Healing a Child's Food "Obsession" (Part 1): Max's Story

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This is not Max, but isn't he cute? Now Max also enjoys treats as a part of a healthy relationship with food.

Helping Max Heal From Food 'Obsession'

One of the most common issues I support parents around is the child who is preoccupied or "obsessed" with food. After a call with a client who has turned the corner, I was inspired to share their story (with permission and details changed). Max is on his way to becoming a competent eater. What this journal-style blog illustrates is the process, the doubt, the transformation, and that leap that parents make as they transition from trying to get a child to eat less to trusting the child to eat based on internal hunger and fullness cues. Parts 2-5 of this series will begin to explore how to know if an interest in food is beyond typical, weight worries, why parents are told to restrict, why it backfires, and what I observe during the transition. At the end of each post following this one, there will be instructions to join a private Facebook group for parents struggling with this issue. While Max's mom said, "No one understands," she is far from alone. Most of my client calls are variations on common themes. One reason for this series is that I have longed for a parent support group for my clients, a safe online community of other parents who understand the challenges. This series will introduce the issues, and with a group of volunteer moderators, we are ready to give it a try. But first, the hope and Max's story: 

Background

Max is 3 1/2 years old, the second child of a professional couple in San Francisco. He has a 5 year-old brother who is in the 10th percentile and not very interested in food. His parents are married. Max sleeps well and is highly intelligent and verbal. BMI is stable around the 85th% ("overweight" according to growth charts). His mother is slim, and his father has struggled with dieting and weight gain as an adult. The following are paraphrased highlights from notes told in Mom’s voice. How it was:"His favorite teacher came to me with tears in her eyes. She said, “I love Max, but something is seriously wrong with him.” If food comes up in a story she is reading, Max spends the rest of the class talking and asking for food. He won’t stop. The teacher referred us to a child psychiatrist who said Max has OCD (obsessive compulsive disorder), but we found a different one who is just going to do play therapy and see what comes up. Max never says he loves me. He doesn’t hug or cuddle like his brother did. We never play. He’s always pestering for food. If my husband is cooking, Max is right there, crying and pitching a fit. He even kicks and hits when he gets really mad if we don't give him food.My friend is a psych nurse. She says it’s probably a medical issue. Max has seen an endocrinologist and everything was normal. We are supposed to have him tested for Prader Willi syndrome next. When he was a baby, he was 70-85% for weight, and the doctor said he was big, so I worried. He seemed to eat so much. I thought if I don’t limit how much he eats, he’ll get even bigger. I was limiting from when he was about 6 months old. I remember him crying after every meal and bottle. Since then we’ve tried to control portions, push protein and veggies, tell him to eat slow, tell him about being healthy and eating healthy foods, to chew and enjoy food. We've seen a dietitian who recommended portion control and making him eat vegetables first, and talking about red-light and green-light foods, but that led to huge fits. He eats really fast— just inhales food then tries to get more. He’s always trying to get more. No one understands what I’m going through. I was a chubby kid until about third grade, then I thinned down. I’m slim naturally, but my husband is getting bigger and is always on a diet. I don’t want my son to struggle like my husband has. My husband doesn’t know when to stop eating, maybe it’s genetic? My husband was athletic and lean until he started working in an office and so many hours. He is stressed and doesn’t have time to exercise, he misses meals and overeats.

The family reached 'rock bottom' when the entire Labor Day holiday revolved around Max crying for more food. Mom found a few blogs about the Division of Responsibility and jumped in with structure and letting Max eat as much as he wanted. Mom contacted me for support.

Early November 2013, First Call: We started about eight weeks ago letting him eat as much as he wants at mealtimes. I can’t watch. It makes me crazy. He eats SOOO much. I’ve snapped a few times. I just cry after meals. I see that he is  happier and more relaxed, but he’ll never stop eating. He eats until his tummy hurts. I don’t know if I can decide to let him be happy but obese or miserable and healthy. His doctor lectures us about diabetes and heart disease and mentioned food addiction. Maybe he's just addicted to food? He eats two full bagels with cream cheese, and they are big ones, I am full before I finish one, and he wants more food, pancakes, bananas... We can hardly get him away from the table. Sometimes he sits and plays with his cereal after he’s eaten two bowls. Before, he would eat any food in front of him and never left any. Is this the beginning of him listening to his body? He puts food on his plate and looks at me, almost like a challenge, just to get a rise out of me. He screams within five minutes of snack being over. He screams for fruit and crackers. I know I’m not supposed to, but I give it to him. The first few weeks he would eat it and ask for more, but now half the time, he just carries it around.

