Facilitating Internal Regulation of Eating: A Treatment Model for Infantile Anorexia

Abstract

Infantile anorexia is characterized by food refusal and failure to thrive. It is defined as a transactional disorder that leads to a developmental disturbance in internal regulation of eating. By this transactional model, the infant's temperament characteristics of emotional intensity, distractibility, and stubbornness evoke conflicts over control and limit setting in a vulnerable mother who becomes anxious and insecure when faced with the infant's food refusal and oppositional behaviors during feeding. Mother and infant become increasingly involved in maladaptive interactions, each struggling for control, with food being the battleground. The infant's eating becomes increasingly externally controlled by the interactions with his or her caregivers instead of internally by hunger and fullness. The therapeutic intervention addresses the three components of the model: (1) it serves to help the parents understand and deal with the anorectic infant's temperament, (2) it addresses the difficulties the parents may have in setting limits, and (3) it provides parents with recommendations on how to structure meal times in order to facilitate internal regulation of eating