Disordered Eating Attitudes and Behaviors in Youth with Overweight and Obesity: Implications for Treatment

Abstract

Purpose of the Review: Children with obesity experience disordered eating attitudes and behaviors at high rates, which increases their risk for adult obesity and eating disorder development. As such, it is imperative to screen for disordered eating symptoms and identify appropriate treatments. Recent findings: Family-based multicomponent behavioral weight loss treatment (FBT) is effective at treating childhood obesity and demonstrates positive outcomes on psychosocial outcomes, including disordered eating. FBT utilizes a socio-ecological treatment approach that focuses on the development of individual and family healthy energy balance behaviors as well as positive self- and body-esteem, supportive family relationships, richer social networks, and the creation of a broader environment and community that facilitates overall physical and mental health. Summary: Existing literature suggests FBT is an effective treatment option for disordered eating and obesity in children. Future work is needed to confirm this conclusion and to examine the progression and interaction of obesity and disordered eating across development to understand the time for optimal intervention.

Change in eating disorder symptoms following pediatric obesity treatment

“…The results in this study support previous research that pediatric behavioral weight‐loss treatment does not appear to exacerbate ED symptomatology (Balantekin et al, ; Butryn & Wadden, ; Carter & Bulik, ; Epstein, Paluch, Saelens, Ernst, & Wilfley, ; Hayes et al, ). These results contribute to the literature by further evaluating FBT, the current recommended treatment for childhood obesity.…”

“…Two early review articles suggested that participating in a child weight-loss program did not increase ED symptomatology; however, because only a few studies were included (Butryn & Wadden, 2005) and the ED variables were inconsistently assessed (Carter & Bulik, 2008), both encouraged the need for additional research. A more recent review (Hayes et al, 2018) evaluated how family-based behavioral treatment (FBT) for obesity, the current recommended treatment for childhood obesity (O'Connor et al, 2017), is positioned to both reduce weight and discourage EDs. One recent study that assessed change in ED symptoms following FBT in children 7-11 years old showed that weight concerns decreased across the entire sample, whereas shape concerns decreased in those who had high shape and weight concerns before treatment (Balantekin et al, 2017).…”

Psychiatric Aspects of Obesity: A Narrative Review of Pathophysiology and Psychopathology

“…The idea of viewing obesity—or at least a subset of it—as a result of an eating disorder (ED) has gained increasing acceptance in the last years, since subjects with obesity often display aberrant eating patterns, linked to emotional dysregulation or executive dysfunction and are prone to develop a “food addiction”, for which many authors have suggested a genetic basis of dopaminergic insufficiency in the mesolimbic pathway [ 11 , 12 , 13 , 14 ]. Obesity, in facts, is commonly accompanied by variable disorganization in eating habits and deficits in the regulatory mechanisms of appetite, reward and emotions [ 15 , 16 , 17 , 18 ]. For example, obesity is associated with leptin and insulin resistance, which results in an impaired capacity of sensing the nutritional status of body disrupts the hypothalamic control of energy homeostasis [ 19 ].…”

Item Response Theory-based validation of a short form of the Disordered Eating Attitude Scale (DEAS-s) to a Brazilian sample

“…Disordered eating behaviors are observed mostly in the young female people and described as "epidemic" in teenagers and college students 7,8,9,10 -and are related to debilitating and costly health conditions. Disordered eating has been associated to the development of classical eating disorders 11 , with obesity 12,13 and perpetuation of overweight progress 14,15 . Disordered eating also leads to diverse psychological and behavioral consequences, e.g.…”