The additive and interactive effects of parenting style and temperament in obese youth seeking treatment

Emotion dysregulation links pathological eating styles and psychopathological traits in bariatric surgery candidates

Objectives

Approximately one-third of bariatric surgery patients experience weight regain or suboptimal weight loss within five years post-surgery. Pathological eating styles and psychopathological traits (e.g., emotion dysregulation) are recognized as potential hindrances to sustain weight loss efforts and are implicated in obesity development. A comprehensive understanding of these variables and their interplays is still lacking, despite their potential significance in developing more effective clinical interventions for bariatric patients. We investigate the prevalence of and interactions between pathological eating styles and psychopathological traits in this population.

Materials and methods

110 bariatric surgery candidates were characterized using the Binge Eating Scale (BES), Hamilton Depression/Anxiety Scales (HAM-D/A), Barratt Impulsiveness Scale (BIS-11), Experiences in Close Relationships (ECR), Difficulties in Emotion Regulation Scale (DERS). We analyzed these variables with multiple logistic regression analyses and network analysis.

Results

Patients with pathological eating styles showed more pronounced anxiety/depressive symptoms and emotion dysregulation. Network analysis revealed strong connections between BES and DERS, with DERS also displaying robust connections with HAM-A/D and ECR scales. DERS and attention impulsivity (BIS-11-A) emerged as the strongest nodes in the network.

Discussion

Our findings demonstrate the mediating role of emotion dysregulation between pathological eating styles and psychopathological traits, supporting existing literature on the association between psychopathological traits, insecure attachment styles, and pathological eating behaviors. This research emphasizes the significance of emotion regulation in the complex network of variables contributing to obesity, and its potential impact on bariatric surgery outcomes. Interventions focusing on emotion regulation may thus lead to improved clinical outcomes for bariatric patients.

The longitudinal effects of maternal parenting practices on children's body mass index z-scores are lagged and differential

BACKGROUND

The longitudinal relation between parenting practices and styles with children's body mass index z-scores (zBMI) is poorly understood. Previous studies suggest the relationship may be complex, but small samples and short follow-ups diminish the strength of the evidence. The objectives of this study were to investigate whether the relationship is bidirectional, time-varying, and lagged using data from a large, representative birth cohort of Quebec children.

METHODS

Data were from the Québec Longitudinal Study of Child Development (QLSCD), a prospective birth cohort (n = 1,602). The mothers' interactions with their children (at ages 6, 8, 10, and 12 years) were utilized in factor analysis to identify three latent parenting practices (disciplinarian, lenient, and responsive). The parenting practices were analyzed with K-means clustering to identify the parenting styles. The temporal and bidirectional relationships were assessed in a cross-lagged path analysis using a structural equation modelling framework. Mixed models controlling for age, sex, income, mother's education, and whether the participant was first-born were estimated. Missing data were handled with full information maximum likelihood.

RESULTS

From the linear mixed models, greater lenient and responsive parenting practices were associated with higher zBMI (B = 0.03, p < 0.05) two years later. However, there was no evidence that the relationship was bidirectional nor that parenting style was predictive of children's zBMI.

CONCLUSION

While mothers' parenting practices were unaffected by their children's zBMI, parental practices were predictive of future zBMI among their prepubertal children. More in-depth exploration of parenting practices and their potential impact on pediatric weight is needed.

Sex Differences in the Relationship Between Childhood Self-Regulation and Adolescent Adiposity

OBJECTIVE

Research suggests that higher childhood self-regulation (CSR) predicts lower adiposity in adolescence. However, it is unclear whether this relationship differs by sex or by baseline weight status. Thus, this study investigated these questions in a longitudinal, community-based cohort.

METHODS

The cohort included 221 girls and 214 boys. At age 9, CSR was assessed via parent/teacher reports of effortful control, and childhood BMI z scores (BMIz) were calculated from staff measurements. Late-adolescent waist-to-height ratio was based on staff measurements at age 18.

RESULTS

CSR has a small inverse correlation with concurrent childhood BMIz in girls, but not in boys. Prospectively, however, CSR has a small inverse association with late-adolescent weight-to-height ratio in both sexes, after adjusting for childhood BMIz and other childhood predictors. This prospective association is marginally stronger for girls with higher (vs. lower) childhood BMIz.

