Food control focuses on creating an environment that limits access to food. Children who have medical conditions associated with binge eating and weight gain may need to live, learn, and play in spaces that either don’t have food or have food securely stored away to prevent unlimited intake. Families with children who have Prader-Willi Syndrome (PWS), a rare genetic disorder, those with medical issues like diabetes or weight gain, as well as those who are food seeking due to behavioral or cognitive issues should consider how the following information can help create safer spaces.
Jean Park, MS, MBA, RD, LD, Director of Nutritional Services at Nexus Children’s Hospital, explains the first step is evaluating your child’s level of food seeking. “Some kids eat anything while other kids are more discretionary. Some might binge eat fruit or snacks while others eat raw meat or pet food.”
It’s equally important to understand your child’s cognitive status. Food can be controlled in many ways, from physically locking it away to not purchasing excess groceries to keeping food at a family member’s or neighbor’s home. Jean mentioned that oftentimes families have other children to feed, and therefore food needs to be kept at home. She said, “In those instances, food could be stored in a secondary location, like a mini fridge or cabinet in the garage or parent’s room—anywhere the child who has food seeking behaviors can’t access it freely.”
If your child has higher cognitive function, combination locks might not keep him or her out of cabinets or the refrigerator for long. Locks with keys or placing a door to close off the entire kitchen might be a more effective long-term solution.
Age and physical status are important factors to consider when securing food at home. Jean said, “If your child is small, you might be able to put food on a higher shelf. But as your kid gets older and more physical, different strategies will need to be implemented, including more sophisticated locks or removing objects and tools that could facilitate their access to food.”
Regardless of the food control strategies deployed, Jean explained it is crucial to have the proper documentation from doctors, so that neighbors or landlords (if renting) understand the modifications you’re making to your home.
“We also recommend parents or guardians communicate their unique situation to neighbors and local food stores and restaurants,” said Jean. “If a kid has more intense food seeking behaviors and higher cognitive function, he or she could manipulate others into feeding him or her.”
It’s also critical to keep your child’s school informed. Jean recommends documenting your child’s diagnosis and their environmental needs in an Individualized Education Plan (IEP) or 504. Determining what is appropriate for your child while at school will help him or her be more successful.
“When you think about it, most schools would be okay making a safe, peanut-free environment if a student had a severe allergy,” said Jean. “However, with these kids¬—where food can be just as deadly— it can be challenging to have accommodations followed. It’s very important to advocate for your child and ensure the school is held accountable for his or her safety.”
Jean went on to say, “School recommendations could range from no food in the child’s classroom or no access to other students’ lunch bags, to eating outside the cafeteria or at a separate table with a teacher or aide. They also depend on the school district and how food is served or made available throughout the day.”
Nexus Children’s Hospital offers the only inpatient program for children with established weight control problems, including Prader-Willi Syndrome (PWS). The Changes Health & Wellness program incorporates low-calorie diets, set daily schedules, individualized physical training regiments, and behavioral health support for both the patient and family members.
“Our program offers children the consistency they need to reach health goals and learn strategies to help them be more successful after they discharge,” explained Jean. “The only food allowed on the unit is delivered to each specific patient. Staff isn’t allowed to bring in food and dirty trays are removed after mealtime and the trash is monitored.”
Jean also explained that while children are in-house, program staff along with the psychology department work to figure out strategies that will work for each child and his or her family’s lifestyle, house layout and family support
“We have some families who have already established food control but just need or want a refresher for new ideas,” said Jean. “And we also have some families who have never locked anything away and don’t know where to start.”