Late November, second call: Max said “I love you” for the first time and he even climbed onto my lap. He stayed for about five minutes and let me tickle his back. Then his head snapped up and he said, “I’m hungry.” It was like he forgot for a few minutes and then remembered again. My heart just broke. I was so excited, but he can’t stop thinking about food. The psychiatrist says she is seeing progress and we haven’t even told her what we are doing at home.

Mid-December, third call: We hired a new babysitter, and we’ve told her a little of our struggles, but she hasn’t noticed anything! I was able to play Matchbox cars with Max for more than an hour while she cooked and helped my older son with his homework. This was the first time in Max's life that we played like this. Ever. The first time someone was in the kitchen and he wasn’t right there. I watched Max playing and having a blast at daycare. The phone rang, and it was amazing. He looked up, kind of blinked and said, “I’m hungry!”My mother notices that Max is doing so much better at her house. She is totally supportive of our new approach. It’s still really hard to get Max to leave the table at home, but apparently there he hops down and plays. Why is Max doing this to me? He still pesters me for food and it makes me crazy. If I eat anything in front of him, he has to have it. With my in-laws, he ate a huge meal and complained about his tummy hurting. I was so embarrassed. I don’t know how I can trust Max. I think he is gaining weight. It terrifies me. I know he’s happier but I worry about his health. I don’t think I can be okay with having a fat child. I feel stuck.

EMAIL: He’s eating huge meals, I can never trust him. He’s as happy as I’ve ever seen him but I can’t stop crying.Strangers will comment about how thin his brother is, and how "big and strong" Max is. I know people pay attention to how much he eats, and he does have that little tummy. There is just so much talk about my kids and their bodies.If I try to suggest dinner is over, he puts up a fit. I’m so embarrassed. I know my in-laws are judging me and Max.

January 2014, fourth call: Things are so much better at home. He never carries fruit around anymore. I have to really think about it or I forget how much progress we have made.I wonder if my anxiety sets him off so he eats more, or if him eating more sets off my anxiety. I can’t tell which comes first. He still sometimes eats really big meals. Will he ever be 'normal?' We went to the grocery store and he saw the candy and immediately asked for it. I said, “Sure, choose a candy” and he picked M & Ms. Normally I would have told him he could have maybe five, and I know he would have pestered me the whole way home for more. He asked how many he could have and I said he could eat as many as he wanted. I honestly felt so relaxed, I didn’t care if he ate the whole bag. Then he ate about four or five and said he’d save the rest. I wanted to let him know he could eat them all and we could always buy more another time, but he just kept them in his hand and put them in the pantry when we got home. It blew my mind. I’m happy now that he is actually pestering me for those more 'normal' foods like candy or ice cream and not begging for more pasta or chicken.He asked for seconds on noodles, and I gave it to him and I was cutting his meat and then he just said, “I’m done.” Pasta was the one food I thought he would never turn down, he always begged for more of it. I almost cried tears of joy.  

Late January, sixth call: I used to think he wasn’t affectionate. But he is. Max now climbs onto my lap, says, “I love you” all the time. Our psychiatrist says he’s doing great. No need to see us anymore. I know now not to discuss eating at all, or tummies, or nutrition. The less we talk, the more relaxed I feel and the better he does.We were all fighting nonstop before this. My husband and I were always fighting over Max’s eating. It’s so much better now I can’t believe it. My husband has noticed how much calmer I am too and more relaxed, but it’s still not easy. I try not to talk to him about it. He’s so sick of it. I think my husband is being better about not missing meals too.I look forward to talking to you all week. No one understands this. I know this is the right approach now. My biggest challenge will be my in-laws. They are both slim and very focused on healthy eating and exercise. They think that being thin is the only way to be, and that being fat is a moral weakness. They talk about how much Max eats and his tummy all the time. His teacher pulled me aside and said he is like every other kid now. He can share snacks, he plays, she thinks he is learning better too. Getting him down from the table after dinner isn’t a problem anymore. Sometimes we share an apple after dinner and he just says, “I’m full.” And gets down. It feels like a miracle. I feel so grateful we did this, and I’m finally trusting that Max can learn to eat well and have a healthy body and be happy.

Stay tuned for part 2: Is Your Child 'Obsessed' with Food?