Loss of control (LOC) eating in youth is associated cross-sectionally with eating-related and psychosocial distress, and is predictive of excessive weight gain. However, few longitudinal studies have examined the psychological impact and persistence of pediatric LOC eating. We administered the Eating Disorder Examination (EDE) and self-reported measures of depressive and anxiety symptoms to 195 boys and girls (M = 10.4, SD = 1.5 y) at baseline and again 4.7 (SD = 1.2) y later to 118 of these youth. Missing data were imputed. Baseline report of LOC was associated with the development of partial or full-syndrome binge eating disorder (p=.03), even after accounting for the contribution of sex, race, baseline characteristics (age, disordered eating attitudes and mood symptoms), body mass index growth between baseline and follow-up, and years in study. Half (52.2%, CI=1.15–6.22) of children who endorsed experiencing LOC at baseline reported persistence of LOC at follow-up (p=.02). Compared to children who never reported LOC eating or reported LOC only at baseline, those with persistent LOC experienced significantly greater increases in disordered eating attitudes (ps<.001) and depressive symptoms (p=.027) over time. These data suggest that LOC eating in children is a problematic behavior that frequently persists into adolescence and that persistent LOC eating is associated with worsening of emotional distress.

Background: Eating in the absence of hunger (EAH) is typically assessed by measuring youths' intake of palatable snack foods after a standard meal designed to reduce hunger. Because energy intake required to reach satiety varies among individuals, a standard meal may not ensure the absence of hunger among participants of all weight strata. Objective: The objective of this study was to compare adolescents' EAH observed after access to a very large food array with EAH observed after a standardized meal. Design: Seventy-eight adolescents participated in a randomized crossover study during which EAH was measured as intake of palatable snacks after ad libitum access to a very large array of lunchtype foods (.10,000 kcal) and after a lunch meal standardized to provide 50% of the daily estimated energy requirements. Results: The adolescents consumed more energy and reported less hunger after the large-array meal than after the standardized meal (P values , 0.001). They consumed '70 kcal less EAH after the large-array meal than after the standardized meal (295 6 18 compared with 365 6 20 kcal; P , 0.001), but EAH intakes after the large-array meal and after the standardized meal were positively correlated (P values , 0.001). The body mass index z score and overweight were positively associated with EAH in both paradigms after age, sex, race, pubertal stage, and meal intake were controlled for (P values 0.05). Conclusion: EAH is observable and positively related to body weight regardless of whether youth eat in the absence of hunger from a very large-array meal or from a standardized meal. This trial was registered at clinicaltrials.gov as NCT00631644.Am J Clin Nutr 2010;92:697-703.

OBJECTIVEThe purpose of this study was to determine whether having childhood depressive symptoms is a risk factor that prospectively predicts impairment in glucose homeostasis.RESEARCH DESIGN AND METHODSA non–treatment-seeking sample of 115 children (aged 5–13 years), oversampled for being at risk for adult obesity, was assessed at baseline and again ~6 years later. Children self-reported depressive symptoms using the Children’s Depression Inventory at baseline. Insulin resistance was assessed at baseline and follow-up with the homeostasis model assessment of insulin resistance index (HOMA-IR).RESULTSChildren’s depressive symptoms were a significant predictor of follow-up HOMA-IR, fasting insulin, and fasting glucose in models accounting for baseline HOMA-IR, insulin, or glucose values; sex; race; baseline age; baseline BMI; change in BMI at follow-up; family history of type 2 diabetes; and time in the study (P < 0.01).CONCLUSIONSIn this study, depressive symptomatology at baseline predicted the progression of insulin resistance during child and adolescent development independent of changes in BMI. Research is needed to determine whether early intervention to decrease elevated depressive symptoms in youth ameliorates later development of insulin resistance and lessens the risk of type 2 diabetes.

The observed intake patterns are congruent with known sexual dimorphisms for body composition, peak growth velocity, and pubertal development. Consistent with their higher energy requirements, males can consume significantly larger amounts of food than females, especially during later puberty. This trial was registered at clinicaltrials.gov as NCT00320177.