Identifying children at risk of eating disorders is key to saving lives

    January 6, 2017 by Ashley

    From the Newcastle University media release:

    Spotting eating disorder symptoms in children as young as nine years old will allow medics to intervene early and save lives, experts say.

    A team from Newcastle University has identified that girls and boys with more eating disorder symptoms at age nine also had a higher number of symptoms at age 12.

    A new study published in the academic journal, Appetite, reveals the need to treat eating disorder problems as early as possible to help prevent children developing the life-threatening illness.

    The six-year study identified three areas that parents, teachers and doctors should be alert to when looking to detect and help youngsters at risk of the mental health problem.

    These factors are: boys and girls with body dissatisfaction, girls with depressive symptoms, and boys and girls who have had symptoms at an earlier stage.

    It is believed that this research will help pave the way for early interventions to help young patients deal with their eating disorder.

    Dr Elizabeth Evans, Research Associate at Newcastle University’s Institute of Health and Society, led the study.

    She said: “This research was not about investigating eating disorders themselves, rather we investigated risk factors for developing early eating disorder symptoms.

    “Most previous work on children and young adolescents has only looked at the symptoms at one point in time so cannot tell which factors precede others.

    “Our research has been different in that we have specifically focused on the factors linked with the development of eating disorder symptoms to identify children at the greatest risk.

    Results suggest the need to detect eating disorder symptoms early, since a higher level of symptoms at nine years old was the strongest risk factor for a higher level of symptoms at 12 years old.”

    Eating disorders are rare at age nine (1.64 per 100,000) but more prevalent at age 12 (9.51 per 100,000). The most common age for hospitalisation is 15 years old for both boys and girls.

    Many more children have symptoms but do not develop a full eating disorder. Symptoms can include rigid dieting, binge-eating, making oneself sick after eating, and high levels of anxiety about being fat or gaining weight. Eating disorders are serious and can be fatal.

    For the research, children from a birth cohort, the Gateshead Millennium Study, completed questionnaires about eating disorder symptoms, depressive feelings and body dissatisfaction when they were seven, nine and 12.

    The North East has the highest rate of eating disorder hospital admissions in the UK, at approximately six per 100,000. Many more sufferers are treated as outpatients.

    The research highlights that some risk factors precede the symptoms of the condition and others occur at the same time.

    At age 12, boys and girls who are more dissatisfied with their bodies have greater numbers of eating disorder symptoms. Body dissatisfaction is an important indicator of increased risk of the condition.

    Girls with depressive symptoms at 12 years old also have greater numbers of eating disorder symptoms. This relationship was not seen in boys.

    The study is being followed up by repeating the questionnaires with the same cohort of children at 15 years old. This will allow researchers to assess what happened next for the youngsters with greater numbers of eating disorders at age 12.

    Dr Evans said: “Future studies we do will investigate if our findings with young adolescents hold true for older adolescents, or whether we detect new risk factors.

    “Both possibilities will further inform our efforts to promote and target early prevention for eating disorders.”


  3. No sweet surrender: Glucose actually enhances self-control, study shows

    June 7, 2016 by Ashley

    From the Taylor & Francis media release:

    blueberries blackberriesIn the age of the ‘sugar tax’, good news about glucose is hard to come by. But an Australian scientist has just proposed a new understanding of the established link between the sweet stuff and improved .

    As Neil Levy, from Macquarie University, explains in the journal Philosophical Psychology, the current ‘ego depletion’ model of the link between glucose and self-control holds that self-control is a depletable resource. Or put another way, glucose is the fuel for the engine of self-control.

    But Dr Levy isn’t convinced. After examining all the available evidence, he proposes a rival ‘opportunity costs’ model. Glucose isn’t a ‘fuel’ to support self-control, he suggests, but a signal of environmental quality. He explains that, “a resource-poor environment is one in which it is relatively urgent to pursue shorter-sooner rewards; a resource-rich environment is one in which there is little urgency.”

