Case Challenges

Picky Eating and Food Aversion, From Typical to Extreme

Katja J. Rowell, MD; Jenny H. McGlothlin, MS, CCC/SLP


April 04, 2016

Choking, Anxiety, and Weight Loss

Courtney is a normally developing 8-year-old with an unremarkable history, other than typical separation anxiety as a toddler and occasional nightmares. Courtney's mother brings her in today as a walk-in. One month ago, she was eating her favorite chicken fettucine and choked on a piece of chicken. Her mother performed the Heimlich maneuver, and the episode lasted for less than 10 seconds, after which Courtney vomited.

Since then, Courtney is refusing to eat solid foods and has difficulty sleeping, and her school work is suffering. Recently, she has gone from eating mashed or pureed foods to only drinking liquids—primarily smoothies that she sips throughout the day. Her mother believes that Courtney has lost weight. Courtney's mother has been on medications in the past for generalized anxiety disorder.

Courtney weighs 3 lb less than she did at her last visit 6 months ago, dropping her from the 75th to the 50th percentile. She appears anxious, but her exam is otherwise unremarkable, with no indication of dehydration.


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