Intense appetite during childhood linked to later eating disorder symptoms

According to a new study led by researchers from UCL and Erasmus University Rotterdam, an enthusiastic response to food in early childhood may be linked to a higher likelihood of exhibiting eating disorder symptoms in later life, according to a new study led by researchers from UCL and Erasmus University Rotterdam. adolescence.

The study, published in The Lancet Child and Adolescent Healthexamined data from a survey of 3,670 young people in the United Kingdom and the Netherlands to determine how early childhood appetite traits might be linked to the likelihood of developing symptoms of eating disorders. diet up to 10 years later.

The researchers found that particularly high food reactivity, defined as the urge to eat when you see, smell or taste a palatable food, at ages four and five was linked to a higher likelihood of report a range of eating disorder symptoms at age 12. at 14.

The team also found that a slower eating pace and faster feeling of fullness (high sensitivity to satiety) in early childhood may protect against the later development of certain eating disorder symptoms.

Co-senior author Dr Ivonne Derks (UCL Institute of Epidemiology and Healthcare) said: “While our study cannot prove causality, our results suggest that reactivity to food cues could be a predisposing risk factor for the onset of eating disorder symptoms in adolescence. »

“However, high reactivity to food is also a normal and very common behavior and should be considered as one potential risk factor among many rather than something that parents are concerned about.”

Greater food reactivity was associated with a 16% to 47% increase in the odds of reporting eating disorder symptoms, including binge eating symptoms, uncontrolled eating, emotional eating, restrained eating, and behaviors compensatory.

The 47% increase was seen for symptoms of binge eating (eating a very large amount of food and/or feeling out of control over eating), meaning teens whose parents told them rated highest in food responsiveness were almost three times more likely to suffer from binge eating disorder. reported symptoms of binge eating disorder compared to adolescents whose parents had the lowest scores.

A 16% increase in odds was found for restricted eating, in which a person limits their food intake to lose weight or avoid gaining weight.

Like food reactivity, emotional overeating in early childhood was also associated with higher risks of engaging in compensatory behaviors, intended to prevent weight gain, such as skipping meals, fasting, and excessive exercise.

In turn, certain appetite traits appeared to protect against the later development of eating disorder symptoms. Greater satiety reactivity, that is, feeling full more quickly after eating and feeling full longer, was linked to a lower risk of uncontrolled eating (defined as the measure in (a person feels out of control and eats more than usual) and compensatory behaviors.

Meanwhile, a slower eating pace was linked to a lower likelihood of compensatory behaviors and food restriction.

Researchers also found that appetite traits such as fussiness, emotional undereating (eating less due to a bad mood), and enjoyment of eating in early childhood were not linked to symptoms. later eating disorders in adolescence.

For the study, researchers looked at data from two separate longitudinal studies: Generation R, which follows children born in Rotterdam, Netherlands, between 2002 and 2006, and Gemini, which follows twins born in England and in Wales in 2007.

Appetite traits were assessed based on parents’ responses to the questionnaire when the children were four or five years old. Eating disorder symptoms were self-reported by the adolescents themselves aged 12 to 14 years, when eating disorder symptoms typically begin to appear.

About 10% of adolescents report symptoms of binge eating disorder, meaning they eat an unusual amount of food and/or experience a feeling of loss of control over their eating. Alongside this, 50% reported at least one behavior to compensate for their food intake or to avoid gaining weight, such as skipping a meal.

Dr Clare Llewellyn (UCL Institute of Epidemiology and Healthcare), co-lead author, said: “Although the role of appetite in the development of obesity has been studied for many decades, this is the first study to comprehensively examine the role of appetitive traits. in the development of eating disorder symptoms.

“Eating disorders can be more difficult to treat effectively once they develop and so it would be better to prevent their onset in the first place. Our work in identifying risk factors early in life aims to support the development of possible prevention strategies. These could, for example, involve providing additional support to children most at risk.

Appetite traits indicate how we respond to food and the opportunity to eat, as well as the extent to which we want to eat more or less when we experience negative emotions. They are divided into food-approach appetite traits (e.g., food reactivity, eating pleasure, emotional overeating) and food-avoidance traits (e.g., satiety reactivity, food restlessness, slow eating, under- emotional eating).

Professor Pauline Jansen, co-lead author from Erasmus University Rotterdam, said: “Overall, our results suggest that developing and testing prevention strategies can be a worthwhile effort. Although appetite has a substantial genetic component, we also know that there are environmental influences that provide opportunities. for behavior change.”

Researchers indicate that a healthy eating environment and appropriate parental eating strategies can help reduce the risk of developing eating disorders.

Co-lead author Dr Zeynep Nas (UCL Institute of Epidemiology and Healthcare) explained: “A healthy food environment is one in which healthy foods are available and more important, more salient and affordable than less healthy options. to food, for example what types of food outlets are available in our neighborhood and what food we see on TV.

“Adapted feeding involves providing nutritious foods at set meal and snack times and then allowing the child to decide what and how much to eat (if at all) without pressure.”

In a separate article, accepted for publication in the International Journal of Eating DisordersA similar research team examined the same two cohorts, Generation R and Gemini, to study how parental dietary practices during early childhood might affect the likelihood of eating disorder symptoms in adolescence.

Researchers found that nonresponsive eating practices, such as pressuring children to eat or using food as a reward or to soothe their emotions, were linked to a higher likelihood of specific eating disorder symptoms. feeding later. However, the associations were weak and varied between the two cohorts, and the researchers said additional replication studies were needed.