    [Glucose] is a signal that the environment is such that there is relatively less urgency to pursue [smaller sooner] rewards, and that strategies aimed at securing [larger later] rewards are likely to be relatively more successful.” As Levy explains, when people in a resource-rich environment are less sensitive to ‘competing rewards’, they tend to work longer at tasks for which the payoff or reward is delayed: the very definition of self-control.

    “The opportunity costs of allocating attentional and cognitive resources … to a particular task are relatively low; therefore, the subject persists longer or performs better at the task,” he writes. “The subject persists longer because the subject continues to deploy resources without shifting them; the subject performs better because the subject allocates proportionally more resources to the task, as a consequence of not needing to devote resources to scouring for competing opportunities.” Despite his commitment to his theory, Levy acknowledges that glucose might only be one signal of environmental richness. “Any cue that signals a lack of urgency to pursue immediate reward should be expected to have the same effect,” he observes.

    It’s also unlikely that sensing glucose alone would be enough for the body to change its strategy; it may be the case that the body picks up on glucose only when other signals of poverty, conflict or instability are absent. “It is not glucose per se that constitutes the signal: it is glucose correlated with the absence of cues indicating the need to pursue it immediately,” he concludes.

    Dr Levy acknowledges that his theory needs further exploration — but when the experiments involve glucose, he’s unlikely to have any shortage of volunteers.


  4. Overeating and depressed? There’s a connection, and maybe a solution

    January 8, 2016 by Ashley

    From the Yale University media release:

    midnight snackChronic overeating and stress are tied to an increased risk of depression and anxiety, and in a new study, Yale researchers explain why that happens and suggest a possible solution.

    The researchers report that the anesthetic ketamine reverses depression-like symptoms in rats fed a high-fat diet in a similar way it combats depression and synaptic damage of chronic stress in people.

    The effects of a high-fat diet overlap with those of chronic stress and could also be a contributing factor in depression as well as metabolic disorders such as Type 2 diabetes,” said Ronald Duman, the Elizabeth Mears and House Jameson Professor of Psychiatry, professor of neurobiology, and senior author of the paper published in the journal Neuropharmacology.

    Scientists at Yale have shown that ketamine, also known as “Special K” and abused as a recreational drug, can quickly and dramatically reduce symptoms of chronic depression in patients who are resistant to typical antidepressant agents. Subsequent research showed that ketamine activates the mTORC pathway, which regulates the synthesis of proteins involved in creation of synaptic connections in the brain that are damaged by stress and depression.

    The pathway is also involved in cellular responses to energy and metabolism, and people with metabolic disorders like Type 2 diabetes are also at higher risk of depression. A Yale team headed by lead author Sophie Dutheil in Duman’s lab decided to explore whether diet might influence behavior of rats fed six times the normal amount of fat. They found that after four months of the diet, pathways involved with both synaptic plasticity and metabolism were disrupted, and the rats exhibited signs of depression and anxiety.

    They also found that a single low dose of ketamine reversed those symptoms quickly, and reversed the disruption of mTORC signaling pathways.

    Duman cautioned that the effects of ketamine on metabolism need more research and its proper dosage and use for depression are still a subject of clinical trials.


  5. Have an apple-shaped body? You may be more susceptible to binge eating

    November 20, 2015 by Ashley

    From the Drexel University media release:

    healthy_decisionsWomen with apple-shaped bodies — those who store more of their fat in their trunk and abdominal regions — may be at particular risk for the development of eating episodes during which they experience a sense of “loss of control,” according to a new study from Drexel University.

    The study also found that women with greater fat stores in their midsections reported being less satisfied with their bodies, which may contribute to loss-of-control eating.

    This study marks the first investigation of the connections between fat distribution, body image disturbance and the development of disordered eating.

    Eating disorders that are detected early are much more likely to be successfully treated. Although existing eating disorder risk models comprehensively address psychological factors, we know of very few biologically-based factors that help us predict who may be more likely to develop eating disorder behaviors,” said lead author Laura Berner, PhD, who completed the research while pursuing a doctoral degree at Drexel.

