Published online April 3, 2006
PEDIATRICS Vol. 117 No. 4 April 2006, pp. 1203-1209 (doi:10.1542/peds.2005-1329)
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A Prospective Study of Psychological Predictors of Body Fat Gain Among Children at High Risk for Adult Obesity

Marian Tanofsky-Kraff, PhDa, Marc L. Cohen, MDa, Susan Z. Yanovski, MDa,b, Christopher Cox, PhDc, Kelly R. Theim, BAa, Margaret Keil, MS, CRNPa, James C. Reynolds, MDd and Jack A. Yanovski, MD, PhDa

a Unit on Growth and Obesity, Developmental Endocrinology Branch
c Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development
b Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases
d Nuclear Medicine Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland

OBJECTIVE. Limited data suggest that psychological factors, including binge eating, dieting, and depressive symptoms, may predispose children to excessive weight gain. We investigated the relationship between baseline psychological measures and changes in body fat (measured with dual-energy x-ray absorptiometry) over time among children thought to be at high risk for adult obesity.

METHODS. A cohort study of a convenience sample of children (age: 6–12 years) recruited from Washington, DC, and its suburbs was performed. Subjects were selected to be at increased risk for adult obesity, either because they were overweight when first examined or because their parents were overweight. Children completed questionnaires at baseline that assessed dieting, binge eating, disordered eating attitudes, and depressive symptoms; they underwent measurements of body fat mass at baseline and annually for an average of 4.2 years (SD: 1.8 years).

RESULTS. Five hundred sixty-eight measurements were obtained between July 1996 and December 2004, for 146 children. Both binge eating and dieting predicted increases in body fat. Neither depressive symptoms nor disturbed eating attitudes served as significant predictors. Children who reported binge eating gained, on average, 15% more fat mass, compared with children who did not report binge eating.

CONCLUSIONS. Children’s reports of binge eating and dieting were salient predictors of gains in fat mass during middle childhood among children at high risk for adult obesity. Interventions targeting disordered eating behaviors may be useful in preventing excessive fat gain in this high-risk group.

Key Words: child • disturbed eating behaviors • depression • adiposity • overweight

Abbreviations: CI—confidence interval • DXA—dual-energy x-ray absorptiometry • ChEAT—Children’s Eating Attitude Test

Accepted Sep 2, 2005.




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