Ask Nurse Lynn: Hunger or Food Anxiety

Question:

Female, 14 years old, unknown subtype

Does the hunger come with anxiety? What kind of medication is helpful?

Nurse Lynn’s Response:

Anxiety and food worries are very common PWS. First, I want to say that I am not a physician or a prescriber, but I can share information that may help you talk with your child’s healthcare team.

In PWS, what looks like hunger is not always true hunger. Sometimes anxiety shows up as “food anxiety.” This means a person may feel very worried about food or start looking for food even when their body has had enough to eat. This can happen when routines change, when someone feels stressed, or when they are unsure about when the next meal will be. Some individuals with PWS may wake up feeling anxious and immediately ask for food. In many cases, this behavior is related more to anxiety than to the body needing calories.

Because of this, strong routines and food security are very important. Meals and snacks should happen at the same times every day, so your child knows when food is coming. It can also help to keep food in a secured environment, such as locked cabinets or refrigerators, so there is no confusion about access. Visual schedules that show the day’s plan, including mealtimes, can be helpful. Timers or countdowns between meals can also reduce anxiety. Many families find that using simple tools like a “first–then” board works well. For example, “First homework, then a walk,” or “First shower, then screen time.” Keeping your teen busy with activities between meals, such as exercise, hobbies, or helping with chores, can also help shift the focus away from food.

If the anxiety or food focus becomes very strong, it may be helpful to talk with your child’s doctor or mental health provider. You may want to ask if anxiety could be playing a role, if any medications might be contributing to the behavior, or if additional supports such as behavioral therapy might help. Sleep problems, stress at school, or changes in routine can also make food anxiety worse, so it is helpful for the care team to look at the whole picture. I will include several links that will be helpful if you are thinking about medication.

Resources:

Nutrition-Adolescence-Adult-Revised-Aug-2022.pdf

Follow-the-Principles-of-Food-Security.pdf

Behavior-Management-Guidelines.pdf

PWS-Information-for-Psychiatrists.pdf

Mental-Health-and-Behavior-Changes.pdf

The-Mental-Health-of-People-with-PWS-T-Holland.pdf

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