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

Katherine N Balantekin, Jacqueline F Hayes, Daniel H Sheinbein, Rachel P Kolko, Richard I Stein, Brian E Saelens, Kelly Theim Hurst, R Robinson Welch, Michael G Perri, Kenneth B Schechtman, Leonard H Epstein, Denise E Wilfley, Katherine N Balantekin, Jacqueline F Hayes, Daniel H Sheinbein, Rachel P Kolko, Richard I Stein, Brian E Saelens, Kelly Theim Hurst, R Robinson Welch, Michael G Perri, Kenneth B Schechtman, Leonard H Epstein, Denise E Wilfley

Abstract

Objective: Children with overweight or 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 or obesity entering family-based behavioral weight loss treatment (FBT) and examined whether children with distinct patterns differed in their ED pathology and BMI z score (zBMI) change across FBT.

Methods: Before participating in a 16-session FBT, children (N = 241) completed surveys or interviews assessing ED pathology (emotional eating, shape/weight/eating concerns, restraint, and loss of control [LOC]). Shape and weight concerns (SWC) and LOC were also assessed post treatment. Child height and 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, SWC, only loss of control, and high ED pathology. SWC decreased across treatment, with the highest decreases in patterns characterized by high SWC. 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.

Trial registration: ClinicalTrials.gov NCT00759746.

Conflict of interest statement

Disclosure: Dr. Epstein reports involvement with Kurbo/Datri Health outside the submitted work; Dr. Wilfley reports consulting for Shire Pharmaceuticals and Sunovian Pharmaceuticals outside the submitted work. No other authors report any disclosures or conflicts of interest.

© 2017 The Obesity Society.

Figures

Figure 1
Figure 1
Four ED pathology patterns identified from Latent Class Analysis, and each group’s probability (dark gray = yes, light gray = no) of reporting each of the ED pathology variables

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Source: PubMed

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