    “Our preliminary findings reveal that centralized fat distribution may be an important risk factor for the development of eating disturbance, specifically for loss-of-control eating,” said Berner. “This suggests that targeting individuals who store more of their fat in the midsection and adapting psychological interventions to focus specifically on body fat distribution could be beneficial for preventing eating disorders.”

    The study, titled “Examination of Central Body Fat Deposition as a Risk Factor for Loss-of-Control Eating,” was published in the American Journal of Clinical Nutrition.

    Berner is now a postdoctoral research fellow at the Eating Disorders Center for Treatment and Research at UC San Diego Health. Michael R. Lowe, PhD, a professor in Drexel’s College of Arts and Sciences, was a co-author, along with Danielle Arigo, PhD, who was a postdoctoral research fellow at Drexel and is now an assistant professor of psychology at the University of Scranton; Laurel Mayer, MD, associate professor of clinical psychiatry at the Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute; and David B. Sarwer, PhD, professor of psychology in Psychiatry and Surgery at the Perelman School of Medicine at the University of Pennsylvania as well as director of clinical services at the Center for Weight and Eating Disorders.

    Mounting evidence suggests that experiencing a sense of loss-of-control during eating — feeling driven or compelled to keep eating or that stopping once one has started is difficult — is the most significant element of binge-eating episodes regardless of how much food is consumed, according to the researchers.

    “This sense of loss of control is experienced across a range of eating disorder diagnoses: bulimia nervosa, binge eating disorder and the binge-eating/purging subtype of anorexia nervosa,” said Berner. “We wanted to see if a measurable biological characteristic could help predict who goes on to develop this feeling, as research shows that individuals who feel this sense of loss of control over eating but don’t yet have an eating disorder are more likely to develop one.”

    Using a large dataset that followed female college freshman for two years, the researchers preliminarily investigated whether body fat distribution is linked to body dissatisfaction over time and increases risk for the development or worsening of loss-of-control eating.

    The nearly 300 young adult women completed assessments at baseline, six months and 24 months, that looked at height, weight and total body fat percentage and where it’s distributed. Participants, none of whom met the diagnostic criteria for eating disorders at the start of the study, were assessed for disordered eating behaviors through standardized clinical interviews in which experiences of sense of loss of control were self-reported.

    In this sample, the researchers found that women with greater central fat stores, independent of total body mass and depression levels, were more likely to develop loss-of-control eating and demonstrated steadier increases in loss-of-control eating episode frequency over time. Women with a larger percentage of their body fat stored in the trunk region were also less satisfied with their bodies, regardless of their total weight or depression level.

    The findings indicate that storage of body fat in trunk and abdominal regions, rather than elsewhere in the body, is more strongly predictive of loss-of-control eating development and worsening over time, and that larger percentages of fat stored in these central regions and body dissatisfaction may serve as maintenance or exacerbation for loss-of-control eating.

    “Our results suggest that centralized fat deposition increased disordered eating risk above and beyond other known risk factors,” said Berner. “The specificity of our findings to centralized fat deposition was also surprising. For example, a one-unit increase in the percentage of body fat stored in the abdominal region was associated with a 53 percent increase in the risk of developing loss-of-control eating over the next two years, whereas total percentage body fat did not predict loss-of-control eating development.”

    According to Berner, more research is needed to explain the mechanism behind these findings, though she speculates that there are a number of reasons why this might happen.

    “It’s possible that this kind of fat distribution is not only psychologically distressing, but biologically influential through, for example, alterations in hunger and satiety signaling,” she said. “Fat cells release signals to the brain that influence how hungry or satiated we feel. Our study didn’t include hormone assays, so we can’t know for sure, but in theory it’s possible that if a centralized distribution of fat alters the hunger and satiety messages it sends, it could make a person feel out of control while eating.”

    The findings may apply to other disordered eating behaviors beyond loss-of-control eating, but more research is needed. “Body fat distribution hasn’t been studied in disorders characterized by binge-eating behaviors as much as it has in anorexia nervosa,” said Berner. “The participants in our sample didn’t develop eating disorder diagnoses within the two year period that we studied them, but this study suggests that future research should investigate whether individuals with greater central fat stores are more likely to develop bulimia nervosa and binge eating disorder.”


