Stories from the Clinic: What’s Really Going On?

Sometimes the reason a family seeks support sounds quite simple.

“She only eats beige foods.”“He refuses to try anything new.” “We’ve stopped going out for dinner.” "Every mealtime ends in an argument.”

But after more than 25 years of working with children, adolescents, adults and families, I’ve learnt that the presenting problem is rarely the whole story.

Eating difficulties don’t happen in isolation. Food can become tangled with anxiety, sensory sensitivities, neurodivergence, previous frightening experiences, family stress, eating disorders and a nervous system that has learnt that eating is something to fear or avoid. And slowly, almost without anyone noticing, the problem can begin to shape family life.

Parents cook separate meals. Restaurants disappear. School camps become frightening. Sleepovers are avoided. Parents become increasingly worried and start encouraging, negotiating or pleading. The young person feels watched and pressured. Everyone becomes exhausted.

Often, by the time a family reaches my clinic, they have already tried very hard to make things better. That’s why one of the first things I’m interested in isn’t simply “How do we get them to eat?”

I want to understand:

What is happening underneath the eating?

What makes food feel difficult? What is the young person experiencing? How has the family adapted around the problem? What helps, and what unintentionally makes things harder? And importantly, what has this difficulty started taking away from the child or family?

These Stories from the Clinic are inspired by common situations I have encountered throughout my work as a dietitian, counsellor and family therapist. They are not stories about individual clients; identifying details have been changed and experiences combined to protect privacy.

They are stories about what can sit behind the behaviour.

Because sometimes progress isn't measured by the number of new foods on a plate.

Sometimes it's a child attending their first sleepover.

A family going to a restaurant again.

A parent feeling less frightened at dinner.

Or a young person beginning to understand that their eating difficulty isn't something they need to feel ashamed of.

Sometimes helping with food is really about helping life become bigger again.

When eating starts making life smaller, it may be time to look beyond the food. 

I work with children, adolescents, adults and families to understand what may be sitting underneath eating difficulties and to develop practical, compassionate ways forward. Support can include nutrition therapy, ARFID and feeding support, eating disorder treatment, counselling and family-focused work.