Posted by Marta Swanson on September 18, 2025
In this two-post series, ICN Registered Dietitian, Marta, reflects on working with patients with IBD and their families around establishing a balance between following dietary "best practices" while holding some space for kids and teens to learn and develop their own food autonomy through trial and error.
The volume has been turned up about diets and nutrition, more than ever. Being a Registered Dietitian (RD) for over 20 years, I am glad more people are thinking about what they are eating and nourishing themselves and their family, however, I don’t want a diet to be used as a sword.
Diet changes are more likely to occur once a person is diagnosed with a chronic condition, an example is IBD (Inflammatory Bowel Disease, an umbrella term for Crohn’s Disease and ulcerative colitis). I often see momentum for eating perfectly - or close to perfectly - after big life changes like learning about a chronic condition. It’s normal and desirable for a parent to feel a responsibility for their child’s nutrition, especially once a diagnosis like IBD is made.
As an RD, of course I want all of my patients to eat fruits, vegetables, beans/legumes, and wholesome foods. However, eating isn’t a race for perfection even though there is pressure in our culture to eat optimally. Sometimes in the push to eat optimally, we forget about the pleasure component of eating! Eating and enjoying food has so many facets; there are naturally going to be some challenges, some mistakes, and some imperfections. I have found there is a fine line between following “best practice” and allowing for natural eating autonomy to occur – especially for teens.
Being a teenager is a chance to practice making choices and sometimes mistakes are made. When it comes to food choices, it can feel like a lot of pressure to eat perfectly, especially once diagnosed with IBD.
Teens can make some bizarre foods choices. Being a teenager is a chance to practice making choices and sometimes mistakes are made. When it comes to food choices, it can feel like a lot of pressure to eat perfectly, especially once diagnosed with IBD. I caution parents and other health professionals to avoid using a chronic condition to endorse perfection in a diet. This brings restrictions, limitations, and in some cases, permission to entertain disordered eating.
Some trial and error is part of life, especially for teens. A mindset of eating perfectly or nearly perfectly can contribute to unnecessary stress. A guide I like to give families is the 80/20 rule as a mindful approach to eating; 80% of the time strive to eat wholesome foods and allow for 20% imperfection – more or less!
It's also important to consider the messages that teens are getting from their parents/caregivers. These subtle (or not so subtle) cues can be very empowering and inform lifelong habits. Here are some examples:
💚 Parent/caregivers should model desired dietary changes
Don’t expect your teen to eat one way (because of a diagnosis) while you continue eating as freely as you want as their adult example. Any change you want your kids or teens to make should be modeled by parents/caregivers, their mirror for support and compassion.
💙 Teens build autonomy when they make choices (and mistakes) without judgement
Giving your teen space to order for themselves while dining out, and avoiding judgement of their choices, helps them build self-trust and autonomy. If you feel uncomfortable with their choice, perhaps first pause to see if it happens only once or if it is repeated. If, for instance, they keep ordering something that you know hasn't agreed with them, try warmly engaging them in conversation about it. Here are some examples of how that might sound:
“I noticed you ordered the burger, fries and mudslide pie. Can we talk about how that went for you sometime?”
"I noticed your belly hurts after eating hot chips. I was wondering if we can find something else for you to enjoy? I would be happy to stop eating them as well."
💚 Eating meals together can positively affect mental health
We know that teens who enjoy meals with their family 3 days per week are less likely to deal with depression, anxiety, and/or eating disorders1. Make the dinner table a place where your kids and teens want to be. One way to do that is by avoiding comments about food choices - like how many peas they ate or if they took a second slice of bread. Comments like these will not shift eating behavior and may actually drive your teen away from the table.
📌 Sources
- Neumark-Sztainer, Dianne. "I’m, like, So Fat!” – Helping Your Teen Make Healthy Choices about Eating and Exercise in a Weight-Obsessed World. Guilford Press, 2005.