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

Binge Eating and Weight-Related Quality of Life in Obese Adolescents

Limited data exist regarding the association between binge eating and quality of life (QOL) in obese adolescent girls and boys. We, therefore, studied binge eating and QOL in 158 obese (BMI ≥ 95th percentile) adolescents (14.5 ± 1.4 years, 68.0% female, 59% African-American) prior to weight-loss treatment. Youth completed an interview to assess binge eating and a questionnaire measure of QOL. Controlling for body composition, binge eating youth (n = 35), overall, reported poorer QOL in domains of health, mobility, and self-esteem compared to those without binge eating (ps < 0.05). Also, girls, overall, reported poorer QOL than boys in activities of daily-living, mobility, self-esteem, and social/interpersonal functioning (ps < 0.05). Girls with binge eating reported the greatest impairments in activities of daily living, mobility, self-esteem, social/interpersonal functioning, and work/school QOL (ps < 0.05). Among treatment-seeking obese adolescents, binge eating appears to be a marker of QOL impairment, especially among girls. Prospective and treatment designs are needed to explore the directional relationship between binge eating and QOL and their impact on weight outcomes

The Role of Affective Instability in Loss of Control Eating in Youth with Overweight/Obesity Across Development: Findings from Two EMA Studies

Affective instability is common during adolescence, but at high levels it is associated with a variety of internalizing and externalizing disorders, including eating disorders. Although most models focus on affective intensity as a mechanism for explaining eating disorders in adults, affective instability may be more developmentally relevant at predicting eating behaviors in youth. Using ecological momentary assessment, this manuscript explored the association between loss of control over eating (LOC), a key component of dysregulated eating in youth, and affective instability in youth with overweight/obesity in two separate studies, one with youth in middle childhood and early adolescence (Study 1: ages eight to 13) and one in youth in early through middle adolescence (Study 2: ages 12-17). Overall, there was no association between affective instability and LOC in Study 1, but in Study 2, age moderated the association between positive affective instability and LOC, such that greater between-person positive affective instability (i.e., relative to peers) was associated with lower average LOC for youth earlier in adolescence and higher average LOC for those later in adolescence. Negative affective instability was also associated with LOC in Study 2, such that on days when youth reported less within-person negative affective instability (i.e., relative to their own average), they also reported greater average LOC. Findings across the two studies indicate that the association between affective instability and LOC may not emerge until adolescence, and when it does, both positive and negative affective instability may be important to consider