Psychometric properties of a new questionnaire to assess eating in the absence of hunger in children and adolescents

Background: Eating in the absence of hunger (EAH), studied in the context of laboratory paradigms, has been associated with obesity and is predictive of excess weight gain in children. However, no easily administered questionnaire exists to assess for EAH in children. Objective: We developed an Eating in the Absence of Hunger Questionnaire to be administered to children and adolescents (EAH-C) and examined psychometric properties of the measure. Design: Two-hundred and twenty-six obese (BMI ≥ 95th percentile for age and sex, n = 73) and non-obese (BMI \u3c 95th percentile, n = 153) youth (mean age ± S.D., 14.4 ± 2.5 y) completed the EAH-C and measures of loss of control and emotional eating, and general psychopathology. Temporal stability was assessed in a subset of participants. Results: Factor analysis generated three subscales for the EAH-C: Negative Affect, External Eating, and Fatigue/Boredom. Internal consistency for all subscales was established (Cronbach’s alphas: 0.80–0.88). The EAH-C subscales had good convergent validity with emotional eating and loss of control episodes ( p’s \u3c 0.01). Obese children reported higher Negative Affect subscale scores than non-obese children ( p ≤ 0.05). All three subscales were positively correlated with measures of general psychopathology. Intra-class correlation coefficients revealed temporal stability for all subscales (ranging from 0.65 to 0.70, p’s \u3c 0.01). We conclude that the EAH-C had internally consistent subscales with good convergent validity and temporal stability, but may have limited discriminant validity. Further investigations examining the EAH-C in relation to laboratory feeding studies are required to determine whether reported EAH is related to actual energy intake or to the development of excess weight gain

A randomized, comparative pilot trial of family-based interpersonal psychotherapy for reducing psychosocial symptoms, disordered-eating, and excess weight gain in at-risk preadolescents with loss-of-control-eating: SHOMAKER et al.

Preadolescent loss-of-control-eating (LOC-eating) is a risk factor for excess weight gain and binge-eating-disorder. We evaluated feasibility and acceptability of a preventive family-based interpersonal psychotherapy (FB-IPT) program. FB-IPT was compared to family-based health education (FB-HE) to evaluate changes in children’s psychosocial functioning, LOC-eating, and body mass

Associations between Family Weight-Based Teasing, Eating Pathology, and Psychosocial Functioning among Adolescent Military Dependents

Weight-based teasing (WBT) by family members is commonly reported among youth and is associated with eating and mood-related psychopathology. Military dependents may be particularly vulnerable to family WBT and its sequelae due to factors associated with their parents’ careers, such as weight and fitness standards and an emphasis on maintaining one’s military appearance; however, no studies to date have examined family WBT and its associations within this population. Therefore, adolescent military dependents at-risk for adult obesity and binge-eating disorder were studied prior to entry in a weight gain prevention trial. Youth completed items from the Weight-Based Victimization Scale (to assess WBT by parents and/or siblings) and measures of psychosocial functioning, including the Beck Depression Inventory-II, The Rosenberg Self-Esteem Scale, and the Social Adjustment Scale. Eating pathology was assessed via the Eating Disorder Examination interview, and height and fasting weight were measured to calculate BMIz. Analyses of covariance, adjusting for relevant covariates including BMIz, were conducted to assess relationships between family WBT, eating pathology, and psychosocial functioning. Participants were 128 adolescent military dependents (mean age: 14.35 years old, 54% female, 42% non-Hispanic White, mean BMIz: 1.95). Nearly half the sample (47.7%) reported family WBT. Adjusting for covariates, including BMIz, family WBT was associated with greater eating pathology, poorer social functioning and self-esteem, and more depressive symptoms (ps ≤ 0.02). Among military dependents with overweight and obesity, family WBT is prevalent and may be linked with eating pathology and impaired psychosocial functioning; prospective research is needed to elucidate the temporal nature of these associations

Heart Rate Variability and Laboratory-Based Loss-of-Control Eating in Children and Adolescents

Among youth, greater heart rate (HR) and lesser HR variability (HRV) are precursors to loss-of-control (LOC) eating episodes in the natural environment. However, there are limited data examining whether pre-meal HR and HRV are associated with greater LOC-eating in the laboratory setting. We therefore examined temporal relationships between pre-meal HR, frequency- and time-based metrics of pre-meal HRV, perceived LOC-eating, and energy intake during a meal designed to simulate a LOC-eating episode. Among 209 participants (54.5% female, 12.58 ± 2.72 years, 0.52 ± 1.02 BMIz), 19 reported LOC-eating in the prior month. Perceived LOC-eating during the laboratory meal was not significantly linked to pre-meal HR (p = 0.37), but was positively related to pre-meal HRV (ps = 0.02–0.04). This finding was driven by youth with recent LOC-eating, as these associations were not significant when analyses were run only among participants without recent reported LOC-eating (p = 0.15–0.99). Pre-meal HR and HRV were not significantly related to total energy intake (ps = 0.27–0.81). Additional research is required to determine whether early-stage pediatric LOC-eating is preceded by a healthy pre-meal stress response. Longitudinal studies could help clarify whether this pattern becomes less functional over time among youth who develop recurrent LOC-eating episodes

Preventing Obesity in the Military Community (POMC): The Development of a Clinical Trials Research Network

Obesity impacts the U.S. military by affecting the health and readiness of active duty service members and their families. Preventing Obesity in Military Communities (POMC) is a comprehensive research program within Patient Centered Medical Homes (PCMHs) in three Military Training Facilities. This paper describes three pilot randomized controlled trials that target critical high risk periods for unhealthy weight gain from birth to young adulthood: (1) pregnancy and early infancy (POMC-Mother-Baby), (2) adolescence (POMC-Adolescent), and (3) the first tour of duty after boot camp (POMC-Early Career). Each study employs a two-group randomized treatment or prevention program with follow up. POMC offers a unique opportunity to bring together research and clinical expertise in obesity prevention to develop state-of-the-art programs within PCMHs in Military Training Facilities. This research builds on existing infrastructure that is expected to have immediate clinical benefits to DoD and far-reaching potential for ongoing collaborative work. POMC may offer an economical approach for widespread obesity prevention, from conception to young adulthood, in the U.S. military as well as in civilian communities