CONCLUSIONS

CSR inversely predicts changes in adiposity across adolescence in both sexes, with some evidence that this association is stronger for girls with higher (vs. lower) childhood adiposity. However, this inverse association between CSR and adiposity may emerge earlier in girls. Future research should examine the causal status of CSR and its relationship to behaviors (e.g., diet).

A biopsychosocial approach to processes and pathways in the development of overweight and obesity in childhood: Insights from developmental theory and research

Childhood obesity has reached alarming proportions in many countries. There is consensus that both biological (especially genetic) and environmental (including psychosocial) factors contribute to weight gain and obesity in childhood. Research has identified extensive risk or predictive factors for childhood obesity from both of these domains. There is less consensus about the developmental processes or pathways showing how these risk factors lead to overweigh/obesity (OW/OB) in childhood. We outline a biopsychosocial process model of the development of OW/OB in childhood. The model and associated scholarship from developmental theory and research guide an analysis of research on OW/OB in childhood. The model incorporates biological factors such as genetic predispositions or susceptibility genes, temperament, and homeostatic and allostatic processes with the psychosocial and behavioral factors of parenting, parental feeding practices, child appetitive traits, food liking, food intakes, and energy expenditure. There is an emphasis on bidirectional and transactional processes linking child biology and behavior with psychosocial processes and environment. Insights from developmental theory and research include implications for conceptualization, measurement, research design, and possible multiple pathways to OW/OB. Understanding the developmental processes and pathways involved in childhood OW/OB should contribute to more targeted prevention and intervention strategies in childhood.

Associations between parental impulsivity and child body mass index

Objective

The aim of this study was to examine the association between parental impulsivity and (12–15 year old) child body mass index (BMI).

Methods

In total, 300 parents completed a survey regarding their own impulsivity level (Barratt impulsiveness scale) and that of their child (impulsivity scale of the temperament in middle childhood questionnaire), and supplied details of their own and their child’s height and weight. Partial correlations were computed to assess relationships between both parental and child impulsiveness scores and child BMI z-scores, independent of parental BMI. Mediation analyses were performed to assess the potential mediating role of child impulsivity on the relationship between parental impulsivity and child BMI z-score.

Results

For daughters, parental impulsivity was significantly correlated with BMI z-score. Parent-reported child impulsivity was not related to child BMI z-score, and no evidence was found for a mediating effect of parent-reported child impulsivity on the relationship between parental impulsivity and child BMI z-score.

Conclusion

There is a stronger association between parental impulsivity and child BMI z-score than between child impulsivity and child BMI z-score. The relationship between parental impulsivity and-child BMI z-score could possibly be explained by parenting styles and practices. The potentially mediating role of parenting should be taken into account in future studies investigating the role of personality in children becoming overweight or obese.

Electronic supplementary material

The online version of this article (doi:10.1186/s40064-016-3048-x) contains supplementary material, which is available to authorized users.

Does child temperament modify the overweight risk associated with parent feeding behaviors and child eating behaviors?: An exploratory study

BACKGROUND

Child temperament is a measure of an individual's behavioral tendencies. The primary objective of this study was to examine whether child temperament modified the overweight risk associated with parent feeding behaviors and child eating behaviors.

METHODS

A sample of predominantly African American, Midwest families (N = 120) recruited from four metropolitan primary care clinics participated in this cross-sectional, mixed methods study. Parents reported on feeding practices, child eating behaviors, and child temperament.

RESULTS

Difficult temperament was not statistically related to parent feeding practices or child eating behaviors (p > 0.05). Tests of interaction indicated that the risk of child overweight differed by difficult temperament and easy temperament for two child eating behaviors (emotional eating and food fussiness, p < 0.05). For example, the effect of food fussiness decreased the risk of overweight for difficult temperament children but increased overweight risk for easy temperament children. Further, the effect of emotional eating increased the risk of overweight for difficult temperament children but decreased overweight risk for easy temperament children.

CONCLUSIONS

Tailoring parent-level interventions to child temperament or promoting environments that trigger less reactive individual responses may be effective in lowering risk of child overweight.

