Understand Your Child's Hunger Profile
Do you ever get frustrated because your kiddo refuses to eat anything at dinner, but then wants a snack a few minutes later? Do you look at other parents who have kids eating broccoli and think, "what am I doing wrong?" Are you worried because it seems like your kiddo is hungry all the time?
Well it turns out, kids have really different hunger profiles and understanding hunger profiles can lower your stress by helping you know what to expect ...
“When he was little he did not have this sort of connection that would alert him to the fact that he was hungry ”
There are three dimensions that affect your child's hunger profile: sensitivity to hunger, ease of satiety, and reward from food. Some children are really sensitive to hunger they- might eat a snack and then be hungry again an hour later. Other kids rarely seem interested in eating and can go for long periods without a snack. Satiety is the lack of feeling hungry which is a little different than feeling full. Some children feel satiated pretty easily and want to stop eating quickly. Other children are much closer to full when they feel satiated. In terms of reward from food, we can all probably imagine the euphoric feeling of eating a piece of chocolate - to varying degrees most foods trigger a chemical reward in our body. For some children, this reward is greater than others. These dimensions work together to create hunger profiles. There is a lot of normal variation in how much kids want to eat.
Regardless of your child's hunger profile, your child can be healthy - but certain hunger profiles suggest certain problems are more likely. Children who are sensitive to hunger, insensitive to satiety, and are highly rewarded by food ("Good" Eaters) are more likely to deal with issues related to overeating. These kiddos like to snack between meals, often shock you with how much they can eat, and know where you keep all the goodies. Children who are insensitive to hunger, sensitive to satiety, and are not as rewarded by food (Eats Like a Bird) are more likely to deal with issues related to under-eating. These kiddos don't like to snack, are always trying to leave the table, and if they get excited about food at all, it is probably going to be densely choleric salty or sweet food (e.g. pizza, ice-cream, soda, chicken nuggets). Children can fall all along this continuum. For example, some children might not be rewarded as much by food so they're very picky, but they also don't get hungry very often. These kiddos can be in danger to overeat too because they will hold out for a long time until you give them what they want, which is more likely to be something that is unhealthy. While most children have some consistency on where they fall along each dimension, it can change from day to day and across their lifespan.
“He’s picky. As far as vegetables, he likes asparagus, broccoli and salad. Don’t put any other vegetables on his plate.”
You can use your child's hunger profile to help cut down on some of your stress. Try working with their body, not against it. If your child hungers easily, keep healthy food easily accessible and make snacking okay at your house. If your child isn't very motivated by food, put your energy into increasing the quality of what they eat. If your child is at risk for overeating, start teaching them to recognize their body's cues. For example, buy treats that come in small portions like jelly beans or gummy bears. Ask your child how many they would like at a time (you can limit the choice to specific options- "Would you like three, five, or seven gummies?"). This will help build their capacity to set their own limits.
There are other factors that affect over-eating and under-eating, for example, if your child will eat in the absence of hunger. This could be due to a willingness to comply or because food is extremely rewarding. The capacity to inhibit eating, which is related to self-control, affects eating habits. How quickly a child eats seems to be related to satiety - if you eat really fast, your brain may not have enough time to realize that you are full. Medication can significantly influence a child's hunger profile. This is all to say our hunger profiles and eating behaviors are complex. The hunger profiles cannot take every single factor into account, but they can help you understand some of the natural variations you can expect.
Question: When do I need to talk to a doctor about my child's diet?
It's never a bad idea to talk to your child's pediatrician or a nutritionist about diet, but you NEED to talk to someone if your child is very underweight or experiencing excessive weight gain. Although there is a lot of expected variation in children's hunger patterns (there are 8 different profiles!) some children with autism are so limited in what they eat that they can experience malnourishment or an eating disorder. On the other hand, obesity is a big concern for children with autism.
“People say ‘if you if you accommodate them...if you spoil them...Eventually they’ll eat if you don’t give them what they want.’ But with Autistic kids-that’s just not true. They will pretty much starve themselves. I’ve watched it happen. He was not eating and he would get thinner and thinner. It’s just not worth fighting about.”
Question: My child is a picky eater. Do I need to worry about overeating?
YES!!! Children with autism can be very particular about what they eat. They may prefer foods that are low in nutritional value and high in sugar, salt, and fat. Even for kids who are minimally rewarded by food or have sensory aversions to food, junk food can be exciting (when you're full you still might have room for dessert- a similar principle). Unfortunately, some experts who aren't used to working with kids with autism might recommend you withhold food until the child is willing to eat something new, but WITHHOLDING FOOD FROM CHILDREN WITH AUTISM IS DANGEROUS AND INEFFECTIVE - even if the child is struggling with being overweight. On the other hand, there are many picky eaters who struggle with being underweight, because they're just not willing to consume enough calories. For the most part, picky eating is an expected (but still tricky) part of childhood, but when it causes health concerns you may need to get help.
Question: My kid seems to get hangry a lot. Is that related to their hunger profile?
Hangriness happens because of how hard it is for kids (and adults) to recognize that they are hungry and do something about it. A child who often gets hangry may be more sensitive to feeling hungry, but it could happen to any child- a kiddo that doesn't get hungry often might not recognize the sensation when they are hungry and just get grumpy instead of getting something to eat. Hanger can be a big issue for kids on the spectrum. Kids with autism might have more difficulty communicating that they are hungry. At the same time, they may have more difficulty recognizing they are hungry as they may be less aware of what's going on in their body. Additionally, many kiddos with autism struggle with regulation so a little frustration can turn into a big hangry melt-down really quickly. On the bright side, knowing your child's hunger profile will help you anticipate their hunger.
References
All content is original to Mealtimes on the Spectrum, but is based on the following scientific literature:
Carnell, S., & Wardle, J. (2007). Measuring behavioural susceptibility to obesity: validation of the child eating behaviour questionnaire. Appetite, 48(1), 104-113. doi: 10.1016/j.appet.2006.07.075
Epstein, L. H., Leddy, J. J., Temple, J. L., & Faith, M. S. (2007). Food reinforcement and eating: a multilevel analysis. Psychological bulletin, 133(5), 884 - 906. doi: 10.1037/0033-2909.133.5.884
French, S. A., Epstein, L. H., Jeffery, R. W., Blundell, J. E., & Wardle, J. (2012). Eating behavior dimensions. Associations with energy intake and body weight. A review. Appetite, 59(2), 541-549. doi: 10.1016/j.appet.2012.07.001