  6. Scientists unravel brain circuits involved in cravings

    November 13, 2015 by Ashley

    From the Dartmouth College media release:

    mind mazeDartmouth researchers studying rats have discovered that activation of designer neural receptors can suppress cravings in a brain region involved in triggering those cravings.

    The study is the first to systematically show how designer brain receptors and designer drugs work together to change how cues for food stimulate motivation. The findings, which may help scientists to fight addiction, overeating and other habitual behavior in humans, appear in the European Journal of Neuroscience.

    In everyday life, we are bombarded with advertisements, or cues, that garner our attention and trigger us into purchasing products, or rewards. Consequently, these reward-paired cues can become attractive themselves. For example McDonald’s golden arches can produce cravings for fast food even though you haven’t seen the food or aren’t even hungry. Scientists study this phenomenon using sign-tracking, or autoshaping, an experimental conditioning in which the reward is given regardless of the subject’s behavior.

    “Although we have a sense of what brain circuits mediate reward, less is known about the neural circuitry underlying the transfer of value to cues associated with rewards,” says lead author Stephen Chang, a postdoctoral fellow. “We were primarily interested in whether the ventral pallidum, a brain region implicated in processing reward, is also involved in sign-tracking.”

    Previously, it was impossible to inactivate brain areas like this repeatedly and temporarily to study how cues become valuable in themselves. But it is now possible with a new technology called DREADDs (designer receptors exclusively activated by designer drugs). Your brain cells are loaded with natural receptors, or molecules like jigsaw puzzles that are activated when another molecule arrives that fits like a missing piece. But DREADDs are engineered receptors introduced into neurons using viruses. Injection of a synthetic drug can activate these receptors, thus shutting down the neurons as a sort of remote control.

    This technology allowed the Dartmouth researchers to inactivate the ventral pallidum repeatedly and temporarily during tests in which a lever was inserted into the experimental chamber for 10 seconds, followed by a food pellet reward when the lever was withdrawn. Even though the food was delivered regardless of the rats’ behavior, the rats pressed and bit the lever as if it were the reward itself. The results showed that activating DREADDs in the ventral pallidum before each training session blocked that behavior. In addition, recordings of individual neurons in the ventral pallidum following DREADD activation showed that ventral pallidum activity can become suppressed or excited to varying speeds and amounts.

    “These results are the first to show that the ventral pallidum is necessary for the attribution of value to cues that are paired with rewards,” Chang says. “This is surprising because the ventral pallidum was historically considered to be just an area for expressing motivations in behavior. In terms of clinical applications, the results carry the potential for stripping away value from reward-paired cues in cases such as addiction. The ventral pallidum is a novel target for such work.”

  7. Teasing girls about weight is more than a playground joke, study finds

    by Ashley

    From the University of Houston media release:

    girls_bulliesCurrent research about childhood obesity has illustrated the complexity of the epidemic–how it intertwines with hunger, poverty, food deserts and socioeconomic status.

    A new University of Houston study examined a practice that may seem like a harmless playground antic, but could have long-lasting and harmful effects to a young girl’s perception of herself and of food.

    Professor Norma Olvera, health educator with the UH College of Education, examined the impact of teasing on minority, adolescent girls, specifically as predictors of disordered eating behaviors. Olvera said there are two reasons to pursue this kind of research.

    “First because Hispanic and African-American girls are at a higher risk of obesity, which may increase their desire to be thinner and lead them to engage in unhealthy eating behaviors,” she said. “Secondly, there is not a lot of research that explores these issues in minority girls.”

    Olvera’s study surveyed 135 girls who were all about 11-years-old. All the girls had high body fat; 81 percent were considered obese. Almost all the girls indicated they were unhappy with their body size, wishing they were thinner than their perceived size. When teasing was added to this climate about body size and weight, Olvera said, it sparked unhealthy, or what she called “disordered” eating behaviors.

    “Weight status may be a more sensitive issue for children who are overweight or obese, and being teased about it may elicit a stronger response from them as opposed to children who are not overweight or obese,” she said.