Time with friends and physical activity as mechanisms linking obesity and television viewing among youth

Background

Though bivariate relationships between childhood obesity, physical activity, friendships and television viewing are well documented, empirical assessment of the extent to which links between obesity and television may be mediated by these factors is scarce. This study examines the possibility that time with friends and physical activity are potential mechanisms linking overweight/obesity to television viewing in youth.

Methods

Data were drawn from children ages 10-18 years old (M = 13.81, SD = 2.55) participating in the 2002 wave of Child Development Supplement (CDS) to the Panel Study of Income Dynamics (PSID) (n = 1,545). Data were collected both directly and via self-report from children and their parents. Path analysis was employed to examine a model whereby the relationships between youth overweight/obesity and television viewing were mediated by time spent with friends and moderate-to-vigorous physical activity (MVPA).

Results

Overweight/obesity was directly related to less time spent with friends, but not to MVPA. Time spent with friends was directly and positively related to MVPA, and directly and negatively related to time spent watching television without friends. In turn, MVPA was directly and negatively related to watching television without friends. There were significant indirect effects of both overweight/obesity and time with friends on television viewing through MVPA, and of overweight/obesity on MVPA through time with friends. Net of any indirect effects, the direct effect of overweight/obesity on television viewing remained. The final model fit the data extremely well (χ² = 5.77, df = 5, p<0.0001, RMSEA = 0.01, CFI = 0.99, TLI =0.99).

Conclusions

We found good evidence that the positive relationships between time with friends and physical activity are important mediators of links between overweight/obesity and television viewing in youth. These findings highlight the importance of moving from examinations of bivariate relationships between weight status and television viewing to more nuanced explanatory models which attempt to identify and unpack the possible mechanisms linking them.

The feeding practices and structure questionnaire: construction and initial validation in a sample of Australian first-time mothers and their 2-year olds

BACKGROUND

Early feeding practices lay the foundation for children's eating habits and weight gain. Questionnaires are available to assess parental feeding but overlapping and inconsistent items, subscales and terminology limit conceptual clarity and between study comparisons. Our aim was to consolidate a range of existing items into a parsimonious and conceptually robust questionnaire for assessing feeding practices with very young children (<3 years).

METHODS

Data were from 462 mothers and children (age 21-27 months) from the NOURISH trial. Items from five questionnaires and two study-specific items were submitted to a priori item selection, allocation and verification, before theoretically-derived factors were tested using Confirmatory Factor Analysis. Construct validity of the new factors was examined by correlating these with child eating behaviours and weight.

RESULTS

Following expert review 10 factors were specified. Of these, 9 factors (40 items) showed acceptable model fit and internal reliability (Cronbach's α: 0.61-0.89). Four factors reflected non-responsive feeding practices: 'Distrust in Appetite', 'Reward for Behaviour', 'Reward for Eating', and 'Persuasive Feeding'. Five factors reflected structure of the meal environment and limits: 'Structured Meal Setting', 'Structured Meal Timing', 'Family Meal Setting', 'Overt Restriction' and 'Covert Restriction'. Feeding practices generally showed the expected pattern of associations with child eating behaviours but none with weight.

CONCLUSION

The Feeding Practices and Structure Questionnaire (FPSQ) provides a new reliable and valid measure of parental feeding practices, specifically maternal responsiveness to children's hunger/satiety signals facilitated by routine and structure in feeding. Further validation in more diverse samples is required.

Maternal-infant relationship quality and risk of obesity at age 5.5 years in a national US cohort

Background

Poor quality relationships between mothers and toddlers have been associated with higher risk for childhood obesity, but few prospective studies of obesity have assessed maternal-child relationship quality in infancy. In addition it is not known whether the increased risk is associated with the mother’s or the child’s contribution to the relationship quality.

Methods

We analyzed data (n = 5650) from the Early Childhood Longitudinal Study, Birth Cohort, a national study of U.S. children born in 2001 and followed until they entered kindergarten. At 9 months of age, the Nursing Child Assessment Teaching Scale (NCATS) was used to assess the quality of observed playtime interactions between mothers and infants, yielding separate scores for maternal and infant behaviors. Obesity (BMI ≥95th percentile) at age 5.5 years was based on measured weight and height.

