Tanofsky-Kraff Marian, Faden Dara, Yanovski Susan Z, Wilfley Denise E, Yanovski Jack A
Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892-1103, USA.
Int J Eat Disord. 2005 Sep;38(2):112-22. doi: 10.1002/eat.20158.
The current study investigated the self-reported temporal relationships of dieting, binge eating, and overweight in childhood.
One hundred five non-treatment-seeking overweight children ages 6-13 years were interviewed with the children's Eating Disorder Examination (ChEDE) and queried regarding dieting, loss of control (LOC) eating, and overweight history. Questionnaires of depressive symptoms, trait anxiety, and parent-reported problems were completed.
Sixty percent of the children reported having attempted at least one diet. These children had higher ChEDE scores (global, p < .001), greater body mass index (BMI) and body fat mass (p < or = .001), and a trend towards an earlier reported age of overweight onset (p = .06) compared with children who had never dieted. The 29.5% of children who reported LOC eating had significantly higher ChEDE scores (global, p < .001), ineffectiveness, negative self-esteem, and externalizing scores (all ps < .05) compared with those who had never experienced LOC eating. Most children reported becoming overweight before either dieting (79.4%) or experiencing LOC eating (63.6%). Among the 25.7% reporting both dieting and LOC eating, two thirds reported LOC eating before dieting. Participants who reported dieting before overweight had higher negative mood scores (p < .01). Children reporting dieting before LOC eating had higher ChEDE Weight Concern (p < .01) and global (p < .05) scores.
For overweight, non-treatment-seeking children, both dieting and LOC eating are common. Dieting precedes the development of LOC eating only one third of the time, but is associated with greater disordered eating cognitions. The relationship between childhood-onset dieting and LOC eating in overweight children requires further investigation to determine the causal pathways for the subsequent development of eating disorders.
本研究调查了儿童期节食、暴饮暴食和超重之间自我报告的时间关系。
对105名6至13岁未寻求治疗的超重儿童进行了儿童饮食失调检查(ChEDE)访谈,并询问了节食、失控进食和超重史。完成了抑郁症状、特质焦虑和家长报告问题的问卷。
60%的儿童报告至少尝试过一次节食。与从未节食的儿童相比,这些儿童的ChEDE得分更高(总体,p<.001),体重指数(BMI)和体脂肪量更大(p≤.001),且有超重发病年龄较早的趋势(p=.06)。报告有失控进食的29.5%的儿童与从未经历过失控进食的儿童相比,ChEDE得分显著更高(总体,p<.00)、无效感、负面自尊和外化得分(所有p<.05)。大多数儿童报告在节食(79.4%)或经历失控进食(63.6%)之前就超重了。在报告节食和失控进食的25.7%中,三分之二报告在节食之前就有失控进食。报告在超重之前节食的参与者负面情绪得分更高(p<.01)。报告在失控进食之前节食的儿童ChEDE体重关注得分更高(p<.01)和总体得分更高(p<.05)。
对于超重且未寻求治疗的儿童,节食和失控进食都很常见。节食仅在三分之一的时间里先于失控进食的发展,但与更严重的饮食失调认知相关。超重儿童中儿童期开始节食与失控进食之间的关系需要进一步研究,以确定饮食失调后续发展的因果途径。