Loss of control over eating, adiposity, and psychopathology in overweight children

Abstract

OBJECTIVE-To investigate the relationship between loss of control over eating, adiposity, and psychological distress in a non-treatment sample of overweight children.METHOD-Based on self-reports of eating episodes, 112 overweight children, 6-10 y, were categorized using the Questionnaire of Eating and Weight Patterns -Adolescent Version into those describing episodes of loss of control over eating (LC), and those with no loss of control (NoLC). Groups were compared on measures of adiposity, dieting and eating behavior, and associated psychological distress.RESULTS-LC children (33.1%) were heavier and had greater amounts of body fat than NoLC children. They also had higher anxiety, more depressive symptoms, and more body dissatisfaction. 5.3% met questionnaire criteria for BED. Episodes of loss of control occurred infrequently, were often contextual, and involved usual meal foods. DISCUSSION-As in adults, overweight children reporting loss of control over eating have greater severity of obesity and more psychological distress than those with no such symptoms. It remains unknown whether children who endorse loss of control over eating before adolescence will be those who develop the greatest difficulties with binge eating or obesity in adulthood. KeywordsBinge eating; obesity; child; race; psychopathology Binge eating is a frequent behavior in overweight adults ( Loro & Orleans, 1981;Gormally, Black, Daston & Rardin, 1982;Marcus, Wing & Lamparski, 1985;Spitzer et al, 1992;Fairburn & Wilson, 1993;Grisset & Fitzgibbon, 1996;Robertson & Palmer, 1997), and is Author ManuscriptAuthor Manuscript Author ManuscriptAuthor Manuscript defined by the consumption of large amounts of food associated with a feeling of loss of control over eating (Fairburn & Wilson, 1993). A smaller proportion of individuals reporting binge eating meet criteria for binge eating disorder (BED), a research diagnostic category of the DSM IV that is characterized by recurrent binge-eating episodes associated with marked distress, but without inappropriate compensatory behaviors. The prevalence of BED in obese adults seeking weight loss treatment may be as high as 20% to 30% (Spitzer et al., 1992 while rates of BED in community samples have been estimated at somewhat less than 3% (Yanovski, 1999).In adults, binge eating is often associated with obesity (Telch, Agras & Rossiter, 1988;Smith, Marcus, Lewis, Fitzgibbon & Schreiner, 1998) and other disturbed eating behaviors. Besides having less ability to control eating behavior (Grisset & Fitzgibbon, 1996;Wadden, Foster, Letizia & Wilk, 1993;Kuehnel & Wadden, 1994), obese adults reporting binge eating also have greater concerns with body shape and weight (Marcus, Smith, Santilli, Kaye, 1992;Spitzer et al., 1993;Wilson, Nonas & Rosenblum, 1993), report an earlier onset of obesity and dieting, and describe a higher percentage of their lifetimes spent on a diet than non-binge eating obese individuals (Brody, Walsh & Devlin, 1994). Several studies have shown that obese adult binge eaters also report...

The association of parental characteristics and psychological problems in obese youngsters

“…31,32 Moreover, using the same cutoffs for the CBCL as Epstein et al 6 and according to gender, between 41.4 and 53.1% of the youngsters seeking weight-loss treatment showed considerable adjustment problems, whereas their parents scored higher than a representative norm group on psychiatric symptoms. Compared with the study of Epstein et al, 6 the present study even found a larger percentage of parents exceeding clinical cutoffs for psychiatric symptoms (59.6% of mothers and 35.7% of fathers) than Epstein et al 6 (27.6% of mothers).…”

Evaluating binge eating disorder in children: Development of the children's binge eating disorder scale (C‐BEDS)

“…Some studies use queries to further explain loss of control (e.g., ''when you start to eat, and you eat and eat and eat, and you just can't stop''). 12 Other batteries including the Questionnaire of Eating and Weight Patterns-Adolescent version (QEWP-A) 9,12-15 and the Binge Eating Scale (BES) 16 have also been used; however, these measures were not designed to be interviewer-administered. It has been reported that self-report measures of eating disorder assessment in children (e.g.…”

“…[10][11][12][13][14][15][16] For example, when using the ChEDE, studies have found a 0% prevalence of BED 22,23 ; however, 7.9% of children aged 10-16 seeking outpatient weight loss treatment reported subthreshold binge eating 22 and of children aged 6-14, 6.2%, 3.1%, and 20.4% reported objective binge episodes, subjective binge episodes, and overeating, respectively. 23 When using the QEWP-A, although only 5.3% of children aged 6-10 met BED criteria, 33.1% reported loss of control over eating.…”

“…23 When using the QEWP-A, although only 5.3% of children aged 6-10 met BED criteria, 33.1% reported loss of control over eating. 12 When using the QEWP-A, children aged 10-19 had a 1% prevalence of BED 15 ; however, when using the KEDS, which does not evaluate loss of control, prevalence rates have shown to be much higher (26.3% and 6.5% in boys and girls, respectively). 10 Thus, accurate prevalence estimates are complicated by the multitude of measures currently used and a lack of a reliable consensus method of diagnosing binge eating disorder in children.…”

“…In addition, as in adults, loss of control over eating is associated with more morbidity, including adiposity and psychiatric symptoms. 12 Thus, Criterion A, recurrent binge episodes, are characterized by both food seeking in the absence of hunger and a sense of lack of control over eating. The behavioral correlates specified in Criterion B (food seeking in response to negative affect, food seeking as a reward, and sneaking or hiding food), were also proposed based on the extant literature reviewed by Marcus and Kalarchian.…”