    Her findings are published in the Journal of Early Adolescence.

    The girls answered questions about peer-weight teasing at the hands of boys and girls. They also discussed their response to the teasing.

    Fifty-two percent of respondents indicated they had been teased about their weight by girls. Sixty percent had been teased by boys. Some of the teasing came from siblings.

    Olvera said the girls became at risk of developing disordered eating behaviors in order to control their weight and avoid the psychological disturbances and stigma of being overweight. Seventy percent of the girls reported implementing weight-control behaviors, such as cutting back or skipping meals, dieting or starving themselves in order to be thinner. Twelve percent said they engaged in binge and purge behaviors (feeling unable to stop eating followed by forcing themselves to throw up) in order to lose weight. Thirty-three percent said they engaged in emotional eating (eating more or less because they felt bored or upset) because of being teased about their weight.

    “Results from this study may guide health educators and practitioners to design interventions to teach coping strategies to these children to help them deal with peer-weight teasing,” Olvera said. “The findings also support social policies of no tolerance of weight-related teasing particularly in school settings.”

    Olvera is a fellow of The Obesity Society, which is dedicated to expanding research, preventions and treatment of obesity. She also is the founder and director of the BOUNCE program (Behavior Opportunities Uniting Nutrition Counseling and Education), a summer program for minority, adolescent girls to empower them and their families to adopt health lifestyles and positive self-esteem.

  8. Doctors trained to be confidantes for risk-taking teenagers

    October 1, 2015 by Ashley

    From the University of Melbourne media release:

    teens friendsDoctors have successfully reduced risk-taking behaviour in teenagers and young people, in a world-first trial led by the University of Melbourne.

    The study involved 901 young people doctors and practice nurses at 42 General Practices in 15 urban and eight regional divisions in Victoria, Australia.

    They were trained to screen and counsel young people aged 14 to 25-years-old for six common risk-factors, including smoking, binge drinking, mental health problems, drug use, risky driving and unsafe sex — either with a form or simply enquiring about these areas in a sensitive way.

    They found traditionally, screening for these issues is very low. For example, while many doctors are alert to mental health issues, hardly any screen for risky driving and partner abuse.

    The researchers found 90 per cent of the 901 young people were engaging in one or more of the risky behaviours. The health professional then recommended a course of action to minimise risk or a plan to stop the behaviour.

    After discussing these issues with the GP, the young people reported less illicit drug use and less risk for sexually transmitted illness after three months and fewer unplanned pregnancies at 12 months. The GPs were also able to detect more cases of partner abuse.

    Encouragingly, almost all (97%) of young people in the study said they would be willing to discuss their personal lives with their doctor as a trusted source of information. A further 93 per cent said they’d tell a friend to do the same.

    Associate Professor Lena Sanci, of the Department of General Practice, was lead author on the study, published in PLOS one.

    She said adolescence and young adulthood are peak years for the onset of mental disorders, injuries and reproductive health risks. Risky drinking, smoking, drug use, and low rates of physical exercise in adulthood are usually established during these years, yet young people are the group most likely to be overlooked by the medical profession.

    “Young people will come to the doctor for coughs, colds and injuries, but not things like stopping smoking or reducing alcohol or talking about abuse in a relationship or learning about safer sex,” Assoc Prof Sanci said.

    “Perhaps it’s because they don’t view these things as health issues, or they’re embarrassed, or maybe they feel they should be able to cope on their own. Doctors are the perfect confidantes for teens, who may not want to talk about these health risks with their parents.

    “We didn’t expect it to solve all the problems, but we did start a conversation that could help the young person manage the risks.

    We know that young people visit the doctor once or twice a year, so there are repeated opportunities to address multiple risks. And in this trial, overwhelmingly, young people welcome these discussions if they are raised sensitively by youth-friendly providers.”

    The researchers recommend trainee doctors should be taught how to have these conversations with young people. They are currently working on an online screening tool to streamline the process.

