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

Abstract

Binge eating is common in middle childhood (6-12y) 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 & Kalarchian, 2003) 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.

Psychological correlates of childhood obesity

“…70 Whereas loss of control over eating appears also in children and is associated with increased general and eating disorder psychopathology, there are several important differences in the phenomenology of binge eating in children compared with adults. 30,[70][71][72][73][74][75][76] Subjectively uncontrollable binge eating is further associated with substantial increase in body fat mass of 15%, as indicated by a prospective longitudinal study over 4 years. 77 Children experience eating binges also during regular meals or special eating occasions such as parties or during offered snacks.…”

Eating in the absence of hunger but not loss of control behaviors are associated with 16p11.2 deletions

“…Children were only asked to report LOC questionaire responses for themselves if they were deemed capable (FSIQ >90). A study participant was characterized as having had LOC eating if they reported A) recurrent LOC eating episodes characterized by a feeling of losing control over eating; B) (1) seeking food after feeling satiated or in the absence of hunger or (2) feeling that the amount eaten was too much at the time; (C) two or more LOC eating episodes within the previous 3 months; and (D) experiencing LOC eating episodes characterized by at least three of the following: (1) negative affect-induced eating, (2) eating in secrecy, (3) feeling numb or a lack of awareness during eating, (4) eating more than others or perceiving this to be true, and (5) negative feelings (e.g., shame or guilt) after eating (18).…”

“…At the clinical evaluation, Eating in the Absence of Hunger (EAH) (23) and Loss of Control (LOC) eating (18) questionnaires were administered to children, adults, and parents, and Child Feeding Questionnaires (CFQ) (24) were administered to parents, regardless of CNV status. Standardized IQ tests were used to measure full-scale intelligence quotient (FSIQ).…”

“…LOC over eating is defined as the subjective experience of losing control over eating and is similar to BED except that it does not necessarily involve consumption of a large amount of food. Both LOC and BED are more prevalent in overweight compared to nonoverweight children (15)(16)(17), but the former is believed to be the more salient construct since it captures more children who exhibit hallmarks of severe disinhibited eating, while few youths meet diagnostic criteria for BED (18).…”

Confirmatory Validation and Measurement Equivalence of the Eating Loss of Control Scale in Binge Eating and Non-Clinical Samples

“…For instance, research suggests that LOC over eating is a risk factor for eating disorder severity, general psychopathology, and poorer quality life in diverse samples (Elder et al 2008;Latner et al 2007), and that it predicts obesity even after controlling for total amount of food consumption (Sonneville et al 2013). LOC is also related to poor health (Tanofsky-Kraff et al 2008) and negative response to bariatric surgery (White et al 2010) Until recently there were no assessment methods for measuring LOC over eating as a standalone uni-dimensional construct in clinical samples. LOC has typically been measured as an item or small set of items within more general eating disorder instruments (e.g., Cooper & Fairburn, 1993;Gormally, Black, Daston, & Rardin, 1982).…”