Hypnotherapy for Food Aversions/Picky Eating in an 11-Year-Old Male
There is limited evidence supporting hypnotherapy as a treatment for food aversions or picky eating in children, with only case series evidence available, but no well-established clinical trials specifically for this application.
Current Evidence for Treating Food Aversions in Children
Hypnotherapy Evidence
- A small case series from 1996 described successful use of hypnobehavioral approaches in five school-age children with maladaptive eating behaviors, including food aversion 1. However, this represents very low-quality evidence without controlled trials or larger studies to confirm efficacy.
Well-Established Treatments for Eating-Related Issues
- Family-based treatment (FBT) approaches are considered well-established for treating eating disorders in adolescents, particularly for anorexia nervosa and bulimia nervosa 2, 3.
- Cognitive-behavioral therapy (CBT) is recommended for eating disorders in adults and has some evidence for adolescents with bulimia nervosa 4, 5.
Understanding Picky Eating vs. Eating Disorders
Picky Eating
- Picky eating is a common behavior in early childhood that may persist into school age 6.
- Causes include early feeding difficulties, late introduction of textured foods, pressure to eat, and early choosiness 6.
- Consequences may include poor dietary variety and potential nutrient deficiencies, particularly iron and zinc 6.
When Picky Eating Becomes Problematic
- Avoidant/Restrictive Food Intake Disorder (ARFID) is a formal diagnosis when food avoidance leads to:
- Significant weight loss or failure to meet expected growth
- Nutritional deficiency
- Dependence on nutritional supplements
- Marked interference with psychosocial functioning 7
Evidence-Based Approaches for Food Aversions
First-Line Approaches
- Repeated exposures to unfamiliar foods
- Parental modeling of eating fruits, vegetables, and unfamiliar foods
- Creating positive social experiences around mealtimes 6
- Family-based treatment approaches that empower parents to address eating behaviors 2, 5
For More Severe Cases
- For cases meeting criteria for ARFID, family-based treatment is considered possibly efficacious 2
- Cognitive-behavioral approaches may be beneficial for some eating-related issues 4, 5
Clinical Application
Assessment Considerations
- Determine severity of food aversion:
- Impact on growth and development
- Nutritional adequacy of diet
- Psychosocial functioning
- Rule out ARFID or other eating disorders 7
Treatment Recommendations
Begin with evidence-based behavioral approaches:
- Structured family meals
- Gradual exposure to new foods
- Positive reinforcement
- Elimination of pressure to eat
Consider referral to specialists if:
- Growth is affected
- Nutritional deficiencies are present
- Significant psychosocial impairment exists
Hypnotherapy could be considered as an adjunctive approach if:
- First-line behavioral approaches have been unsuccessful
- The child is amenable to hypnotic techniques
- A qualified practitioner experienced with children is available
Conclusion
While hypnotherapy has been reported in case series to help some children with food aversions 1, there is insufficient evidence to recommend it as a first-line treatment. Family-based approaches and behavioral strategies have stronger evidence bases for addressing problematic eating behaviors in children and should be prioritized. If considering hypnotherapy, it should be viewed as a potential adjunctive treatment provided by qualified practitioners, rather than a primary intervention.