In children (6–12 years) at high risk for adult obesity, LOC eating predicted a greater increase in BMI over time. None of the ChEDE subscales significantly predicted excess BMI growth.
The finding that childhood LOC eating, regardless of the reported amount of food consumed, is predictive of an increased rate of weight gain is novel and may have important implications. What constitutes a “large amount of food” is subjective and varies by age, making a definitive determination difficult in growing children. Further, many children report a sense of “numbing” when experiencing LOC eating,12
possibly compromising recall of the amount eaten. We propose that identification of classic OBEs may not be necessary to diagnose children at risk of inappropriate weight gain. Healthcare providers may be able to direct interventions to youth reporting an inability to stop eating, regardless of the reported amount of food consumed, and thereby potentially decrease their risk for later obesity.
Contrary to prior reports,2–4,26
dietary restraint was not predictive of excessive weight gain. This result may reflect the use of interview methodology, and may help to clarify the seemingly contradictory prior findings that self-reported dieting predicts excess body weight and fat gain.2–4,26
The ChEDE Restraint subscale measures both behavioral and cognitive restriction. Some children may have been actually restricting their intake (behavioral restraint) while others were thinking about restricting or trying and failing (cognitive restraint), leading to variable outcomes. The finding that restraint was associated with higher BMI throughout the follow-up period supports the hypothesis that reported dieting may be a marker, rather than a cause, of overweight in youth.4
Strengths of this investigation include the use of a structured interview and measured heights and weights. Limitations include the relatively small sample, especially with regard to the subsample of children reporting LOC eating (n = 19), and the fact that children were not recruited in a population-based fashion. However, families were recruited for studies measuring plasma hormones, understood that they would not receive treatment, and did not have prior knowledge of the ChEDE contents. Thus, we believe this sample to be reasonably representative of the general population of children at high risk for adult obesity.
In conclusion, for children at high risk for adult obesity, those reporting LOC eating gain BMI more rapidly over time. Future investigation is necessary to determine if interventions aimed at reducing LOC eating during middle childhood are efficacious in the prevention of inappropriate weight gain.