Parents of young children with higher body weights frequently report concerns about disordered eating behaviors when entering pediatric weight interventions, according to a new study that followed families over more than two years.
The study, published in the Journal of Nutrition Education and Behavior, analyzed data from families enrolled in a long-running pediatric obesity intervention conducted in primary care settings.
Researchers examined parental concerns about disordered eating among children ages 3 to 11 with higher body weights who were participating in the Population Effects of Motivational Interviewing on Pediatric Obesity in Primary Care (BMI²+) study. The intervention included up to six motivational interviewing–based nutrition counseling calls with registered dietitians, delivered remotely over approximately two to two-and-a-half years.
Disordered eating was defined broadly to include behaviors and concerns such as loss of control eating, excessive preoccupation with weight or shape, or restrictive eating patterns that do not necessarily meet diagnostic criteria for an eating disorder.
At the start of the intervention, 44.9% of parents reported at least one concern related to disordered eating. The most common concerns involved loss of control eating and heightened attention to weight or shape. Parental concerns were more likely to be reported for children with higher body mass index values and for children perceived by parents as overweight or obese.
Importantly, researchers found that parental concerns did not significantly increase or decrease over the course of the intervention. Baseline concerns also did not predict whether families remained engaged in the program over time.
“This study shows that concerns about disordered eating behaviors are common among parents of young children with high weights, but these concerns do not appear to worsen when families engage in supportive, autonomy-focused counseling,” said Kendrin R. Sonneville, associate professor in the Department of Nutritional Sciences at the University of Michigan School of Public Health and the study’s lead investigator.
The findings suggest that motivational interviewing–based approaches, which emphasize collaboration, autonomy and nonjudgmental support, may help families address health-related behaviors without reinforcing weight stigma or unhealthy weight-control practices.
The authors note several limitations, including reliance on parental report and the lack of validated tools specifically designed to assess disordered eating concerns in very young children. Still, the results underscore the need for developmentally appropriate screening methods and for clinician awareness of parental concerns during pediatric weight-related care.
This study was supported by the National Institutes of Health, including the National Institute of Diabetes and Digestive and Kidney Diseases and the National Heart, Lung, and Blood Institute, along with additional support from the American Academy of Pediatrics and the U.S. Department of Health and Human Services.