Results

The prevalence (95% confidence interval) of obesity at 5.5 years of age was higher among children in the lowest quartile of maternal NCATS score (20.2% [95% CI: 17.2%, 23.2%]) than in the highest quartile (13.9% [11.3%, 16.5%]), but maternal NCATS score was not significantly associated with obesity after adjustment for race/ethnicity, maternal education and household income. The prevalence of obesity at 5.5 years of age was similar among children in the lowest quartile of infant NCATS score (17.4% [14.4%, 20.3%]) and in the highest quartile (17.6% 14.4%, 20.8%]), and was not changed with covariate adjustment.

Conclusions

Maternal-infant relationship quality, assessed by direct observation at 9 months of age in a national sample, was not associated with an increased risk of obesity at age 5.5 years after controlling for sociodemographic characteristics.

Persistently obese youth: interactions between parenting styles and feeding practices with child temperament

OBJECTIVE

To assess the interaction of parent and child characteristics with feeding practices and mealtime functioning.

DESIGN

Longitudinal, predictive study comparing baseline characteristics with follow-up assessments.

PARTICIPANTS

The caregivers of 52 persistently obese youth and 32 nonoverweight comparison youth completed measurements of child temperament, parental feeding practices, parenting styles, and interactions during mealtimes.

RESULTS

Adolescents with persistent obesity were significantly more likely to be parented using problematic feeding practices when parents also reported difficult child temperaments. Additionally, adolescents with persistent obesity and difficult temperaments were significantly more likely to have lower levels of positive mealtime interactions.

CONCLUSION

Persistently obese youth are at increased risk for problematic parental feeding practices and mealtime functioning, particularly when youth are described as having difficult temperaments. These results indicate that further investigations are needed to better understand the mechanisms linking parent and child characteristics with health-related behaviors for adolescents with obesity.

Parental alliance and family functioning in pediatric obesity from both parents' perspectives

OBJECTIVE

The aim of the present study was to investigate the maternal and paternal specific contributions on the associations between family socioeconomic status, parental anthropometric factors, parental alliance, and family functioning. These were assessed separately for mothers and fathers, by means of a case-control study with families of Italian youths with and without overweight/obesity.

METHODS

Ninety families with children aged 11 to 16 years (mean = 13.27 years; SD = 1.5) participated in the study. Half of the families included children with overweight/obesity (n = 45). The body mass indices (BMIs) of youths and parents were measured and the former transformed in BMI z-scores. The parents completed the Parenting Alliance Measure and the Family Assessment Measure Version III, General Scale.

RESULTS

Higher levels of dysfunction in parental alliance and family functioning of the mothers and fathers of the overweight/obese group were found. Socioeconomic status did not contribute significantly to the prediction of overweight and obesity in youth. Both maternal and paternal BMIs were positively associated with youth overweight/obesity. The degrees of parental alliance perceived by both mothers (odds ratio [OR], 81; 95% confidence interval [CI], 0.72-0.90) and fathers (OR, 89; 95% CI, 0.81-0.98) predicted child's weight status. The perception of poor parental and familial functioning by both parents contributed to the prediction of overweight and obesity in youth (mother: OR, 1.06; 95% CI, 1.02-1.10; father: OR, 1.06; 95% CI, 1.01-1.11).

CONCLUSION

The results support a strong effect of parental and family functioning on a youth's overweight/obesity also from the father's perspective. The importance of considering the father's perspective is discussed.

Positive parenting mitigates the effects of poor self-regulation on body mass index trajectories from ages 4-15 years

OBJECTIVE

This study sought to determine whether parenting style moderates the effects of delay of gratification on body mass index (BMI) trajectories from ages 4-15 years.

METHOD

Longitudinal data were analyzed for 778 children drawn from the Study of Early Child Care and Youth Development. Parenting style (i.e., authoritative, authoritarian, permissive, and neglectful) was created from measures of mothers' sensitivity and expectations for self-control when children were age 4 years. Self-regulation was also measured at 4 years using a well-known delay of gratification protocol. BMI was calculated from measured height and weight at each time point. Mixed modeling was used to test the interaction of parenting styles and ability to delay gratification on BMI trajectories from 4-15 years.

RESULTS

There was a significant interaction effect of parenting and ability to delay on BMI growth from 4-15 years for boys. Boys who had authoritarian mothers and failed to delay gratification had a significantly steeper rate of growth in BMI from childhood through adolescence than children in any other parenting by delay group.

