This study examined the relationship between reported meal and snack consumption frequency in a sample of adolescents with and without loss of control (LOC) eating patterns. Youth with LOC eating reported consuming lunch and dinner less frequently, but morning, afternoon, and nocturnal snacks more frequently, than their non-LOC counterparts. Controlling for age, race, socioeconomic, and BMI-z, youth with LOC were less likely to regularly consume all three meals (breakfast, lunch, and dinner) most of the time compared to their peers without LOC eating.
The adult literature is inconsistent in regards to the relationship between binge eating behaviors and the consumption of specific meals.1-3
In the present sample of adolescents, we found that youth with LOC eating reported consuming fewer lunches and dinners. Although this finding does not entirely parallel Masheb and Grilo’s1
finding in adults that binge episodes are negatively correlated with evening meals only, it may reflect differences between adult and child samples. The vast majority of youth with LOC in our sample only reported one episode of LOC in the past month. Similar to data suggesting that the presence of any LOC is salient in youth,4
our findings on eating patterns may represent developmental differences between children with LOC and adults with BED.
As hypothesized, youth with LOC eating reported consuming more afternoon snacks than those without LOC. However, we did not find a relationship between evening snacking and LOC eating episodes as reported in the adult literature.2, 3
This finding suggests that the afternoon, likely the after-school time frame, may be a particularly vulnerable time for snacking among youth with LOC. It is possible that the afternoon is a time when adolescents are alone, devoid of social interaction and with limited parental control over food consumption. Furthermore, if the afternoon snacking reported by youth with LOC involves overeating or psychological distress, helping youth to find alternative reinforcers during this time period of the day, other than food, could potentially serve as one form of intervention. Given this finding, the afternoon may be a crucial time point to monitor within the day in order to prevent or limit LOC eating episodes. Since successful cognitive behavioral therapeutic approaches used to treat adults with BED can involve implementing a structured three meals and two planned snacks per day regimen,14
a similar approach needs to be studied to determine its effects on LOC eating frequency and BED development among youth.
Notably, regardless of LOC status, very few children reported consuming completely regular meals, and breakfast was the least commonly eaten meal. This finding is concerning given the proposed role of breakfast in appetite control15, 16
and weight-related outcomes in children and adolescents.17-19
By contrast, youth did appear to consume lunch and dinner with greater frequency and regularity, with three-quarters eating lunch and over ninety percent eating dinner regularly. More studies are needed to determine what role, if any, specific meal consumption plays in the promotion or reduction in disinhibited eating behaviors among children and adolescents.
Strengths of this study include a relatively large, diverse sample comprised of adolescents of all weight strata. Additionally, structured interviews were administered by interviewers who had received extensive training on how to assess LOC eating and meal and snack pattern intake. However, the present study utilizes cross-sectional data, so causal conclusions about meal and snack frequency and LOC eating patterns cannot be determined. Additionally, although we controlled for intervention-seeking status, the sample was comprised of a convenience sample of youth who were willing to participate in research studies. Therefore, participants may differ from adolescents in the general population.
In conclusion, youth with LOC eating appear to report different meal intake patterns compared to youth without LOC episodes. Further research should focus on the role that meal and snack patterns may play in the development of adverse eating and weight outcomes.