Disordered Eating Behaviors Assessment

When screening children for weight issues and obesity risk, keep in mind that disordered eating behaviors may be a possible cause. These behaviors are treatable if identified early during the lifestyle screening and counseling process. 
 

Disordered eating among infants and toddlers 

Several feeding styles are associated with a higher risk of weight gain in these age groups: 
 

• Food restriction: How parents control the child’s consumption of sugary and high-fat foods. 
• Pressure to eat: How parents encourage the child to eat or “clean their plate.”
• Over-monitoring: How parents direct the child toward healthy eating habits.

All parents exhibit some of these feeding practices during a child’s life; however, they should not use them regularly, especially in early childhood. 

There are ways to help parents resist these feeding styles. Some strategies include: 
 

• Balanced food exposure: Parents can encourage children to understand the difference between healthy and unhealthy foods and discuss with them under what situations and conditions unhealthy foods may be allowed. 
• Teach satiety: Parents should regularly ask children if they feel full when eating. Inform parents that most toddlers will not eat the standard three full meals per day until school age. Instead, most snack throughout the day, so it is normal for them to eat a small amount and feel full and satisfied. 
• Encourage independence: Giving children choices over what and when they eat can reduce power struggles and teach them food independence. 

Disordered eating among older children 

Pre-adolescents and adolescents can display other behaviors related to disordered eating. Providers should screen for the following: 
 

• Negative attitudes toward their body: A child’s self-esteem is often associated with his or her weight. Statistics show that almost half of girls and one-quarter who are overweight/obese report body dissatisfaction. 
• Weight control behaviors: Examples include fasting, skipping meals, eating very little food, using food substitutes, and using cigarettes or diet pills to suppress appetite. 
• Binge-eating and loss of control eating: Binge eating is consuming large amounts of food over a short time. Loss of control eating includes seeking food when not hungry, eating in secret, lack of awareness while eating, and feeling shame after eating. Knowing the criteria and screening tools for both behaviors can ensure proper diagnosis and treatment.