Your "Picky Eater" Could Actually Have Food Aversion, & It's A Vital Distinction

If you've declared your child a "picky eater," you've probably heard a particular refrain from well-meaning family and friends: "When they get hungry enough, they'll eat." The danger with this? Actual food aversion is a neurobiological response that cannot be persuaded, giving that piece of advice the potential to do a lot of harm.

But how can a parent know the difference between garden-variety picky eating and true food aversion? I asked Matthew Broberg-Moffitt, an autistic chef and author of Color Taste Texture: Recipes for Picky Eaters, Those with Food Aversion, and Anyone Who's Ever Cringed at Food, to help sort it out.

Broberg-Moffitt, whose education is also in behavioral science, was extremely food averse when young — so much so that they would have met the criteria for Avoidant Restrictive Food Intake Disorder (ARFID), a new diagnosis in the DSM-5, previously referred to as "Selective Eating Disorder." Food aversion can tip into ARFID if food intake doesn't keep the body nourished enough for growth.

"[Food aversion is] safety-based ... Your brain is telling you, 'Don't eat this. You may get sick, and you may die,'" Broberg-Moffitt shares. But instead of getting curious, they explained, parents often default to slapping a "picky eater" label on their kids and calling them difficult.

In all actuality, our kids might be in distress with no way of communicating it.

What is food aversion, exactly?

Food aversion is very similar to a subcategory of ARFID called sensory avoidance, which is when a person has issues with food tastes, textures, temperature, and smells. What avoids the slip into ARFID is the quantity of food a child consumes. As long as a child has enough "safe foods" to find the nourishment their body needs, they remain food averse and not ARFID.

Many children, especially autistic children, struggle with this. In fact, food aversion is common with autism, Broberg-Moffitt says, and can also be an indicator for the undiagnosed.

Here are some clues your child may have food aversion, according to Cleveland Clinic:

• Disliking certain foods
• Coughing, gagging, nausea, or vomiting over the smell or taste of food
• Displaying strong emotion when given food they don't like (crying, screaming, throwing a tantrum)
• Refusing to eat foods that look, smell, or share the same texture as the food they don't like
• Refusing to eat food in the same way that they eat other foods (messy eating, not chewing it completely before swallowing)
• Eating meals takes longer than usual when given food they don't like

Severe symptoms that indicate it could be ARFID:

• Unable to gain or lose weight
• Malnutrition
• Dehydration
• Frequent headaches

If it's just "picking eating":

• Eating a limited amount of food
• Refusing food (particularly fruits and vegetables)
• Being unwilling to try new foods
• Preferring drinks over food
• Having strong food preferences

Food aversion is neurobiological.

"If you're biting into something and it's not what you're expecting, your brain is going to start sending you signals," Broberg-Moffitt tells me. And for neurodivergent children, especially those with sensory processing disorder, those signals are so much stronger. "They can't tune them out." A child might be feeling like, I should not eat this. I cannot eat this. This is bad. Yet, Broberg-Moffitt explains, their loved one is telling them, 'No, go ahead eat it.'"

According to Broberg-Moffitt, forcing a child to eat when they're reacting strongly to food could create a schism. While someone they love is telling them to eat something, their body and brain are telling them it's a hazard. Ultimately, says Broberg-Moffitt, "They cannot physically do it."

And if that's the case, then what can we, as parents, do?

Build trust around food.

I asked Matthew what they see children choosing as "safe foods." They listed things like chicken fingers — "things that don't have much variance to them." Such things fall under safe foods because "they know what to expect when they bite into it."

If your child is eating enough food that provides a sustaining amount of calories and nutrients, it's OK if they only eat five foods, reassures Broberg-Moffitt. (Yes, really!)

Food is such a traumatic potential trigger for people who grow up experiencing intense fighting around food. We know that eating disorders start young and center around control. "When nothing else in life can be controlled, I can control what I put into my body. A lot of that stems from childhood," says Broberg-Moffitt, adding, "Every single one of those people who made me sit down at that table until my plate was clean, I do not have fond feelings of them."

Broberg-Moffitt suggests building trust with a food-averse child by trying these four tips:

• Acknowledge your child's big feelings around food.
• Don't force your child to eat.
• Pay attention to what your child gravitates towards.
• Create a worksheet that lists what your child likes and doesn't like to send with them when they visit other households.

Even if your child's preferred foods sheet isn't taken seriously, they'll know you advocated for them. "The child knows, Even if other people aren't going to expect my wishes, I know that my parents have my agency in mind because they care about what I want and there's a safe place for [me] to fall," Broberg-Moffitt says.

What's a good "safe food" to keep in regular rotation at home?

As previously mentioned, chicken fingers are often a go-to food for food-averse children because they don't have much variance. The child knows what to expect, and it brings them comfort.

To that end, Broberg-Moffitt shared the following recipe for chicken fingers from Color Taste Texture.

Ingredients:

• 1 1/2 cups whole wheat flour
• 1 tsp baking powder
• 1 1/2 tsp kosher salt, plus more to taste
• 1 tsp freshly ground pepper
• 1 1/2 lbs skinless, boneless chicken breasts sliced into "fingers"
• 2 large eggs
• 1 tb non-skim milk
• vegetable oil for frying

To make:

1. Mix the flour, baking powder, and half of the salt and pepper in a gallon-size sealable bag.
2. Season the chicken with the remaining salt and pepper.
3. Lightly beat the eggs and milk in a shallow bowl and place the mix in a second freezer bag.
4. Prepare a foil-lined cookie sheet.
5. And one-third of the chicken to the bag with the flour mixture and seal it. Lightly shake the bag and cover the chicken.
6. Remove the chicken, shaking the excess flour off. Put the floured chicken in the egg bag and seal it. Lightly shake the bag to coat the chicken.
7. Unseal it and remove the chicken, placing it back into the flour bag. Repeat step 5.
8. Place the now twice-flavored chicken on the foil-lined baking sheet and repeat steps 5 to 8 for the remaining chicken.
9. Place the chicken on the tray in the refrigerator to rest for 30 minutes.
10. Heat the oil to a depth of 3/4 inch in a deep-frying skillet over medium heat until it reaches 365 degrees Fahrenheit on the candy thermometer.
11. Carefully place one-third of the chicken in the hot oil, one piece at a time. Allow to cook on one side for 6 to 8 minutes. Flip the chicken and cook another 6 to 8 minutes.
12. Place the chicken on the cooling rack over a cookie sheet. Repeat step 11 twice for the remaining chicken.

Keeping "safe foods" on hand ensures that, if your child rejects what you offer, you have a better shot at ensuring they're still getting the calories and nutrients they need. The saying is true: Fed really is best.