Countless parents struggle with their children’s picky eating habits and nothing ruins a family meal quicker than a fight over eating vegetables. And some parents worry that a child’s poor diet can turn into or mask an eating disorder.

Jennifer Schott, MD, NorthShore Pediatrics, offers suggestions to deal with picky eaters, and guidance on what could constitute a more serious problem.

One of the first things to consider is what kinds of food is your child refusing; if it’s fruits and vegetables, that is par for the course for many kids, and doesn’t typically suggest behavioral or emotional issues. If a child is skipping all carbs, fatty foods or desserts, that can be more concerning, said Dr. Schott.

In addition to what the child is eating, or not eating, warning signs for an eating disorder include a preoccupation with their weight, their look or wanting to weigh themselves.

 “I tell parents, don’t even have a scale and don’t have kids or other family members weighing themselves or talking about weight,” said Dr. Schott. “We should use words like ‘healthy’ and put the focus on being healthy and active, not on weight or size.”

In general, younger children are not as likely to have true eating disorders, and it’s usually around age 10 or pre-teen years when concerns about weight and looks can develop into problems.

“Some children have anxiety and it can be expressed as picky eating, sensory things can be a part of their anxiety,” explained Dr. Schott. “I like to de-emphasize picky eaters and take the pressure off eating. I tell parents to put the meal down in front of their kids, if they eat it, they eat it, if they don’t, let it go. I don’t like parents acting as short-order cooks.”

Dr. Schott counsels parents to serve normal, balanced diets and move on without excessive discussion.

“The more we focus on a child’s eating, the more it becomes an issue,” said Dr. Schott, who acknowledged that, sadly, eating disorders are a serious problem and all too common.

There is also a fine line between eating a healthy diet and being “too healthy” and avoiding all carbs and fats, she said.

“The body needs fats and carbs as fuel and it needs a varied, balanced diet. I think if we model good behavior for our children, starting when they are very young it helps set the stage for healthy eating and good relationships with food,” added Dr. Schott.

Three meals a day and two snacks are important for children. Adults can get away with skipping a meal, but that is not a good plan for growing children. Not getting enough fuel can cause a host of problems for children and can also disturb brain chemistry, cautioned Dr. Schott.