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Adoption Techniques for Treating Adoptive Parent Issues
Adoptive Parent continuing education counselor CEUs

Section 12
Psychological Adjustment: Eating Difficulties

CEUs Question 12 | CEUs Test | Table of Contents | Adoption
Social Worker CEUs, Counselor CEUs, Psychologist CEs, MFT CEUs

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On the last track, we discussed sleep adjustments.  These have included vigilance, sleeping alone, refusal tactics and night terrors.

On this track, we will discuss eating difficulties, which adoptive children may experience.  These will include picky eating, overeating and undereating.

Eating problems which adopted children may experience can range from simply adjusting to new tastes to serious disorders.  Many children may pick food issues as their major control point.  As any parent who has raised a child through toddlerhood knows, there is no way to control what enters or exits your child’s body.  If you force peas into your daughter’s mouth, she can throw them right back even more forcefully.  This battle can be impossible to win.  If your child feels the need to exert control over her life, eating is probably the easiest way to do it.

Toby and Candace, both age 38, were the adoptive parents of Mei, age 9, from Vietnam.  Candace stated, "Mei will only drink Coke and water, and forget juice!  On occasion, she will drink diet, non-caffeinated stuff.  Forget fish sauce and anything typically Vietnamese!  She didn’t even eat it there in Vietnam!  However, she’ll eat fruit and cabbage four times a day and noodles until she looks like one!" 

Toby stated, "And she even sulks about the food she requests!  Just yesterday, when Candace bought the ingredients to make a traditional Vietnamese dish, Mei said, ‘What!  You bought this cabbage?  I wanted another kind!’  And then the world falls apart in anger for thirty to forty minutes, and then Mei doesn’t talk to whoever bought the food she doesn’t like, only to eat it two days later!"

Three Eating Difficulties of Adoptive Children

Difficulty #1 - Picky Eating
I stated, "First, let’s discuss picky eating.  Mei may be reeling from the loss of familiar foods, angry at all she left behind and feeling like it’s all out of her control.  Fighting over food may feel like a safe way for Mei to vent anger and grief.  If Mei is this combative over food, one of the best things you can do is to not make it a battle for control.  Some families are afraid of putting themselves into the position of cooking several different meals each night.  But that doesn’t have to happen.  If Mei is displaying control issues through food, then you can give her the control.  You might let her shop with you and pick what she wants to eat. 

"If Mei hates the food you make, and you feel that she is old enough, you might let her prepare her own simple meals.  If you don’t feel comfortable letting Mei cook for herself, then you might let her eat fortified breakfast cereal for dinner or bread three times a day if you have to.  Mei isn’t likely to let herself starve, and by allowing her that measure of control, you may have made her world a little safer.  This can possibly serve to free her up to work on her other feelings of grief and loss."

I continued to stated, "Problems sometimes arise simply from a difference in tastes.  Mei may be used to eating a bland diet while you serve spicy food.  Or perhaps Mei is used to eating only a few comfort foods and has never tried much of what you set before her.  I have found that this pickiness can be especially true of international adoptees."

I explained to Toby and Candace that families deal with these problems in a variety of ways.  Some parents learn to cook dishes that are very important to their children.  I stated, "This can be an excellent way to incorporate their culture and preferences into your home, and it emphasizes that the whole family, not just Mei, is changing because of the adoption." 

Profound differences in diet, however, can require moving a child’s expectations and tastes to a healthier level.  I stated, "Letting Mei accompany you to the store to help choose what to eat may be especially helpful if you’re trying to change her diet preferences."  Have you found, as I have, that children are often more willing to try something they have picked out themselves?

Some families find that their biggest food issue is not really about food, but the way it is eaten.  Candace and Toby also expressed concern over Mei’s table manners.  Toby stated, "Mei’s table manners are virtually nonexistent!  She scarfs down her food in about ten minutes flat, but insists on talking while she does it!  I can only imagine what that must have been like for her in Vietnam…" 

I stated, "If you can stand it, it may be better to let the problem slide at first.  You will undoubtedly have larger issues to worry about.  However, when you begin trying to change Mei’s eating habits, try to keep in mind that it probably won’t happen quickly.  It can take months and sometimes years to teach even American toddlers good table manners.  If Mei has never learned table manners before, it could take a long time."

Difficulty #2 - Overeating
Second, Candace, Mei and I discussed overeating.  Many families report that their children ate voraciously when they first arrived, and some still do months or years later.  Many children have never had enough to eat and will eat tremendous amounts of food as their bodies grow rapidly after their arrival. 

