HYPERPHAGIA IN FOSTER CARE CHILDREN

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Hyperphagia, defined as excessive appetite, characterized by a grossly increased intake of and constant searching for food, was noted in a group of 15 foster children evaluated for developmental impairment or behavioral management problems. Caretakers described these children's eating habits as showing a driven quality without achievement of satiety or pleasure. These behaviors were evident when the children first came into foster care and often persisted over time. The hyperphagia did not result in excess weight gain; only one child achieved substantial increase in weight on followup. The children in the group tended to have mild degrees of intellectual impairment, while emotional and behavioral problems were frequent and severe. 80% of the children functioned in the mildly retarded range; 53% had Attention Deficit Disorder with Hyperactivity and 47% had a form of Pervasive Developmental Disorder. Speech and language problems were common; 73% had articulation disorders and 40% other types of language impairment. Sixty percent of the biological mothers were known to have histories of alcohol and/or drug abuse. Though eating disorders have been described among mentally retarded individuals, there is no report of long-term hyperphagia among children with mild mental retardation with the exception of Prader-Willi syndrome. Its presence signals the existence of substantial childhood psychopathology as well as the increased risk for deviant behaviors in adulthood.