A prospective study of pediatric loss of control eating and psychological outcomes

Abstract

Loss of control (LOC) eating in youth is associated cross-sectionally with eating-related and psychosocial distress and is predictive of excessive weight gain. However, few longitudinal studies have examined the psychological impact and persistence of pediatric LOC eating. We administered the Eating Disorder Examination and self-reported measures of depressive and anxiety symptoms to 195 boys and girls (mean age = 10.4 years, SD = 1.5) at baseline and again 4.7 years (SD = 1.2) later to 118 of these youth. Missing data were imputed. Baseline report of LOC was associated with the development of partial- or full-syndrome binge eating disorder (p = .03), even after accounting for the contribution of sex, race, baseline characteristics (age, disordered eating attitudes, and mood symptoms), body mass index growth between baseline and follow-up, and years in study. Half (52.2%; 95% CI [1.15, 6.22]) of children who endorsed experiencing LOC at baseline reported persistence of LOC at follow-up (p = .02). Compared with children who never reported LOC eating or reported LOC only at baseline, those with persistent LOC experienced significantly greater increases in disordered eating attitudes (ps < .001) and depressive symptoms (p = .027) over time. These data suggest that LOC eating in children is a problematic behavior that frequently persists into adolescence and that persistent LOC eating is associated with worsening of emotional distress.

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Figures

Figure 1

Baseline loss of control eating and follow-up disordered eating attitudes. Experiencing loss of control over eating ever at baseline predicted increases on the Eating Disorder Examination Restraint, Shape Concern and Weight Concern subscales at follow-up. Analysis adjusted for baseline age, sex, race, years in study, body mass index growth, respective baseline disordered eating subscale. N=195, ps≤.04.

Figure 2

A: Persistent loss of control eating and follow-up disordered eating. Eating Disorder Examination Global score at follow-up is shown. Children who reported ever experiencing loss of control at baseline and loss of control at follow-up (persistent) had significantly greater disordered eating at follow-up compared to youth who never reported loss of control (never LOC), those who reported loss of control at baseline only (resolved), and those who reported loss of control at follow-up (emergent). Analysis adjusted for baseline age, sex, race, years in study, body mass index growth, baseline global disordered eating. N=195. Main effect p<.001. B: Persistent loss of control eating and follow-up depressive symptoms. Children who reported ever experiencing loss of control at baseline and loss of control at follow-up (persistent) had significantly greater total scores on the Children’s Depression Inventory at follow-up compared to youth who never reported loss of control (never LOC) and those who reported loss of control at baseline only (resolved). Analysis adjusted for baseline age, sex, race, years in study, body mass index growth, baseline depressive symptoms. N=195. Main effect p=.03.