Abstract
BackgroundFussy eating has been associated with autism spectrum disorder (ASD), attention‐deficit/hyperactive disorder (ADHD), anxiety, and depression. Despite these disorders being prevalent in obesity treatment, no studies have been published on the association of fussy eating in children with obesity and these disorders. Understanding fussy eating in children with obesity and comorbid disorders is important as acceptance of healthy foods tends to be low, especially in children with sensory sensitivities.ObjectivesInvestigate the prevalence of fussy eating in a cross‐sectional sample of children with obesity and ASD, ADHD, anxiety, and depression; and whether they were more likely to be fussy eaters, comparing those with and without these disorders.MethodsOne hundred and four children referred to family‐based obesity treatment in Iceland 2011–2016, mean age 12.0 (SD = 3.0), mean body mass index standard deviation score 3.5 (SD = 0.9). Binary logistic regression was used to estimate the relationship between fussy eating and disorders, adjusting for medication use.ResultsA large minority (41.6%) were fussy eaters and 48.9% had at least one comorbid disorder. Over a third of children rejected bitter and sour tastes, and 1.9% and 7.9% rejected sweet and salty tastes, respectively. Compared with those without disorders, the odds of being a fussy eater were increased by a factor of 4.11 when having anxiety (95% confidence intervals) (1.02–16.58, p = 00.046), adjusting for medication use. The odds of being a fussy eater were not increased for other disorders; ASD, ADHD, or depression.ConclusionsIn children attending obesity treatment, fussy eating was common. Clinical care models in pediatric obesity treatment should address fussy eating, especially in children with anxiety.
Highlights
Childhood obesity rates have increased globally in the last decades.[1]
Childhood overweight and obesity have been linked to neurodevelopmental disorders (ND) such as autism spectrum disorder (ASD) as well as attention‐deficit/hyperactive disorder (ADHD).[4,5]
No significant associations were found for ADHD, and only Fussy eating was significantly associated with depression
Summary
Childhood obesity rates have increased globally in the last decades.[1]. The health consequences of obesity are substantial, especially since children with obesity seem likely to have obesity as adults, with several physical and psychological comorbidities.[2,3] Childhood overweight and obesity have been linked to neurodevelopmental disorders (ND) such as autism spectrum disorder (ASD) as well as attention‐deficit/hyperactive disorder (ADHD).[4,5] Psychological disorders including anxiety and depression are more commonly seen in children attending obesity treatment and may significantly affect children's quality of life and well‐being.[6,7] The relationship between obesity and psychological problems such as anxiety and depression seems to be bidirectional, in that psychological difficulties might promote weight gain, and obesity may lead to psychosocial problems.[7]. Fussy eating has been associated with autism spectrum disorder (ASD), attention‐deficit/hyperactive disorder (ADHD), anxiety, and depression Despite these disorders being prevalent in obesity treatment, no studies have been published on the association of fussy eating in children with obesity and these disorders. Objectives: Investigate the prevalence of fussy eating in a cross‐sectional sample of children with obesity and ASD, ADHD, anxiety, and depression; and whether they were more likely to be fussy eaters, comparing those with and without these disorders. Over a third of children rejected bitter and sour tastes, and 1.9% and 7.9% rejected sweet and salty tastes, respectively Compared with those without disorders, the odds of being a fussy eater were increased by a factor of 4.11 when having anxiety (95% confidence intervals) (1.02–16.58, p = 00.046), adjusting for medication use. BMI‐SDS were derived from BMI reference values for Swedish children adjusting to age and sex.[59]
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