  9. Is defeat sweeter than victory? Researchers reveal the science behind emotional eating

    September 18, 2015 by Ashley

    From the Cornell University media release:

    comfort food ice creamVictory was sweet for the U.S. Women’s World Cup team 5-2 victory this weekend — but it’s a safe bet that the vanquished team from Japan was reaching for actual sweets after the stunning upset.

    Research by Cornell food scientists reveals how a person’s emotional state — particularly in the competitive, wide world of sports — affects the perception of taste. In particular, people in negative emotional states tend to crave sweets more than those in a positive frame of mind.

    We determined how emotions arising from the outcome of college hockey games influenced the perception of sweet, salty, bitter, sour and umami (savory) taste, … in addition to hedonic responses — or how much they liked or disliked the foods,” said Robin Dando, assistant professor of food science in the College of Agriculture and Life Sciences. Dando, who with Corinna Noel, a doctoral student in food science, published “The Effect of Emotional State on Taste Perception” in the journal Appetite, June 27.

    Emotional manipulations in the form of pleasantly or unpleasantly perceived real-life events can influence the perception of taste, driving the acceptability of foods,” said Dando. “These results imply that such modulation of taste perception could promote emotional eating in times of negative emotion.”

    The study shows that emotions experienced in everyday life can alter the hedonic experience of less-palatable food, implying a link to emotional eating, according to the researchers. Dando explained, “In times of negative affect, foods of a less pleasurable nature become even more unappealing to taste, as more hedonically pleasing foods remain pleasurable.

    “This is why when the team wins, we’re okay with our regular routine foods, but when they lose, we’ll be reaching for the ice cream.”


  10. When dinner table defiance could lead to health problems

    August 10, 2015 by Ashley

    From the Penn State Milton S. Hershey Medical Center media release:

    sharing childrenWhen most people think of eating disorders, they think of anorexia nervosa and bulimia nervosa.

    But there’s another condition that has nothing to do with concerns over weight, shape or body image, and it has been recognized in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, which doctors use to diagnose conditions.

    Avoidant/Restrictive Food Intake Disorder, or ARFID, is an eating or feeding disturbance that results in persistent failure to meet appropriate nutritional and energy needs.

    It can lead to one or more of the following conditions:

    • Significant weight loss or failure to achieve expected weight gains or growth
    • Significant nutritional deficiencies
    • Dependency on a naso-gastric or gastrostomy tube or oral nutritional supplements without physical reason
    • Marked interference with psychosocial functioning

    Dr. Rollyn Ornstein, interim division chief of Adolescent Medicine and Eating Disorders at Penn State Hershey Children’s Hospital, says ARFID is more serious than simply being a picky eater. Sometimes a child will be referred to Ornstein after a choking or significant vomiting incident that makes them want to avoid certain foods, or maybe even solid food altogether.

    Many infants, toddlers and preschoolers are labeled picky eaters, and parents assume or are told that it is a phase the child will grow out of. But if a child enters school and still displays a significant level of selective eating, it may be something to address. Ornstein says even though the condition now has a name, many pediatricians are not well-versed in identifying or treating it.

    “You know your child best. So if you think there is a problem, you shouldn’t feel bad about seeking help from an expert,” she says. “It shouldn’t be ignored for too long because if they have texture or sensory issues, it becomes harder to deal with as they get older.”

    Most of the children Ornstein sees are at least eight years of age; some won’t swallow for fear of choking, while others have ongoing complaints of belly aches and not being hungry. “Often there is underlying anxiety, but it isn’t always so severe as to have been obvious before,” she says.

    If left untreated, children with ARFID could lose weight and become malnourished, and the eating issues can interfere with activities of everyday life such as eating dinner and socializing with other children. Those who don’t have enough fiber in their diets may also suffer from constipation.

    A recent Duke University study found that children with severe selective eating disorder were more than twice as likely to be diagnosed with social anxiety or depression, and that doesn’t surprise Ornstein.

    She says a Penn State Hershey study of children admitted to her day program for children ages 8 to 16 with eating difficulties found that 23 percent had ARFID — even though it wasn’t labeled as such at the time — and many of those children had higher rates of anxiety disorders as well.