‘Nonresponsive’ Parental Feeding Practices Could Contribute to Adolescent Eating Disorders
Nonresponsive parental feeding practices were associated with a greater frequency of disordered eating and specific eating disorder (ED) symptoms in adolescence. Results were published in the International Journal of Eating Disorders.
“In line with previous research, our findings suggest that nonresponsive parental feeding practices may reduce a child's autonomy over their food intake and may predispose to ED-related behaviors,” noted shared first authors Holly A. Harris, PhD, University Medical Center, Rotterdam, The Netherlands, and Alice R. Kininmonth, PhD, University of Leeds, Leeds, UK, and co-authors. “It would be prudent for clinical and public health and professionals to emphasize parental feeding practices that are responsive to children's hunger and satiety.”
“Nonresponsive” feeding is any practice that ignores or overrides a child's hunger and satiety, “representing a (likely unintentional) coercive or controlling feeding style.” This parental feeding behavior can include pressure to eat (the frequency with which parents coerced their child to eat more), food restriction, and instrumental feeding (using food as a reward). Authors noted that the theorized connection between disordered eating behaviors and these feeding practices in childhood is because nonresponsive practices “[disrupt] children's autonomy of food intake and appetite self-regulation, thus increasing reliance on external cues (or cues unrelated to appetite) to regulate their eating.”
Researchers used data from 2 established cohorts: the Generation R Study (Netherlands; n = 4900) and the Gemini Study (UK; n = 2094). In both cohorts, parental feeding practices with children aged 4 to 5 years were self-reported using the Child Feeding Questionnaire (CFQ), the Parental Feeding Style Questionnaire (PFSQ), and a subscale from the Poppets study. Adolescents self-reported their compensatory behaviors (fasting, purging, etc.), binge-eating symptoms, restrained eating, uncontrolled eating, and emotional eating using the Development and Wellbeing Assessment (DAWBA), the 4-point Likert scale, the Dutch Eating Behavior Questionnaire (DEBQ), and the Three Factor Eating Questionnaire (TFEQ). Associations between feeding practices and ED symptoms were analyzed separately in each cohort using generalized linear models.
In the Gemini cohort, parental pressure to eat in early childhood was associated with adolescents engaging in compensatory behaviors. The Generation R cohort showed the same result with additional present behaviors like restrained, emotional, and uncontrolled eating. Instrumental feeding was associated with uncontrolled eating and emotional eating in Generation R adolescents.
Authors noted that different subscales were used for parental restriction and instrumental feeding between the 2 cohorts, which could have limited results. Authors also noted that the cohort samples were of people in medium- to high-socioeconomic positions and may not be representative of families in other socioeconomic situations.
“Further research is needed to clarify the direction of associations between parental feeding practices and ED symptoms using repeated measures across childhood development. The mediating or moderating role of child appetite traits or weight in these associations could also provide a greater understanding of mechanisms at play…and potential preventative pathways,” authors concluded.
