The perceived onset of dieting and loss of control eating behaviors in overweight children

Abstract

Objective: The current study investigated the self-reported temporal relationships of dieting, binge eating, and overweight in childhood.

Method: One hundred five non-treatment-seeking overweight children ages 6-13 years were interviewed with the children's Eating Disorder Examination (ChEDE) and queried regarding dieting, loss of control (LOC) eating, and overweight history. Questionnaires of depressive symptoms, trait anxiety, and parent-reported problems were completed.

Results: Sixty percent of the children reported having attempted at least one diet. These children had higher ChEDE scores (global, p < .001), greater body mass index (BMI) and body fat mass (p < or = .001), and a trend towards an earlier reported age of overweight onset (p = .06) compared with children who had never dieted. The 29.5% of children who reported LOC eating had significantly higher ChEDE scores (global, p < .001), ineffectiveness, negative self-esteem, and externalizing scores (all ps < .05) compared with those who had never experienced LOC eating. Most children reported becoming overweight before either dieting (79.4%) or experiencing LOC eating (63.6%). Among the 25.7% reporting both dieting and LOC eating, two thirds reported LOC eating before dieting. Participants who reported dieting before overweight had higher negative mood scores (p < .01). Children reporting dieting before LOC eating had higher ChEDE Weight Concern (p < .01) and global (p < .05) scores.

Discussion: For overweight, non-treatment-seeking children, both dieting and LOC eating are common. Dieting precedes the development of LOC eating only one third of the time, but is associated with greater disordered eating cognitions. The relationship between childhood-onset dieting and LOC eating in overweight children requires further investigation to determine the causal pathways for the subsequent development of eating disorders.

FIGURE 1

Relationship between overweight onset as defined by the 85th percentile based on growth chart and self-reported overweight onset. R = −.06, p = .38.

FIGURE 2

Relationships between dieting and loss of control (LOC) eating in overweight children. Ever LOC = children who reported at least one episode of LOC eating; Never LOC = children who reported no such episodes; Ever Diet = children who reported attempting at least one diet; Never Diet = children who reported no dieting attempts.

FIGURE 3

Children’s Eating Disorder Examination (ChEDE) scores of children who reported both dieting and loss of control (LOC) eating. Diet First = children whose first attempted diet preceded their first LOC eating episode; LOC First = children whose first LOC eating episode preceded their first attempted diet. **p < .01; *p < .05, Diet First vs. LOC First.