Greater social adversity is associated with more disordered eating attitudes and behaviors among children from Southeast Michigan

Abstract

Objective: The objective of this study is to examine the association between indicators of social adversity, including socioeconomic status and race/ethnicity, and children's disordered eating behaviors and attitudes.Methods: Children ages 8-10 years old (n = 183) were recruited from Michigan.Data were collected through in-home surveys. The Children's Eating Attitudes Test (ChEAT-24) measured disordered eating attitudes and behaviors in the sample.Cumulative social adversity was considered the sum of four binary variables: caregiver race/ethnicity, caregiver education, household income, and child-reported food security status. Linear mixed models examined the association between social adversity indicators and ChEAT-24 scores.Results: Children of primary caregivers of color had significantly higher ChEAT-24 scores than children of white caregivers (p = .03). Children who reported food insecurity had significantly higher ChEAT-24 scores compared to children who reported food security (p = .01). Compared to children with the lowest social adversity score, children with the highest score had a 4.8-unit higher ChEAT-24 score (95% CI .3-9.4), after adjusting for covariates. A significant trend was observed for greater social adversity and higher ChEAT-24 score (p-trend = .02). Conclusion:A linear association was observed between greater social adversity and more disordered eating behaviors and attitudes among children in this sample. These findings emphasize the need for eating disorder research in children from racial/ ethnic minorities and socioeconomically disadvantaged populations to support future prevention efforts.Public Significance: Greater exposure to social adversity was associated with more disordered eating behaviors among preadolescent children. Given that eating disorders are understudied in lower-income and minority racial/ethnic populations, this study highlights the need for additional research to better support prevention and treatment efforts among children from socioeconomically diverse backgrounds.

Clinical review: Implementation of trauma informed care to optimally impact the treatment of childhood obesity

“…She did not always have enough money to replace food once it was gone. She seldom talked to or played with Andi • Divorce • Household substance abuse • Emotional and physical neglect • Food insecurity [ 34 ] • Lower household income • Developmental delays [ 35 ] • Behavior/conduct disorders [ 36 ] • Disordered eating behaviors [ 37 ] Developmental The home daycare was a consistent source of food and attention∗. Andi arrived in dirty and unkempt clothes so often, daycare staff began to keep a spare set of clothes just for her.…”

“…She was prescribed a stimulant in the morning and an alpha-2 agonist in the afternoon/evening to help manage the emotional dysregulation and impulsivity that disrupted the school day, strained her relationships (peers, siblings, caregivers), and likely contributed to food seeking behaviors [ 71 , 72 ]. The team explained to James that Andi’s exposure to adverse childhood experiences, including in utero exposure to substances, play a role in her mental and physical health in addition to her food seeking behaviors [ [35] , [36] , [37] ]. Endpoints for pharmacotherapy focus on improved behavior and slower pace of weight gain.…”