Odds of fussy eating are greater among children with obesity and anxiety

Abstract

Background: Fussy eating has been associated with autism spectrum disorder (ASD), attention-deficit/hyperactive disorder (ADHD), anxiety, and depression. Despite these disorders being prevalent in obesity treatment, no studies have been published on the association of fussy eating in children with obesity and these disorders. Understanding fussy eating in children with obesity and comorbid disorders is important as acceptance of healthy foods tends to be low, especially in children with sensory sensitivities.Objectives: Investigate the prevalence of fussy eating in a cross-sectional sample of children with obesity and ASD, ADHD, anxiety, and depression; and whether they were more likely to be fussy eaters, comparing those with and without these disorders.Methods: One hundred and four children referred to family-based obesity treatment in Iceland 2011-2016, mean age 12.0 (SD = 3.0), mean body mass index standard deviation score 3.5 (SD = 0.9). Binary logistic regression was used to estimate the relationship between fussy eating and disorders, adjusting for medication use.Results: A large minority (41.6%) were fussy eaters and 48.9% had at least one comorbid disorder. Over a third of children rejected bitter and sour tastes, and 1.9% and 7.9% rejected sweet and salty tastes, respectively. Compared with those without disorders, the odds of being a fussy eater were increased by a factor of 4.11 when having anxiety (95% confidence intervals) (1.02-16.58, p = 00.046), adjusting for medication use. The odds of being a fussy eater were not increased for other disorders; ASD, ADHD, or depression. Conclusions:In children attending obesity treatment, fussy eating was common.

Body Composition in Fussy-Eating Children, with and without Neurodevelopmental Disorders, and Their Parents, Following a Taste Education Intervention

“…It may also be helpful to compare our present results to a study on 104 Icelandic children with obesity (mean age; 12.0, SD = 3.5, mean BMI-SDS; 3.5, SD = 0.9), where almost half of the parents considered their child a fussy eater. In addition, nearly half of the children had a diagnosed disorder, including ASD with or without ADHD [ 20 ]. Approximately 8% of the children in our sample had obesity, which is slightly higher compared with recent estimates of 7% from The Development Centre for Primary Healthcare in Iceland (DCPHI) for overall obesity in children aged 6, 9, 12, and 14 years old [ 72 ].…”

“…Other mechanisms affecting children’s weight status may also be related to their eating behaviors, such as fussy eating and food neophobia, in which a limited diet may affect children’s general health and growth [ 16 , 17 , 18 ]. Fussy eating is often seen in children with obesity [ 17 , 19 , 20 ], as fussy eaters may be at a higher risk for becoming overweight or have obesity as older children and adolescents, possibly due to a penchant for calorie-dense foods and sweet beverages, and rejection of fruits and vegetables [ 21 ]. However, some researchers have not been able to determine the association between children’s increased weight status and fussy eating [ 22 ], with some studies even reporting the risk of underweight in fussy-eating children [ 23 , 24 , 25 , 26 , 27 , 28 ], especially in those who are not typically developing (TD).…”

Changes in Eating Behaviors Following Taste Education Intervention: Focusing on Children with and without Neurodevelopmental Disorders and Their Families: A Randomized Controlled Trial

“…Problematic eating behaviors in children with ASD and/or ADHD may share certain commonalities, even more so than previously thought [ 91 , 92 ]. Furthermore, regardless of ND-status, most children with fussy eating share a fear of new foods, oppositional behavior, sensitivities to certain stimuli, anxiety, and dislike of fruit and vegetables and other fibrous or bitter foods [ 80 , 91 , 92 , 93 ]. Thus, as deployed in the Taste Education intervention, our gentle methods are perhaps suitable for children who share certain sensitivities regarding food and food-related stimuli.…”

Changes in Anxiety following Taste Education Intervention: Fussy Eating Children with and without Neurodevelopmental Disorders

“…In a recent study published by the authors on children with obesity (mean age 12.0 years), the odds of being a fussy eater were increased by a factor of 4.11 when a child had anxiety, after adjusting for medication use. The odds were not raised for children with ND or depression [36].…”