Parental feeding practices and the relationship with parents in female adolescents and young adults with eating disorders: A case control study

Abstract

Objective Perceived parental influence on diet in early adolescence in the context of the parental relationship had previously not been studied in a clinical sample. The aim of this study was to investigate a possible association between eating disorders and characteristics of the relationship with parents and the parental feeding practices in early adolescence. Methods 21 female adolescents and young adults with an eating disorder (ED)–bulimia nervosa or anorexia nervosa–and 22 females without eating disorder (healthy control; HC), aged between 16 and 26, were assessed via self-report questionnaires for problematic eating behaviour, relationship with parents, perceptions of parent’s feeding practices at the age of 10–13 years and personality. Statistical evaluation was performed by means of group comparisons, effect sizes, regression analyses and mediator analyses. Results Adolescent and young adult females with ED reported more fears/overprotection and rejection/neglect by their mothers and less self-responsibility in terms of eating behaviour during adolescence than did the HC. The relationship with the fathers did not differ significantly. Females who perceived more cohesion, rejection/neglect and fears/overprotection by the mother were more likely to suffer from an ED. Rejection/neglect by both parents were associated with less self-acceptance of the young females with even stronger effect sizes for the fathers than the mothers. Harm prevention in the young females was a partial mediator between fears/overprotection and the drive for thinness. Conclusions The parental relationship is partly reflected in the self-acceptance and self-responsibility in eating of the adolescent and young females, both of them are particularly affected in EDs. Stressors in the parent-child relationship should be targeted in treatment of eating disorders. Nutritional counselling for parents might be useful in early adolescence.

Parental dieting impacts inpatient treatment outcomes for adolescents with restrictive eating disorders

“…These results suggest that parental dieting and exercise behaviours may impact an adolescent's response to inpatient treatment for a restrictive ED. Our findings are consistent with previous studies demonstrating that parent behaviours can influence treatment outcomes (Berge et al., 2013; Gruber et al., 2020; Johnson et al., 2002; Loth et al., 2015; Lydecker & Grilo, 2015; Schmidt et al., 2019; Shoebridge & Gowers, 2000), and extend the literature by specifically examining inpatient treatment outcomes for underweight adolescents with restrictive EDs. Understanding factors that impact weight restoration during intensive treatment is particularly important as achieving weight restoration prior to discharge significantly reduces relapse risk (Frostad et al., 2022; Redgrave et al., 2021).…”

“…While the biological underpinnings of EDs, such as moderate genetic heritability (Bulik et al., 2018; Culbert et al., 2015), have been the focus of research, familial behaviours are also implicated in ED onset. Adolescents with EDs reported greater parental influence and less personal responsibility related to food choices from ages 10–13 compared to controls (Gruber et al., 2020). Anxious and maladaptive behaviours including low paternal affection and overcontrol of child behaviours (e.g., sleeping away from home, monitoring of eating behaviours) are risk factors for the onset (Johnson et al., 2002; Schmidt et al., 2019; Shoebridge & Gowers, 2000) and maintenance (Lydecker & Grilo, 2015) of EDs.…”

Too healthy for their own good: orthorexia nervosa and compulsive exercise in the community

“…There are behavioral experiential risk factors for eating disorders which may also play a role in ON and ONs. Much evidence links early parental feeding practices to disordered eating [ 15 ] and eating disorders [ 16 ]. Recalled parental child feeding practices are associated, in adults, with disordered eating, BMI, and body dissatisfaction [ 17 , 18 ].…”

Parental pressure on child body image, BMI, body image dissatisfaction associated with eating disorders: A path analysis

“…With the onset of puberty, children undergo dramatic changes in their physical as well as social perceptions. There are more reports of stress from parents about their body image and eating disorders among adolescents [31].…”