Research has shown links between parents’ feeding practices and children’s eating and weight status, but causality has remained at issue; experimental research indicates that restriction can cause overeating and is associated with overweight among children (3
), but other findings indicate that overweight girls tend to elicit more restrictive feeding practices by mothers. The findings of this study provide new longitudinal evidence that restrictive feeding practices can promote overeating in response to the presence of palatable foods among young girls during middle childhood, perhaps increasing their risk for subsequent problems with eating and energy balance. Regardless of the level of maternal restriction, the girls’ EAH increased from 5 to 9 y of age in both absolute and relative terms and constituted an increasing percentage of the age-and sex-specific recommended energy intake. This developmental trend, which is consistent with a heightened responsiveness to the presence of food, is consistent with other findings indicating that as children develop, eating becomes increasingly responsive to environmental cues, including portion size (5
). This trend may be especially problematic in our current environment, which is characterized by the ready accessibility and availability of inexpensive, palatable foods. The girls whose mothers reported using higher levels of restriction when their daughters were 5 y old ate more in the absence of hunger at 7 and 9 y of age than did those whose mothers used lower levels of restriction. Furthermore, the girls’ overweight was not a necessary precondition for the imposition of maternal restriction, and restriction increased the girls’ EAH over time for both overweight and nonoverweight girls.
Five-year-old girls who were already overweight and who were subject to higher levels of restriction showed the greatest overeating at 9 y of age. This group also showed the largest increases in overeating from 5 to 9 y of age. These findings, which show that the effects of early restrictive feeding practices were greatest among the girls who were already overweight by 5 y of age, may reflect a gene-by-environment interaction, with the child’s genetic predisposition for overweight status moderating the effect of maternal restriction. It is possible that girls who are already overweight by 5 y of age may also be genetically predisposed to be highly responsive to environmental factors, including both maternal restrictive feeding practices and the presence of palatable food. This pattern is consistent with recent epidemiologic data charting population increases in weight status, which show that the most overweight persons may be the most susceptible to obesigenic environments (1
). During a time period in which the eating environment has been characterized as increasingly obesigenic, the greatest increases in weight status are at the upper end of the weight-status distribution.
The results of the present study corroborate previous experimental findings (3
) showing that feeding practices can foster individual differences in children’s eating within the family context, which indicates that parenting influences child outcomes. In particular, these findings provide the first longitudinal evidence indicating that maternal use of restrictive feeding practices promotes daughters’ EAH. With respect to possible effects of the child on parenting, the mothers of overweight girls in the present study were more concerned about their daughters’ weight and eating and were less likely to pressure their daughters to eat. Paths of influence in parent-child interactions flow in both directions, and these bidirectional paths of influence create feedback cycles in which both maternal feeding styles and the child’s overeating and weight status persist across time, leading to higher levels of restriction and greater degrees of overweight (10
Among adults, dietary disinhibition and binge eating are characterized by consuming relatively large amounts of food in the absence of hunger, and both can be elicited by self-restrictions on eating. Although we know little about the causes of these eating problems, the present research indicates that EAH, a critical feature of both disinhibited eating and binge eating, is apparent among girls during middle childhood (9
) and is fostered by maternal restriction. In a retrospective study of overweight female binge eaters (17
), some women reported that dieting preceded the onset of binge eating, but others indicated that binging preceded the initiation of dieting. The present findings, which show that girls’ overeating in the absence of hunger is promoted by higher levels of maternal restriction, raise the possibility that maternal restriction of girls’ intake might serve as one trigger for initial overeating or binge eating episodes, which in turn, may initiate self-imposed restrictive dieting attempts.
A limitation of the present study is that our sample was exclusively non-Hispanic white and included girls only. We selected this sample because, by adolescence, a high prevalence of overweight; high rates of maladaptive eating behaviors, including binge eating; weight concerns; body dissatisfaction; and high rates of chronic use of unhealthy weight-control practices are endemic among non-Hispanic white girls. However, because our findings were obtained in a sample of exclusively non-Hispanic white families with girls, we cannot generalize these findings to other racial, ethnic, or income groups or to boys. In this instance, because parenting is so culturally specific, there is good reason to predict that our findings would not generalize to other groups. Parenting practices reflect, in part, parents’ responses to perceived environmental threats to goals for their children (18
), and although a few parental goals for children are universal (eg, child health), other goals differ by ethnicity, race, income, education, and child sex. Furthermore, parents may differ in their beliefs about the environmental conditions that either threaten or promote the attainment of particular parenting goals.
For parents of non-Hispanic white girls, physical attractiveness is an important goal for daughters (19
). Especially among this group, overweight is stigmatized, and thinness, as a dimension of physical attractiveness, is especially highly valued (21
). Restrictive feeding strategies are used to protect daughters from the obesigenic environment’s threat to their thinness and attractiveness. In contrast, among Hispanics and African Americans, both of whom have a particularly high prevalence of overweight and obesity during childhood, thinness is not a goal, and childhood overweight is not typically viewed as a problem or a threat to parental goals but as a sign of success in meeting parental goals. The accelerated growth and higher weight status of overweight children is viewed positively, as evidence that the child is eating well, growing well, and attaining the goal of good health (22
). We would not expect restrictive feeding practices to be used by parents who are interpreting children’s overweight status positively. These contrasting parental evaluations of childhood overweight among racial, ethnic, and income groups highlight the need for qualitative and quantitative research in these groups to address links between cultural beliefs and parental goals and beliefs regarding children’s eating and weight status and to determine how parenting practices influence or are influenced by children’s weight status.
An increasingly obesigenic environment has been implicated in the dramatic increases in the prevalence of overweight and obesity among both children and adults of all racial and ethnic groups (1
). For young children, parents play a central role in determining the extent to which the child’s eating environment is obesigenic and may play a central role in determining the child’s susceptibility to environmental factors. In the present study, increases in EAH were noted for all the groups across middle childhood, and these increases in overeating were greater among the girls who received high levels of restriction at 5 y of age than among those who received low levels of restriction. The girls who were already overweight by 5 y of age appeared to be especially susceptible to the effects of maternal restriction, perhaps reflecting a genetic predisposition for a heightened responsiveness to various environmental factors as controls of food intake.
Although the present research shows that mothers’ attempts to restrict daughters’ eating can have negative effects on the girls’ development of food-intake controls, this is only one avenue of parental influence over what, when, and how much children eat. Parents also select the foods and the size of food portions that are offered to children; structure the timing, frequency, and social contexts of eating (ie, determining whether family members eat in front of the TV or together at the table); set an example through their own eating behavior; and directly guide children’s eating via feeding practices. Effective prevention programs must address these multiple avenues of parental influence while being sensitive to differences among racial, ethnic, and socioeconomic groups. The findings of the present study provide additional support for the view that prevention of childhood overweight must begin in early childhood and include anticipatory guidance on parent-child interactions in feeding. Our findings, which indicate that restriction is counterproductive and not an effective approach to limiting girls’ food intake, emphasize the importance of providing guidance to parents on alternative methods of setting limits for children in the feeding context that allow the development of adequate self-control mechanisms. Primary prevention programs should promote parenting skills that help children learn to like healthy food choices, to consume appropriate portion sizes, and to be responsive to hunger and satiety cues as determinants of when and how much they eat. Because our findings indicate that restrictive feeding practices tend to make girls more vulnerable to obesigenic environments, programs to promote healthy eating and weight status among this group should provide parents with alternatives to restrictive approaches to feeding.