Decreasing food fussiness in children with obesity leads to greater weight loss in family‐based treatment

Hayes, Jacqueline F.; Altman, Myra; Kolko, Rachel P.; Balantekin, Katherine N.; Holland, Jodi Cahill; Stein, Richard I.; Saelens, Brian E.; Welch, R. Robinson; Perri, Michael G.; Schechtman, Kenneth B.; Epstein, Leonard H.; Wilfley, Denise E.

doi:10.1002/oby.21622

Cited by 22 publications

(21 citation statements)

References 40 publications

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“…The present study shows that picky eating is prevalent in preschoolers with overweight and obesity. As Hayes et al [ 7 ] recently showed, picky eating may play a role in obesity treatment and should therefore be addressed by healthcare professionals. Parents of picky eaters in the obesity group perceived their child’s weight to be lower and 35% perceived their child to have normal weight; these parents also showed a non-significant trend towards not being as concerned about the child’s weight.…”

Section: Discussionmentioning

confidence: 99%

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Picky eating in Swedish preschoolers of different weight status: application of two new screening cut-offs

Sandvik

Somaraki

et al. 2018

Int J Behav Nutr Phys Act

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BackgroundCharacteristics of picky eaters of different weight status have not been sufficiently investigated. We used two newly developed screening cut-offs for picky eating in the Food fussiness (FF) subscale of the Child Eating Behavior Questionnaire (CEBQ) to investigate the prevalence and characteristics of picky eaters in preschool-aged children with thinness, normal weight, overweight or obesity.MethodsData for 1272 preschoolers (mean age 4.9 years) were analyzed. The parent-reported FF subscale ranges from 1 to 5, and two screening cut-offs were applied to classify children as picky eaters (3.0 and 3.33). Structural Equation Modeling was used to study associations with other factors in the CEBQ, the Child Feeding Questionnaire (CFQ) and the Lifestyle Behavior Checklist (LBC). Scores were compared separately for each weight status group.ResultsNearly half of the children were classified as moderate or severe picky eaters (cut-off 3.0) and 30% as severe (cut-off 3.33). For both cut-offs, prevalence was significantly lower in the obesity group. Still, one-third of children with obesity met the cut-off of 3.0 and 17% met the cut-off of 3.33. While picky eaters displayed similar patterns across weight status groups, some differences emerged. Food responsiveness was lower for picky eaters, but the difference was significant only among children with obesity. Slowness in eating was not as pronounced among picky eaters in the obesity group. In the overweight and obesity groups, parents of picky eaters did not report as high pressure to eat, as compared to the thinness or normal weight groups; in the obesity group, parents of picky eaters also perceived their children’s weight as lower. In all weight status groups, parents of picky eaters were more likely to report their children had too much screen time, complained about physical activity, and expressed negative affect toward food.ConclusionsPicky eating was less common but still prevalent among children with obesity. Future studies should investigate the potential influence of picky eating on childhood overweight and obesity. Moreover, as children with picky eating display higher emotional sensitivity, further research is needed to understand how to create positive eating environments particularly for children with picky eating and obesity.Electronic supplementary materialThe online version of this article (10.1186/s12966-018-0706-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

“…Yet, picky eating also exists in children with overweight and obesity [ 5 , 6 ]. In a family-based obesity intervention with preschool children, a reduced degree of picky eating was associated with greater weight reduction [ 7 ]. This demonstrates that picky eating may play an important role in overweight and obesity.…”

Section: Introductionmentioning

confidence: 99%

Picky eating in Swedish preschoolers of different weight status: application of two new screening cut-offs

Sandvik

Somaraki

et al. 2018

Int J Behav Nutr Phys Act

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“…The current analysis only includes data from the initial weight loss phase in which all families received the same 16‐session FBT. In brief, FBT promotes a reduced‐energy‐dense diet and an increase in the consumption of nutritious foods, increased physical activity, and responsive parenting skills, such as routines, limit setting, and positive reinforcement (see for a detailed description of the program). While not designed to treat ED pathology, FBT included content that targeted aspects of ED pathology (e.g., emotional eating).…”

