Comparison of the child and parent forms of the Questionnaire on Eating and Weight Patterns in the assessment of children's eating-disordered behaviors

Abstract

Objective: The assessment of eating-disordered behaviors in middle childhood is challenging. Frequently, both child and parents are queried about the child's eating behavior. However, no direct comparisons between parent and child reports of child eating disturbance have been published. We compared results from the adolescent and parent versions of the Questionnaire on Eating and Weight Patterns (QEWP-A and QEWP-P, respectively) in a nontreatment sample of overweight and normal weight children.

Method: The QEWP-A and QEWP-P were administered to 142 overweight (body mass index [BMI] > or = 85th percentile) and 121 normal weight (BMI 15th-84th percentile) children, age 9.7 +/- 1.9 years, recruited from the community.

Results: The QEWP-A and QEWP-P showed good agreement for the absence of eating-disordered behavior but were not concordant in terms of the number or type of binge eating, overeating episodes, or compensatory weight control behaviors in the past 6 months. Children categorized by their own reports (QEWP-A) as engaging in no overeating, simple overeating, or binge eating behaviors did not differ significantly in body composition or in eating and general psychopathology. Children categorized according to their parents' reports (QEWP-P) as engaging in binge eating had significantly greater body adiposity, eating-disordered cognitions, body dissatisfaction, and parent-reported problems (all ps <.001) than children engaging in no overeating or simple overeating according to the QEWP-P.

Discussion: Child and parent reports of eating behaviors are not concordant regarding the presence of binge eating or compensatory behaviors. Further investigation of the utility of these questionnaires is needed before either can serve as a surrogate for a clinical interview.

Figure 1

Percentage of subjects with reports of no abnormal eating episodes, simple overeating episodes, or binge eating episodes. Grey bars indicate children with concordant reports from children and their parents; open bars indicate children for whom only the child reported the behavior; black bars indicate children for whom only the parent reported the behavior. Percentages do not add up to 100 percent.

Figure 2

Percentage of subjects with reports of no abnormal compensatory behaviors, vomiting, fasting, laxative or diuretic use, diet pill use, or intense exercise to control body weight. Grey bars indicate children with concordant reports from children and their parents; open bars indicate children for whom only the child reported the behavior; black bars indicate children for whom only the parent reported the behavior.