Perceived Family Functioning in Relation to Energy Intake in Adolescent Girls with Loss of Control Eating.

Manuela Jaramillo,Lauren Shomaker,Marian Tanofsky-Kraff,Merel Kozlosky,Sheila Brady,Jack Yanovski,Natasha Burke

doi:10.3390/nu10121869

Abstract

Family functioning is hypothesized to influence the development, maintenance, and treatment of obesity and eating disorders. However, there are limited data examining family functioning in relation to energy intake in the laboratory among youth at high-risk for eating disorders and excess weight gain. Therefore, we examined the relationship between perceived family functioning and energy intake during a laboratory test meal designed to model a binge episode. We performed hierarchical multiple regression analyses among 108 adolescent girls in an excess weight gain prevention trial. Participants were at high-risk for eating disorders and excess weight gain due to reports of loss of control eating (LOC) and high body mass index (BMI). Participants completed the Family Adaptability and Cohesion Scale III to assess family adaptability and cohesion. Following an overnight fast, girls consumed lunch from a laboratory test meal. Poorer family adaptability, but not cohesion, was associated with lower percentage of total energy intake from protein and greater percentage of total energy intake from carbohydrates. Neither adaptability nor cohesion were significantly associated with total intake. We conclude that among girls with LOC eating and high BMI, poor reported family adaptability is associated with greater consumption of obesity-promoting macronutrients during binge episodes. Directionality and temporality of this association between unhealthy consumption and family rigidity requires further study.

Highlights

Given the high prevalence of obesity among adolescents [1] and the relatively few effective treatment options for this age group [2], elucidating psychological factors that promote excess weight gain is warranted for the development of novel approaches
The interpersonal model of binge eating disorder proposes that the link between difficulties in social functioning and loss of control eating (LOC) eating is largely mediated by negative affect resulting from relationship problems [14]
While the theory focuses on any type of salient relationship, data suggest that among adolescent girls with LOC eating, family members may be most relevant to the interpersonal model [16]

Summary

Introduction

Given the high prevalence of obesity among adolescents [1] and the relatively few effective treatment options for this age group [2], elucidating psychological factors that promote excess weight gain is warranted for the development of novel approaches. Studies have shown that adolescents with binge-eating disorder perceive lower familial adaptability than adolescents without binge-eating disorder [25], report higher cohesion and flexibility compared to adolescent girls with anorexia nervosa or bulimia nervosa [26], and report more negative perceived maternal criticism than a control group [27]. There are no data examining the family functioning and test meal intake of adolescent girls with LOC at high-risk for excess weight gain and eating disorders. Given data showing that youth reporting LOC eating episodes tend to consume more energy from carbohydrate and fat and less energy from protein compared to youth not reporting LOC eating episodes [11,38], girls with overweight have greater overall energy consumption [13,39] and youth with LOC tend to have greater liking of foods in a test meal [40]. We hypothesized that lower levels of adaptability and cohesion would relate to greater total energy consumption, a greater percentage of energy consumed from fat and carbohydrates, and a lower percentage of energy consumed from protein

Participants

Procedure

Statistical Analyses

Results

Discussion