Ecological momentary assessment of maladaptive eating in children and adolescents with overweight or obesity

AbstractObjectivesContextual factors related to maladaptive eating behavior in youth with overweight/obesity are poorly understood. This pilot study sought to elucidate immediate internal and external cues related to perceptions of overeating and loss of control (LOC) over eating in a heterogeneous sample of children and adolescents with overweight/obesity assessed in their natural environments.MethodCommunity‐based youth [N = 40; 55% female (n = 22)], aged 8–14 y (M age = 11.2 ± 1.9 y), with overweight/obesity (M z‐BMI = 2.07 ± 0.49) reported on all eating episodes and their physiological, environmental, affective, and interpersonal antecedents and correlates via ecological momentary assessment over a 2‐week period. Generalized estimating equations were used to assess the relationship between contextual variables and degree of overeating and LOC.ResultsEating occasions involving greater food hedonics (i.e., perceived palatability of food being consumed) were associated with greater LOC severity (within‐subjects effect: B = 0.01, p = .015), although youth with lower overall levels of food hedonics reported higher LOC severity ratings on average (between‐subjects effect: B = –0.04, p = .005). Youth reporting higher overall cravings reported higher average ratings of LOC severity (between‐subjects effect: B = 0.20, p = .001). Finally, youth reporting greater overall influence of others on eating behavior evidenced greater average levels of overeating severity (between‐subjects effect: B = 0.17, p < .001).DiscussionEating‐related factors appear to be most strongly associated with LOC severity, while environmental factors were most associated with overeating severity. Interventions targeting maladaptive eating in youth with overweight/obesity may benefit from helping youth incorporate palatable foods and satisfy cravings in a planned and controlled manner, and enhancing awareness of social‐contextual effects on eating.