Loss of control eating disorder in children age 12y and younger: Proposed research criteria

Unit on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD 20892-1103, USA.
Eating Behaviors (Impact Factor: 1.58). 08/2008; 9(3):360-5. DOI: 10.1016/j.eatbeh.2008.03.002
Source: PubMed


Binge eating is common in middle childhood (6-12 years) and often presents in concert with disordered eating attitudes, emotional distress, overweight and adiposity. Binge eating is also predictive of excessive weight gain and is associated with energy intake. However, few children meet DSM-IV-TR criteria for binge eating disorder, thereby making treatment recommendations a challenge. We propose criteria for a new diagnosis, Loss of Control Eating Disorder in Children age 12 years and younger, for further study. The criteria put forward are a revision of Marcus and Kalarchian's [Marcus, M.D., & Kalarchian, M.A. (2003). Binge eating in children and adolescents. International Journal of Eating Disorders, 34 Suppl, S47-S57.] provisional binge eating disorder research criteria for children 14 years and younger, and are based upon the evolving literature in children with binge and loss of control eating episodes. A rationale for the new criteria set is provided, and future research directions are proposed.

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Available from: Susan Z Yanovski, Feb 27, 2014
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    • "Loss of control eating encompasses objective binge eating (feeling out of control of one’s eating and consuming an objectively large amount of food) and subjective binge eating (feeling out of control of one’s eating but not consuming a large amount of food). It is established that loss of control, regardless of the amount of food eaten, is the key component of binge eating behaviour in childhood [49] and objective and subjective binge eating were both considered for this research. "
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    ABSTRACT: Previous studies have found associations between maternal and family factors and child eating disorder symptoms. However, it is not clear whether family factors predict eating disorder symptoms specifically, or relate to more general child psychopathology, of which eating disorder symptoms may be one component. This study aimed to identify maternal and family factors that may predict increases or decreases in child eating disorder symptoms over time, accounting for children's body mass index z-scores and levels of general psychological distress. Participants were 221 mother-child dyads from the Childhood Growth and Development Study, a prospective cohort study in Western Australia. Participants were assessed at baseline, 1-year follow-up and 2-year follow-up using interview and self-report measures. Children had a mean age of 10 years at baseline and 46% were male. Linear mixed models and generalised estimating equations were used to identify predictors of children's eating disorder symptoms, with outcome variables including a global index of eating disorder psychopathology, levels of dietary restraint, levels of emotional eating, and the presence of loss of control ('binge') eating. Children of mothers with a current or past eating disorder reported significantly higher levels of global eating disorder symptoms and emotional eating than other children, and mothers with a current or past eating disorder reported significantly more concern about their children's weight than other mothers. Maternal concern about child weight, rather than maternal eating disorder symptoms, was significant in predicting child eating disorder symptoms over time. Family exposure to stress and low maternal education were additional risk factors for eating disorder symptoms, whilst child-reported family satisfaction was a protective factor. After adjusting for relevant confounding variables, maternal concern about child weight, children's level of family satisfaction, family exposure to stress, and maternal education are unique predictors of child eating disorder symptoms.
    Full-text · Article · Apr 2014 · Journal of Eating Disorders
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    • "Therefore, a continuum scale of obese adolescents with full-fledged BED and subclinical BED as compared to a control group is needed to fully understand the spectrum of disordered eating behaviours associated with binge eating disorder [34]. Additional research has also proposed investigating LOC in children (6–12 years of age) as opposed to BE or BED due to the efficacy of LOC in identifying disordered eating in children [35]. "
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    ABSTRACT: Objective. This study aimed to investigate potential differences in appetite sensations, ghrelin, peptide YY, and glucose and their relationship with energy and macronutrient intake in obese adolescents with subclinical binge eating disorder. Methods. Fifteen obese adolescents (six and nine individuals with and without subclinical binge eating disorder, resp.) qualified for this study. Visual analog scales and Three-Factor Eating Questionnaires were used to assess eating behaviours. Circulating ghrelin, peptide YY, and glucose were measured after fasting and at multiple time points postprandially following a standardized breakfast meal. Energy and macronutrient intake were measured with an ad libitum lunch buffet. Results. Emotional eating scores were significantly higher in obese adolescents with subclinical binge eating disorder. Hunger levels rose and satiety levels fell significantly over the course of the monitoring period but there was no difference between the two groups. Obese adolescents with subclinical binge eating disorder did not have significantly different levels of appetite signaling proteins or glucose. Obese adolescents with subclinical binge eating disorder had a nonsignificantly higher energy and macronutrient intake. Conclusions. A significant difference between the two groups in terms of their emotional eating scores highlights the important role that psychological factors play in relation to eating behaviours.
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    ABSTRACT: Recent research suggests that binge eating is a common experience in youth. However, it remains largely unknown how children's binge eating presents in everyday life and which psychological factors serve to maintain this binge eating. Children aged 8-13 years with binge eating (n=59), defined as at least one episode of loss of control (LOC) over eating within the past three months, and 59 matched children without LOC history were recruited from the community. Following a combined random- and event-sampling protocol, children were interviewed about their day-to-day eating behavior, mood, and eating disorder-specific cognitions using child-specific cell phones during a 4-day assessment period in their natural environment. LOC episodes led to a significantly greater intake of energy, particularly from carbohydrates, than regular meals of children with and without LOC eating. While LOC episodes were preceded and followed by cognitions about food/eating and body image, there was minimal evidence that negative mood states were antecedents of LOC eating. The results provide support for the construct validity of LOC eating in children. Maintenance theories of binge eating for adults apply to children regarding eating disorder-specific cognitions, but the association with affect regulation difficulties requires further investigation.
    No preview · Article · Nov 2008 · Behaviour Research and Therapy
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