CONCLUSION

Authoritative and permissive parenting styles were protective against more rapid BMI gains for boys who could not delay gratification. Ability to delay gratification was protective against BMI gains for boys who had parents with authoritarian or neglectful parenting styles.

General and food-specific parenting: measures and interplay

BACKGROUND

Parental influence on child food intake is typically conceptualized at three levels-parenting practices, feeding style, and parenting style. General parenting style is modeled at the most distal level of influence and food parenting practices are conceptualized as the most proximal level of influence. The goal of this article is to provide insights into contents and explanatory value of instruments that have been applied to assess food parenting practices, feeding style, and parenting style.

METHODS

Measures of food parenting practices, feeding style, and parenting style were reviewed, compared, and contrasted with regard to contents, explanatory value, and interrelationships.

RESULTS

Measures that are used in the field often fail to cover the full scope and complexity of food parenting. Healthy parenting dimensions have generally been found to be positively associated with child food intake (i.e., healthier dietary intake and less intake of energy-dense food products and sugar-sweetened beverages), but effect sizes are low. Evidence for the operation of higher-order moderation has been found, in which the impact of proximal parental influences is moderated by more distal levels of parenting.

CONCLUSIONS

Operationalizing parenting at different levels, while applying a contextual higher-order moderation approach, is advocated to have surplus value in understanding the complex process of parent-child interactions in the area of food intake. A research paradigm is presented that may guide future work regarding the conceptualization and modeling of parental influences on child dietary behavior.

Maternal parenting behaviors during childhood relate to weight status and fruit and vegetable intake of college students

OBJECTIVE

Examine how maternal parenting behaviors in childhood, both general and feeding specific, relate to weight status and fruit and vegetable consumption in college students.

DESIGN

Retrospective surveys on maternal behaviors and assessments on the college-aged child's current anthropometric measures and dietary intakes.

PARTICIPANTS

College students (n = 424; 66% women).

MAIN OUTCOME MEASURES

Students' weight, height, waist circumference, fruit and vegetable intakes, students' reports on mothers' general and feeding-specific parenting behaviors during childhood.

ANALYSIS

Correlation and regression analyses tested how maternal behaviors in childhood related to students' body mass index, waist circumference, and fruit and vegetable intake.

RESULTS

Mothers' psychological control during childhood was associated with higher body mass index and waist circumference in students, and behavioral control was associated with lower waist circumference. Parent-centered feeding behaviors related to lower fruit and vegetable intakes of students, whereas child-centered feeding behaviors related to higher fruit and vegetable intakes.

CONCLUSIONS AND IMPLICATIONS

Findings suggest that parental use of behavioral control and child-centered feeding practices and minimal use of psychological control and parent-centered feeding practices during childhood may promote a child's healthful weight status and fruit and vegetable consumption in young adulthood, specifically during college.

Family functioning style and health: opportunities for health prevention in primary care

BACKGROUND

The relationship between family and health has not been studied in detail in primary care.

AIM

To evaluate the association between family functioning style and health problems among families receiving primary care.

DESIGN AND SETTING

Cross-sectional study in an underserved primary care clinic in Santiago, Chile.

METHOD

Families registered at the Juan Pablo II Primary Care Clinic in Santiago, Chile from 2006 to 2010 formed the study sample. Each family selected an adult family member to answer a questionnaire to provide data on: family sociodemographics; health problems among family members; and the family functioning style, as assessed with the Family Functioning Style Scale (FFSS). The t-test was used to assess differences in family functioning styles between families with and without health problems, and analysis of variance was used to study the relationship between the family functioning style and the number of health problems present.

RESULTS

A total of 6202 families, comprising 25 037 people, were assessed. The following diseases and conditions were examined: in children--asthma or recurrent bronchitis, delayed development, enuresis or encopresis, behavioural problems, overweight; in adolescents and adults--teenage pregnancy, asthma or chronic obstructive pulmonary disease, smoking, hypertension, type 2 diabetes, major depression, alcohol or drug abuse, and frailty. Families with health problems had a significantly lower FFSS score than families without health conditions. Mental health diseases had the strongest association with family functioning style. An inverse relationship between the number of health problems and the FFSS score was also observed.

