Binge eating in children

Nutrition Research Newsletter, Nov, 2006

Overweight children who undergo weight-loss treatment often report episodes of binge eating, during which they consume large quantities of food and experience loss of control over their eating. Therefore, binge eating may be a factor that contributes to the development of overweight during childhood.

Children who have problems with binge eating report high scores on measures of disinhibited eating (eating in response to cognitive, environmental, and affective stimuli), which suggests that they are disproportionately affected by external food cues. Children who report binge eating may therefore tend to overeat to an even greater extent than children who do not binge eat when offered free access to large quantities of palatable foods.

Investigators examined the energy intake and satiety duration of overweight children during lunch-time meals. A convenience sample of overweight children aged 6 yrs to 12 yrs was recruited. Children were eligible if they had a BMI > 95th percentile for age and sex and were healthy other than having evidence of insulin resistance. The participants were admitted for a 3-day inpatient stay during which each participant ate from a standardized lunch buffet twice, two days apart. Weight and height were measured and BMI was calculated. Body composition was measured using air-displacement plethysmography. To assess binge eating, each child completed the questionnaire of Eating and Weight Patterns-Adolescent Version (QEWP-A). On the basis of their responses to the QEWP-A, children were categorized into two eating behavior groups for analysis: those who reported binge-eating episodes within the past six months and those with no reported binge-eating episodes. The subjects also completed the Three-Factor Eating Inventory, a 51-item questionnaire designed to measure three dimensions of human eating behavior: cognitive restraint, disinhibition, and hunger.

The participants were asked to choose their lunch from a multiple-item buffet meal on two occasions. On the first day, the participants were offered the buffet meal at 11:30 after an overnight fast (the post-fast meal). Two days later, children were offered the buffet meal, which was given at 9:30 (the postbreakfast meal), after they had ingested a standardized breakfast shake meal. The buffet meals offered a variety of foods children commonly eat that differed greatly in macronutrient composition. Children were tested individually and were instructed to eat as much as they wanted, but told that they did not have to eat anything that they did not want. The participants were then left alone in the room that contained the buffet to eat ad libitum. The amount of food consumed was calculated by using the differences in weight of each food item before and after the meal. Immediately before and, again, after eating, children were asked to rate their hunger, fullness, and desire to eat.

After the overnight fast, children in the binge-eating group consumed more energy and exhibited shorter satiety duration than did children in the non-binge-eating group. After the standardized breakfast, binge-eating children reported shorter satiety duration and consumed more energy at the postbreakfast meal.

The investigators believe that the ability to consume large quantities of palatable foods, coupled with decreased subsequent satiety, may be a significant factor in the greater weight gain found in binge-eating children.

M. Mirch, J. McDuffie, S. Yanovski, et al. Effects of Binge Eating on Satiation, Satiety, and Energy Intake of Overweight Children. Am J Clin Nutr; 84:732-738 (October, 2006). [Correspondence: JA Yanovski, Unit on Growth and Obesity, DEB, NICHD, NIH, CRC, Room 1-3330, 10 Center Drive, MSC-1103, Bethesda, MD 20892-11-3. E-mail: jyl5i@nih.gov.]