I recently received an e-mail from a concerned stepmother. She was concerned that her 3-year-old may have an eating disorder due to genetic factors such as anorexia nervosa. Her stepdaughter was having some resistance to eating certain foods – especially healthy foods.
This question is potentially fraught. The danger is not that her 3-year-old may have a disease that manifests itself fully in adolescence, but that the family could be too focused and become transfixed by the concern that this is an “eating disorder”. This can result in struggles at every meal regarding food, and could indeed, in my experience, perhaps increase the likelihood that the child could ultimately develop an actual eating disorder.
Dear Dr. Fishman,
I was wondering if it’s possible for a mother to pass on an eating disorder to her daughter even if the daughter has never really known her mother. My partner’s daughter is 3-years-old and refusing to eat. She won’t eat anything except for potatoes and spaghetti, but even that is a struggle. We have tried a lot of different methods to try and get her to eat but she’s just not interested and often gets upset over it. It’s now at the point where she’s not gaining weight and losing her hair.
I am taking here to the doctor this week as I feel it can’t go on. Any ideas would be gratefully appreciated.
*Not the stepmother’s name, which has been kept private for confidentiality reasons.
My reply was as follows:
This is not an eating disorder like anorexia nervosa. It sounds like she does eat – just not the right things. And her eating gets more reluctant when the struggle emerges. It is a fine line to be concerned and vigilant and yet not have every meal turn into a power struggle. Your GP should be helpful in advising you of her ideal weight according to the norms for her age and build.
When there is enough food on the table, no child starves. They have a built-in hunger mechanism. For children this young, the parents are the ones who control the access to food. Limit the choices to better foods – but be flexible. In moderation, even occasional sweets are alright. The important point here is that meals don’t become battle grounds. That in itself is more dangerous than ice-cream!
Dr Charles Fishman