CONCLUSION

A better family functioning style was associated with a lower prevalence of health problems in families. Bases for further research considering the family as a target for clinical interventions are provided.

Parenting styles and body mass index trajectories from adolescence to adulthood

OBJECTIVE

Parenting styles such as authoritarian, disengaged, or permissive are thought to be associated with greater adolescent obesity risk than an authoritative style. This study assessed the relationship between parenting styles and changes in body mass index (BMI) from adolescence to young adulthood.

METHOD

The study included self-reported data from adolescents in the National Longitudinal Study of Adolescent Health. Factor mixture modeling, a data-driven approach, was used to classify participants into parenting style groups based on measures of acceptance and control. Latent growth modeling (LGM) identified patterns of developmental changes in BMI. After a number of potential confounders were controlled for, parenting style variables were entered as predictors of BMI trajectories. Analyses were also conducted for male and female individuals of 3 racial-ethnic groups (Hispanic, black, white) to assess whether parenting styles were differentially associated with BMI trajectories in these 6 groups.

RESULTS

Parenting styles were classified into 4 groups: authoritarian, disengaged, permissive, and balanced. Compared with the balanced parenting style, authoritarian and disengaged parenting styles were associated with a less steep average BMI increase (linear slope) over time, but also less leveling off (quadratic) of BMI over time. Differences in BMI trajectories were observed for various genders and races, but the differences did not reach statistical significance.

CONCLUSION

Adolescents who reported having parents with authoritarian or disengaged parenting styles had greater increases in BMI as they transitioned to young adulthood despite having a lower BMI trajectory through adolescence.

The Children's Behavior Questionnaire very short scale: psychometric properties and development of a one-item temperament scale

Little research has been conducted on the psychometrics of the very short scale (36 items) of the Children's Behavior Questionnaire, and no one-item temperament scale has been tested for use in applied work. In this study, 237 United States caregivers completed a survey to define their child's behavioral patterns (i.e., Surgency, Negative Affectivity Effortful Control) using both scales. Psychometrics of the 36-item Children's Behavior Questionnaire were examined using classical test theory, principal factor analysis, and item response modeling. Classical test theory analysis demonstrated adequate internal consistency and factor analysis confirmed a three-factor structure. Potential improvements to the measure were identified using item response modeling. A one-item (three response categories) temperament scale was validated against the three temperament factors of the 36-item scale. The temperament response categories correlated with the temperament factors of the 36-item scale, as expected. The one-item temperament scale may be applicable for clinical use.

Parenting styles and home obesogenic environments

Parenting behaviors are known to have a major impact on childhood obesity but it has proven difficult to isolate the specific mechanism of influence. The present study uses Baumrind’s parenting typologies (authoritative, authoritarian, and permissive) to examine associations between parenting styles and parenting practices associated with childhood obesity. Data were collected from a diverse sample of children (n = 182, ages 7–10) in an urban school district in the United States. Parenting behaviors were assessed with the Parenting Styles and Dimension Questionnaire (PSDQ), a 58-item survey that categorizes parenting practices into three styles: authoritative, authoritarian, and permissive. Parent perceptions of the home obesogenic environment were assessed with the Family Nutrition and Physical Activity (FNPA) instrument, a simple 10 item instrument that has been shown in previous research to predict risk for overweight. Cluster analyses were used to identify patterns in the PSDQ data and these clusters were related to FNPA scores and measured BMI values in children (using ANCOVA analyses that controlled for parent income and education) to examine the impact of parenting styles on risk of overweight/obesity. The FNPA score was positively (and significantly) associated with scores on the authoritative parenting scale (r = 0.29) but negatively (and significantly) associated with scores on the authoritarian scale (r = −0.22) and permissive scale (r = −0.20). Permissive parenting was significantly associated with BMIz score but this is the only dimension that exhibited a relationship with BMI. A three-cluster solution explained 40.5% of the total variance and clusters were distinguishable by low and high z-scores on different PSDQ sub-dimensions. A cluster characterized as Permissive/Authoritarian (Cluster 2) had significantly lower FNPA scores (more obesogenic) than clusters characterized as Authoritative (Cluster 1) or Authoritarian/Authoritative (Cluster 3) after controlling for family income and parent education. No direct effects of cluster were evident on the BMI outcomes but the patterns were consistent with the FNPA outcomes. The results suggest that a permissive parenting style is associated with more obesogenic environments while an authoritative parenting style is associated with less obesogenic environments.

