Improving Picky Eating in Teenagers

Core Strategies for Healthy Eating

Focus conversations exclusively on healthy eating behaviors rather than weight, dieting, or body image, as weight-focused discussions increase the risk of both obesity and eating disorders in adolescents, according to the American Academy of Pediatrics 1, 2
Establish family meals at least 7 times per week, as this is the single most evidence-based intervention for improving adolescent eating patterns, recommended by the American Academy of Pediatrics 1, 2
Eating family meals together 7 or more times weekly results in consuming 1 additional serving of fruits and vegetables daily compared to families with no shared meals, as suggested by the American Academy of Pediatrics 1, 2
Family dinners most days or every day protect against purging behaviors, binge eating, and frequent dieting in both males and females, according to the American Academy of Pediatrics 1, 2
These dietary improvements persist 5 years later into young adulthood, as reported by the American Academy of Pediatrics 1, 2
Make family meals enjoyable, as perceived enjoyment provides additional protection against extreme weight-control behaviors in girls, recommended by the American Academy of Pediatrics 1, 2

Parents are responsible for choosing which foods are available, when meals occur, and where eating happens; teenagers decide whether to eat and how much, as suggested by the American Heart Association 3
Provide a wide variety of nutrient-dense foods including fruits and vegetables instead of high-energy-density/nutrient-poor foods like salty snacks, ice cream, fried foods, cookies, and sweetened beverages, recommended by the American Heart Association 3
Use nonfat or low-fat dairy products as calcium and protein sources, as suggested by the American Heart Association 3
Pay attention to portion sizes appropriate for the teenager's age and size, recommended by the American Heart Association 3

Never pressure teenagers to eat or restrict access to specific foods, as both strategies backfire and lead to overeating, food dislikes, and paradoxical interest in forbidden items, as warned by the American Heart Association 3
Allow self-regulation of total caloric intake when BMI is normal, recommended by the American Heart Association 3

Limit sweetened beverages (including fruit juice) to 8-12 oz per day for teenagers ages 7-18 years, as recommended by the American Heart Association 3, 5
Sweetened beverages contribute significantly to excess caloric intake and displace essential nutrients, as reported by the American Heart Association 3, 5
Introduce and repeatedly offer healthy foods even if initially refused, as repeated exposures (up to 10 times) establish taste preferences, suggested by the American Heart Association 3

Limit sedentary screen time to no more than 1-2 hours daily and remove television sets from bedrooms, recommended by the American Heart Association 3
Television watching is directly associated with unhealthy eating habits, increased requests for advertised foods, and higher fat consumption, as reported by the Centers for Disease Control and Prevention 6, 7
Restrict snacking during sedentary behavior or in response to boredom, recommended by the American Heart Association 3

Parents must model healthy eating behaviors themselves, particularly consuming fruits, vegetables, and unfamiliar foods, as parental role modeling is critical in establishing teenagers' food choices, as suggested by the American Heart Association 3, 5

Monitor for signs of Avoidant/Restrictive Food Intake Disorder (ARFID) if the teenager exhibits significant weight loss, failure to achieve expected weight gain, nutritional deficiency, or marked psychosocial interference, as recommended by the American Academy of Pediatrics 8
ARFID differs from typical picky eating by causing clinically significant impairment, as reported by the American Academy of Pediatrics 8
ARFID lacks body image distortion or fear of weight gain, distinguishing it from anorexia nervosa, as noted by the American Academy of Pediatrics 8