Understanding Food Choices Beyond 'Picky Eating': Medical Conditions and their Impact on Eating Habits
Food choices and eating habits are often viewed through a behavioural lens, with labels like 'picky eating' commonly used to explain them. In my work, it’s not uncommon to support individuals or families where no medical assessment has yet been offered, even when eating differences are significant. Instead, families have been previously told by other health providers or school staff that their child is simply “being picky”, “controlling” or “let's wait and see”.
Dismissals that can delay meaningful support.
Because the reality is far more complex and often involves underlying medical, sensory or developmental factors. For many individuals, food decisions are influenced by a variety of medical conditions that affect not just what they eat, but how and when they eat too. These choices are sometimes driven by a need to manage physical or emotional symptoms.
To truly understand someone’s food and eating choices, it's important to look at the broader picture. It's important to be curious about what else their body may be managing in the background. Medical and mental health conditions, from chronic pain to anxiety, can significantly alter eating patterns.
Image from Canva, by Kaboompics.com from Pexels
You might also be interested in my co-authored book about an Autistic young person and their same food ‘Gabby’s Glimmers’ and my other food blogs such as ‘Context Eating: Why We Prefer Specific Foods in Specific Situations‘, ‘Why We Need Low Pressure Food Opportunities‘ , ‘How to Get Them to Eat: Rethinking Some Traditional Parenting Strategies‘
1. Reducing Pain
For individuals dealing with chronic pain, pain can make eating a less than enjoyable experience. Certain foods may exacerbate discomfort, or the physical act of eating can be painful depending on joint issues or gastrointestinal involvement. As a result, people may avoid certain textures or types of food that they find harder to chew or digest, sometimes opting for softer or more easily consumed options.
2. Fatigue Level
Chronic fatigue, as experienced by individuals with conditions like Chronic Fatigue Syndrome, fibromyalgia, or diabetes, can also impact food choices. When energy is limited, the time and effort required for meal prep and eating can feel overwhelming. Quick, low-effort meals may become the preferred option. The need to conserve energy often leads to eating patterns focused on convenience over variety. For some, even the act of sitting at a table can feel too exhausting and they may benefit from alternate seating options and flexible routines.
3. Nausea
Conditions like Crohn's disease, reflux or irritable bowel syndrome (IBS) often come with nausea. Nausea can significantly affect food intake, leading individuals to avoid certain foods or to eat very little. For some, mainly bland or easily digestible foods like crackers, plain rice or broths are all they can manage during flare-ups. The discomfort caused by food can lead to an aversion to eating altogether.
4. Constipation
Chronic constipation can make it difficult for individuals to eat certain foods that exacerbate their symptoms. This can include foods that are rich in fats or certain types of fibre. Constipation can also make someone feel 'full up' and reduce the desire to eat and reduce the amount eaten. In addition, people with constipation might gravitate toward foods that are known to aid digestion like fruits, vegetables and high-water foods, or they may avoid foods that are known to cause discomfort.
The NHS estimates that around 1 in every 7 adults and up to 1 in every 3 children are affected by constipation.
5. Trauma
Trauma, particularly trauma related to past experiences with food, can deeply affect eating habits. This may include trauma linked to illness, medical interventions or being forced to eat certain foods. In such cases, anxiety around food can lead to avoidance behaviours and a sense of disconnection or reduced autonomy in making food choices. A person might feel they have little control because certain foods trigger overwhelming emotional responses or physical reactions, making those foods feel entirely off-limits.
You might also be interested in my other food blogs such as ‘Why We Need Low Pressure Food Opportunities‘ and ‘How to Get Them to Eat: Rethinking Some Traditional Parenting Strategies‘
6. Sensory Needs
Sensory processing differences can have a significant impact on food choices. This is common for many neurodivergent individuals. For someone navigating a world that is often overwhelming and out of their control, food can become one area where they seek consistency and familiarity. Choosing foods that provide a known, sensory experience is a way of managing sensory demand and protecting their well-being.
A Starting List of Medical Conditions That Influence Eating Choices:
Ehlers-Danlos Syndrome and Hypermobility Syndromes: Joint issues and pain affecting food preparation, eating comfort and gut motility.
Diabetes: Blood sugar management affecting meal timing and food choices.
Medications: Side effects from medication, such as nausea or changes in appetite, that alter food preferences.
Crohn's Disease: Gastrointestinal issues causing discomfort and changing food tolerance.
Reflux: Acid reflux and GERD (gastroesophageal reflux disease) can lead to avoidance of foods that trigger symptoms, such as spicy or acidic foods.
Irritable Bowel Syndrome (IBS): Digestive issues, including bloating and cramps, influencing food intake and meal planning.
Allergies and Intolerances: Certain foods might need to be avoided entirely, which can influence meal preparation and variety.
What is gut motility? Gut motility, according to the NHS (National Health Service, UK), refers to the movement of food through the digestive system. It involves the coordinated action of nerves and muscles in the gastrointestinal tract, ensuring efficient transport of digested food and waste.
Conclusion: More Than Just 'Picky Eating'
Understanding food choices requires a shift in perspective. For many people, food choices are deeply connected to managing various physical and emotional conditions. Recognising that someone makes food and eating choices because they are managing pain, fatigue, nausea or other symptoms helps foster empathy and reduces judgment.
By broadening our perspective on the link between health and eating, we can offer more meaningful support, accommodations and understanding to those navigating complex food relationships.
Resources
Gabby’s Glimmers: An Affirming Story of an Autistic Child and their Favourite Food
Context Eating: Why We Prefer Specific Foods in Specific Situations
How to Get Them to Eat: Rethinking Some Traditional Parenting Strategies