Distress at the Dinner Table? Observed Mealtime Interactions among Treatment-Seeking Families of Obese Children

BACKGROUND: Although family-based, behavioral interventions for pediatric obesity require caregivers to make major changes to dietary intake and the family meal, few studies have examined family functioning, and specifically, mealtime behaviors among families of treatment-seeking obese children. The current study compared mealtime family functioning of treatment-seeking obese children and nonobese demographically matched comparisons using a multimethod design. METHODS: Participants included the families of 27 obese children (BMI ≥95(th) percentile; M body mass index (BMI) z-score values [M zBMI] = 2.55) at the time of treatment initiation and 27 families of nonobese children (M zBMI = 0.17). Each family's evening meal was videotaped and coded for observed family functioning using the Mealtime Interaction Coding System (MICS). Caregivers completed a demographics form and a measure of family mealtime climate. RESULTS: Caregivers of obese children self-reported greater mealtime challenges and a less positive meal environment than non-obese comparisons. There were no significant group differences in observed family mealtime interactions. CONCLUSION: Interestingly, although group means on the observational measure of mealtime family functioning were not significantly different, caregivers of obese children reported greater mealtime stress. Accordingly, it is important in the context of treatment to address caregiver perceptions of mealtime challenges and to examine the extent to which these self-reported challenges affect implementation of treatment recommendations and treatment outcomes.

Psychological control by parents is associated with a higher child weight

OBJECTIVE

In this examination of the association between parenting style and child weight, the neglected concept of 'psychological control' has been added to the generally accepted parenting dimensions 'support' and 'behavioural control'. Also explored is whether the potential association between parenting and child weight is moderated by socio-demographic variables (child's age/ethnicity, and parent's education level).

METHODS

A cross-sectional study was performed among 1,665 parent-child dyads. The children's mean age was 8 years. Their height and weight were measured to calculate their body mass index (BMI). Parents completed a questionnaire to measure the three parenting dimensions. Based on these dimensions, five parenting styles were defined: the authoritative, permissive, authoritarian, neglecting and rejecting parenting style. Child BMI z-scores were regressed on parenting style, adjusting for parental BMI, child ethnicity, and parent's education level.

RESULTS

Rejecting parenting, characterized by high psychological control, low support and low behavioural control, is the only parenting style significantly related to child BMI z-scores (β = 0.074, p < 0.001). The positive association was not moderated by socio-demographic variables.

CONCLUSIONS

By adding the dimension of psychological control to the concept of parenting, this study has further elucidated the mechanisms whereby parenting may affect child weight. Demonstrating that 'rejecting parenting' is associated with a higher child weight, emphasizes the need for longitudinal studies in which parenting style is measured three-dimensionally. Potential mediating effects of parental feeding style and children's eating style, as well as age moderation, should be included in these studies.

[Overweight and obesity in childhood and adolescence]

Firstly, essential developmental aspects of the focused periods of life, namely childhood and adolescence, are discussed. Furthermore, different issues of overweight and obesity in childhood and adolescence are highlighted. Besides the definition and the assessment, possibilities of classification and epidemiological aspects are of interest. Physical and psychiatric consequences, which can be associated with obesity are also presented. In the context of a model of multifactorial genesis of obesity, different causing and maintaining factors are described. In addition to genetic and biological risk factors, the significance of several psychosocial factors is illustrated. Finally, the focus is on the therapy of obesity in childhood and adolescence.

The relationship between body weight (body mass index) and attachment history in young women

OBJECTIVE

This study investigated whether attachment history predicts unique variance in body mass index in young women.

METHOD

A cross-sectional design was employed. One hundred and forty five women completed self report measures of attachment history and psychological symptoms.

RESULTS

The findings indicated that negative parental discipline predicted significant variance in body mass index when common variance associated with demographic and psychological symptom measures was taken into account.

CONCLUSIONS

It is concluded that attachment history may contribute to overweight and obesity and may be an important factor to consider in the prevention and treatment of overweight in women.