We’ve all known the kid, or been the kid, that has an even more limited diet than the 4 basic meals on every kids menu – pizza, chicken fingers, french fries and spaghetti  – who’s diets are limited to sugary cereal, frozen fried chicken, or even worse – certain brands of each. Picky eating behavior can also involve temper tantrums when favorite foods are denied, both at home and in public.  Parents tend to deal with this in different ways, with Boomers practicing a more authoritarian approach to “finish what’s on your plate” because there’s “starving kids in Africa” – to Gen X parents taking a softer approach that may often involve cooking a different meal for each kid, or carting around brand-specific snacks.

And, unfortunately for anxiety-ridden parents, picky eating isn’t uncommon.  According to a study from the Department of Psychiatry and Behavioral Sciences at Stanford University in CT, from years 2 to 11 between 13% and 22% of the children studied were reported to be picky eaters. And, most where seen as “chronic” with 40% having a duration of more than 2-years.  In fact other studies show picky eaters across all age ranges can be as high as 50% of children.

While most parents hope it’s a phase that kids will outgrow, and pediatricians are known to give the initial advice to “wait it out” – there may be more that this behavior reveals.  A new study from the Department of Psychiatry and Behavioral Sciences at Duke University School of Medicine published in the journal Pediatrics, has shown that extreme cases of picky eating can be associated with deeper issues including depression and social anxiety.

For the study of nearly 917 children, 20% fell into the “picky eater” category, but only 3% into what researchers defined as “severe selective eaters” – where food choices were so limited that it made meals at home difficult, and meals out almost impossible.  What they found was that amongst this group of 3%, picky children were twice as likely as the children who weren’t picky to have a diagnosis of depression, and seven times as likely to have been diagnosed with social anxiety.  But, even the children in the more moderate group had an increased rate of depression, social anxiety or attention deficit-hyperactivity disorder symptoms compared to children who weren’t picky eaters at all.

According to Nancy Zucker, director of the Duke Center for Eating Disorders, “parents of children who are extremely picky may find it useful to seek help, because kids may not simply outgrow the behavior on their own.”

Researchers said overall this study shouldn’t alarm parents, but help them to better define picky eating parameters and identify when the behavior is a sign of something more serious, like anxiety.