Section: Methodsmentioning

confidence: 99%

Patterns of Eating Disorder Pathology are Associated with Weight Change in Family‐Based Behavioral Obesity Treatment

Balantekin

Hayes

Sheinbein

et al. 2017

Obesity

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Objective Children with overweight/obesity have elevated eating disorder (ED) pathology, which may increase their risk for clinical EDs. The current study identified patterns of ED pathology in children with overweight/obesity entering family-based behavioral weight loss treatment (FBT), and examined whether children with distinct patterns differed in their ED pathology and zBMI change across FBT. Methods Before participating in 16-session FBT, children (N=241) completed surveys/interviews assessing ED pathology [emotional eating, shape/weight/eating concerns, restraint, and loss of control (LOC)]. Shape/weight concerns and LOC were also assessed post-treatment. Child height/weight were measured at baseline and post-treatment. Latent class analysis identified patterns of ED pathology. Repeated-measures ANOVA examined changes in zBMI and ED pathology. Results Four patterns of ED pathology were identified: Low ED Pathology, Shape and Weight Concerns, Only Loss of Control, and High ED Pathology. Shape/weight concerns decreased across treatment, with highest decreases in patterns characterized by high shape and weight concerns. All groups experienced significant decreases in zBMI; however, children with the highest ED pathology did not achieve clinically significant weight loss. Conclusions ED pathology decreased after FBT, decreasing ED risk. While all children achieved zBMI reductions, further research is needed to enhance outcomes for children with high ED pathology.

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“…In older children, picky eating has also been shown to be associated with the development of psychopathology and poor family functioning ( 14 ). Picky eating behavior has been linked to both underweight ( 15 , 16 ) and overweight ( 17 – 19 ) in various studies, and a recent systematic review corroborates these conflicting findings, indicating a problem with inconsistent operational definitions ( 20 ). A recent longitudinal analysis revealed no relationship between picky eating and weight gain over time ( 21 ).…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic Position and Picky Eating Behavior Predict Disparate Weight Trajectories in Infancy

et al. 2018

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Infant weight gain has long-term implications for the establishment of overall health. We examined whether socioeconomic position (SEP), the use of pressure as a feeding practice, and picky eating relate to changes infant in weight-for-length (WFL). A modified developmental design was used to examine whether current levels of child picky eating, parental use of pressure, and SEP were associated with changes in WFL during infancy. Health providers distributed survey packets during routine well-child visits made in the homes of families with young children in New Zealand (n = 193). Primary caregivers of young children provided their child's current level of picky eating, their use of pressure, and their SEP. They also reported their child's professionally-measured WFL from birth, 8, 15, and 21 months of age. A multi-level modeling analysis yielded an interaction between SEP and picky eating in predicting infant weight change over time. Children who had a low SEP and were not picky eaters were on the highest WFL trajectory and children who had a low SEP and were picky eaters were lowest on the WFL trajectory. A main effect revealed that higher levels of parental pressure predicted lower WFL in infants at each age, but did not interact with SEP or picky eating. Findings from this study indicate that the combination of eating behavior and SEP are associated with differential infant growth patterns. These results suggest that eating behavior and SEP should be included in the development of interventions designed to achieve healthy weight during childhood.

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Decreasing food fussiness in children with obesity leads to greater weight loss in family‐based treatment

Cited by 22 publications

References 40 publications

Picky eating in Swedish preschoolers of different weight status: application of two new screening cut-offs

Picky eating in Swedish preschoolers of different weight status: application of two new screening cut-offs

Patterns of Eating Disorder Pathology are Associated with Weight Change in Family‐Based Behavioral Obesity Treatment

Socioeconomic Position and Picky Eating Behavior Predict Disparate Weight Trajectories in Infancy

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