There’s a thin line between picky eaters and children with early eating disorders, the latter calling for early intervention
Fussiness typically begins in early childhood, when children reject textures, tastes, or appearances, or become choosy to assert their independence
We called out to picky-eaters, and many adults responded, saying they were as a child or still are. Fussy eating is still a challenge in many Indian families, particularly among children aged one to five years. A study in the Indian Journal of Pediatrics revealed that up to 50 per cent of parents reported their children as picky eaters at some stage. While most children eventually outgrow this phase, there is reported to be a link between persistent fussiness over food and the development of eating disorders. Understanding this connection is crucial for fostering a healthy relationship with food.
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In developing countries, picky eating has been linked to nutritional deficiencies, especially essential nutrients such as iron, calcium, and vitamins. The National Family Health Survey (NFHS-5) reported high rates of anaemia among children under five in India, a condition that poor dietary habits can worsen. This fussiness typically begins in early childhood, when children reject textures, tastes, or appearances or become choosy to assert independence. “Recognising the difference between a developmental stage and patterns that could indicate deeper issues is important. Extreme or persistent picky eating can signal Avoidant/Restrictive Food Intake Disorder (ARFID),” says Dr Ajit Gajendragadkar, Consultant Paediatrician at PD Hinduja Hospital & Medical Research Centre. leading to nutritional deficiencies.
Dr Samir Shinde, Dr Ajit Gajendragadkar and Dr Samir Dalwai
This writer’s nine-year-old daughter shows signs of ARFID. However, Dr Gajendragadkar warns against liberal labelling. “Easy access of information leads to a problem being overdiagnosed and overlabelled,” he says, “ARFID is not as common as it is made out to be. It is a sensory integration problem or a genetic disorder and there are signs from birth. Unlike other eating disorders like anorexia, ARFID is not born of body image concerns. It can overlap in a small percentage of children who have problems with sensory integration, cognitive textures and scents; it might be part of the autistic spectrum. If left untreated, ARFID can hinder growth and development and may lead to more severe eating disorders later.”
Cultural and social factors play a significant role in shaping eating habits. Family meals, food preferences, and societal norms influence eating patterns. Dr Samir Shinde, who runs Dr Shinde’s Children Hospital in Jogeshwari and its clinic in Dadar, emphasises the importance of addressing these issues early, noting that children often manipulate parents by crying, leading to overindulgence. “Screen time while eating, snacking between meals, and force-feeding also contribute,” he adds, “We see plenty of these cases at the hospital.”
Dr Shinde emphasises the role of weaning to avoid eating disorders. “After six months of breastfeeding, most parents shift infants to formula and baby food supplements. They get used to that taste and do not like the natural taste and texture of foods. It’s best to introduce them to the foods we eat every day (in phases), rather than expose their palates to high sugars and salts at an early age, which can lead to addiction later.”
Encouraging a positive relationship with food, offering various options without pressure, and creating a stress-free mealtime environment can make a significant difference, says Development Paediatrician Dr Samir Dalwai. “If a child becomes anxious, nervous, or agitated when they don’t get something they want, they apply the same pattern to foods they don’t like,” he says, “Early intervention and parent coaching can help develop healthy eating habits that will benefit children for life. If picky eating persists or is accompanied by anxiety or fear around food, consult a paediatrician or child psychologist.”
Dr Gajendragadkar advises, “Such cases might need a multispeciality approach involving a developmental pediatrician or pediatric neurologist and possibly a gastroenterologist for diagnosis and management.”
Emerging initiatives to address these issues focus on nutrition education, parental guidance, and early intervention. Schools and paediatric clinics are increasingly promoting healthy habits and addressing early signs of eating disorders. While research is still evolving, these insights highlight the importance of early detection and culturally sensitive interventions.
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