Thursday, February 22, 2024

Appetitive Traits in Children May Be Associated With Disordered Eating in Adolescence

Children who show greater food responsiveness in early childhood have a higher risk of experiencing eating disorder symptoms in early adolescence, while those who eat more slowly have a lower risk of such symptoms, according to a study published this week in The Lancet Child & Adolescent Health.

“Eating disorders frequently coexist with other psychiatric disorders and have high mortality rates,” wrote Ivonne Derks, Ph.D., of Erasmus Medical Center in Rotterdam, Netherlands, and colleagues. “Because these disorders are difficult to treat, focus is shifting towards prevention and early intervention when symptoms or episodes first arise, often in adolescence.”

Derks and colleagues used data from two population-based cohort studies: Generation R, which is based in Rotterdam, and Gemini, which is based in England and Wales. Parents reported their children’s appetitive traits by completing the Child Eating Behaviour Questionnaire (CEBQ) when children were aged four (Generation R) or five (Gemini). Youth self-reported eating disorder symptoms when they were aged 12 to 13 (Gemini) or 14 (Generation R). Eating disorder symptoms included restrained (restricted) eating, uncontrolled eating, emotional eating, binge eating, and compensatory behaviors (such as purging, extended fasting, or hiding or throwing away foods). A total of 3,670 participants from both studies were included in the final analysis.

The authors looked at seven appetitive traits measured by the CEBQ. Higher scores in three traits reflected a more avid appetite: food responsiveness (how responsive children are toward external food cues), food enjoyment, and emotional overeating. Higher scores in four traits reflected a poorer appetite: food fussiness, satiety responsiveness (how quickly children feel full), eating slowly, and emotional undereating.

Derks and colleagues found that greater food responsiveness in early childhood was associated with increased odds of all five eating disorder symptoms in adolescence, especially binge eating. A 1-unit increase in the food responsiveness scale in early childhood corresponded with a 47% increased risk of binge eating symptoms in early adolescence, the authors wrote.

“This finding is important because overeating and restrictive eating disorder symptoms often co-occur within eating disorders (e.g., in bulimia nervosa or anorexia nervosa binge/purge type) or might trigger one another (e.g., binge eating episodes are often preceded by restrained eating, which can drive binge eating episodes),” the authors wrote.

Additional findings include the following:

  • Emotional overeating in early childhood was associated with an increased risk of engaging in compensatory behaviors in early adolescence.
  • Slowness while eating in early childhood was associated with a reduced risk of engaging in compensatory behaviors and restrained eating in early adolescence.
  • Greater satiety responsiveness during early childhood was associated with a reduced risk of engaging in compensatory behaviors and uncontrolled eating in early adolescence.

“Our findings could provide new opportunities for treatment and prevention of eating disorders,” the authors wrote. “[T]eaching parents and children how to recognize and respond to internal feelings of hunger and satiety, encourage slower eating at mealtimes, and not to offer or eat food for reasons other than homoeostatic hunger… are practices that support the development of healthy eating habits.”

For related information, see the Psychiatric News article “APA Releases Updated Guideline for Treating Eating Disorders.”

(Image: Getty Images/iStock/Tetiana Soares)

Don't miss out! To learn about newly posted articles in Psychiatric News, please sign up here.


The content of Psychiatric News does not necessarily reflect the views of APA or the editors. Unless so stated, neither Psychiatric News nor APA guarantees, warrants, or endorses information or advertising in this newspaper. Clinical opinions are not peer reviewed and thus should be independently verified.