Many kids, however, eat voraciously not because they’re hungry, but because they’re trying to fill an emotional void.  They may be experiencing feelings of emptiness from their losses and subconsciously be trying to fill that emptiness with food.  It can be difficult to decide which type of voracious eating Mei is doing.  Keep in mind that children who are underweight may need to eat more than normal.  Also, teenagers can often eat a complete meal and be famished an hour later, and that is not abnormal for their age and growth patterns.  Some children also eat just because it is offered and they don’t feel comfortable saying no.  Of course, Mei did not seem to have difficulty with saying no.

I stated, "If you find that Mei is eating voraciously to fill emotional needs, try to help her distinguish between physical and emotional hunger.  You might control Mei’s food intake by handing each person at the table a plateful of food, rather than passing food at the table.  If Mei asks for more after she’s clearly eaten enough, you might ask her, ‘I wonder if you’re really hungry," and suggest that a snuggle, hug, or back rub might feel better."

Have you found, as I have, that adopted children who have gone hungry and eat to fill emotional needs may hoard food?  I have found, for many adopted children, the practice of hoarding may continue for years. Some families have to put locks on the refrigerator or cabinets.  For children whose food problems are troublesome, treating the underlying emotional causes may help.  Some children still have difficulty with food-related issues even in adulthood, but to a lesser extent.

Difficulty #3 - Undereating
Third, in addition to picky eating and overeating, Toby, Candace and I discussed undereating.  Some children don’t want to eat much at all when they arrive.  For some children, undereating is a result of their lack of familiarity with American foods.  I stated, "Again, If you have this particular problem with Mei, your best bet is probably to have her accompany you to the store to pick out things she likes.

Have you found, as I have, that adopted children may have trouble eating because of anxiety, fear, or sadness?  I stated, "If Mei is trying to hold in her grief over leaving a familiar place, she may constantly have a knot in her throat or may be nauseated.  If Mei has no appetite for a couple of days, try not to push her.  Ask Mei if she has a favorite food or offer to cook something she likes.  A temporary lull in eating may not be too worrisome, but you should seek the advice of Mei’s doctor if it persists for any length of time."

Do you have a Candace or a Toby who is struggling with their adopted child’s diet?  Might he or she benefit from hearing this track?  On this track, we have discussed eating difficulties.  These have included picky eating, overeating and undereating.

On the next track, we will discuss toileting problems.  These will include different customs, bedwetting, the training technique, soiling and intestinal difficulties.

Peer-Reviewed Journal Article References:
Christian, C., Perko, V. L., Vanzhula, I. A., Tregarthen, J. P., Forbush, K. T., & Levinson, C. A. (2020). Eating disorder core symptoms and symptom pathways across developmental stages: A network analysis. Journal of Abnormal Psychology, 129(2), 177–190.

Goldberg, A. E., & Smith, J. Z. (2013). Predictors of psychological adjustment in early placed adopted children with lesbian, gay, and heterosexual parents. Journal of Family Psychology, 27(3), 431–442. 

Hagerman, C. J., Ferrer, R. A., Klein, W. M. P., & Persky, S. (2020). Association of parental guilt with harmful versus healthful eating and feeding from a virtual reality buffet. Health Psychology, 39(3), 199–208.

Holmes, S. C., Johnson, N. L., & Johnson, D. M. (2019). Understanding the relationship between interpersonal trauma and disordered eating: An extension of the model of psychological adaptation. Psychological Trauma: Theory, Research, Practice, and Policy.

Klump, K. L., Suisman, J. L., Burt, S. A., McGue, M., & Iacono, W. G. (2009). Genetic and environmental influences on disordered eating: An adoption study. Journal of Abnormal Psychology, 118(4), 797–805.

Vannucci, A., Tanofsky-Kraff, M., Crosby, R. D., Ranzenhofer, L. M., Shomaker, L. B., Field, S. E., Mooreville, M., Reina, S. A., Kozlosky, M., Yanovski, S. Z., & Yanovski, J. A. (2013). Latent profile analysis to determine the typology of disinhibited eating behaviors in children and adolescents. Journal of Consulting and Clinical Psychology, 81(3), 494–507.

Online Continuing Education QUESTION 12
What are three examples of eating difficulties that adoptive parents face? To select and enter your answer go to CEU Test.

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