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Questionable things ‘experts’ say #7: “The way you eat is unacceptable.”

Posted by on Aug 21, 2013 in Blog Posts | 4 comments



I cringed when a client told me that their new pediatrician admonished her five-year-old son (with severe food anxieties and selective eating who would likely qualify for a feeding disorder diagnosis) with this: “The way you eat is unacceptable.”

I cringe often, when I hear some of the things that my colleagues in medicine say to young children, even if they think it is for their own good. (My guess is that this doc has no experience or education around feeding problems, all too common I’m afraid. See Questionable things #6, and #4 , and #1. )

Young children in particular are unable to process a message like, “The way you eat is unacceptable.” What the child hears is, “You are unacceptable.”

Guilt, shame, lectures, prodding, or tough love don’t help children (or their adults) make better choices. In fact it likely makes the anxiety about eating worse, and we know anxiety is the enemy when learning to eat.

I’m not saying that a child with feeding struggles should be dismissed or ignored, but the parents primarily need help to support their children. Children don’t need lectures, rationalizing, shaming or bullying—from peers or their pediatrician. While the 2 or 3 year-old selective eater doesn’t feel a lot of shame about eating, the five year-old certainly can. The five-year old who so desperately doesn’t want to let down his parents or his new doctor that he will agonizingly swallow two bites of apple-sauce while crying and gagging before refusing altogether…

How about the doc tries:

  • “I’m sorry you had that experience where you couldn’t find anything to eat at that party. That must feel really tough. Let’s see if your mommy and I can figure out a way to help.”
  • “You like pancakes? Me too! I like mine with blueberries. Maybe you can help your Daddy make pancakes sometime. It’s super fun!”


Hitting people is unacceptable, swearing at the table or throwing food may be unacceptable, but the way a child eats is the way a child eats right now, for any variety of reasons, with many of the child’s behaviors being understandable reactions and adaptations to painful or coercive experiences. Accepting, unconditional love and support will go further to helping him learn to feel good about food and eating than shame or guilt.

Primary care docs can’t be expected to solve these complex issues in a 7 minute well-child check, but they can do a better job of learning about, screening for and supporting parents. Learning about feeding problems, and getting the right help for the family is key.

What is the worst thing someone has said to your child about his or her eating? (Everyone is fair game, from siblings, MILs to doctors or therapists…)

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  1. Sue

    When I was 11 or 12 years old my pediatrician told my mother I must be stealing food from other kids. I have had weight issues since I was a toddler, I was always fat. My 4 brothers and sisters were so skinny they looked malnourished. The doctor said this after my mom expressed her concerns regarding my weight, explaining to the doctor that I often skipped lunch in school.

    • katja

      Oh. I am so, so sorry. There is still so much misinformation about weight, calories, eating etc. And these doctors who don’t listen, and can’t question their own biases can do real harm…

  2. Stacy Croston

    Our pediatrition told my 12yr old who is in the 25 percentile for weight and 50 for height, “you need to eat more.” (Our other 2 children are in 90 percentile for height and @70 for weight) Of course, my daughter took it as “you are doing something wrong and there is something wrong with your body.” My daughter has brought it up a few times and I remind her of her paternal grandmother who is 5’2″ and only weighed 90 lbs. most of her adult life. I also remind her she is going through her adolescent growth spurt right now and who knows what mother nature has in store for her!

    • katja

      Sigh.Amazing that most docs don’t understand the growth charts. You don’t have to be ’50 50′ to be healthy. There is such a thing as biodiversity, and sounds like this has been her pattern for a long time and she’s lean and healthy, just like other children will be stocky and healthy, with wt at 50%, and ht at 25%. I’m so sorry this has caused her to doubt her body. So hard since we tend to trust that doctors know better. Sounds like you are giving her great advice. Did you mention to the doc about your grandmother? You can also share my story too and tell her that doctors don’t actually get training in this stuff! They are great at treating ear infections and rashes and managing diabetes, but not great at understanding how we grow and feed our bodies… Good luck!


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