Lydecker Janet A, Ozbardakci Elise V, Grilo Carlos M
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
Int J Eat Disord. 2024 Mar;57(3):745-751. doi: 10.1002/eat.24153. Epub 2024 Feb 2.
Parental eating disorders are associated with disordered eating behaviors and psychopathology in their children, but it is not known whether parent treatment for binge-eating disorder (BED) is associated with changes in child disordered eating behaviors and weight. Benefits or the "ripple" effect of treatment on untreated family members has been described in the obesity literature but not for BED.
Participants evaluated for two randomized clinical trials for BED were screened for whether they had children. 76 parents completed baseline assessments about a school-aged child; 62 were randomized to treatment, of whom 41 completed end-of-treatment assessments about their child's eating behaviors and weight (which were not targeted in the parent treatments).
Analyses revealed a significant effect of time on children's binge-eating frequency and perceived weight category and a significant effect of parent medication on perceived weight category. Parental change in binge eating was associated significantly with changes in child secretive eating and food hoarding. Parental change in weight was not associated significantly with change in age/sex-normed child BMI percentile, but had some associations with parent-perceived child weight category.
Parent changes during their treatment were associated with changes in their children. Future longitudinal research is needed to examine when disordered eating emerges and clarify critical intervention timing related to children's age and parental BED. Further clinical research is also needed to assess the effectiveness of treating disordered eating at the family level.
Prior cross-sectional work has found that parents with BED are more likely to have children who engage in binge eating compared to parents without eating-disorder psychopathology. This study was an initial exploration of change in children when parents received treatment in randomized controlled trials for BED. In this study, parent changes in binge eating were associated with reduced child secretive eating and food hoarding.
父母的饮食失调与子女的饮食紊乱行为及精神病理学有关，但尚不清楚针对父母的暴食症（BED）治疗是否与子女饮食紊乱行为及体重的变化相关。肥胖领域的文献中描述了治疗对未接受治疗的家庭成员的益处或“涟漪”效应，但暴食症方面尚未提及。
对两项针对暴食症的随机临床试验的参与者进行筛查，看他们是否有孩子。76名父母完成了关于一名学龄儿童的基线评估；62名被随机分配接受治疗，其中41名完成了关于其孩子饮食行为和体重的治疗结束评估（这些并非父母治疗的目标内容）。
分析显示时间对儿童暴食频率和感知体重类别有显著影响，父母用药对感知体重类别有显著影响。父母暴食行为的改变与孩子的秘密进食和食物囤积的变化显著相关。父母体重的改变与按年龄/性别标准化的儿童BMI百分位数的变化无显著关联，但与父母感知的孩子体重类别有一些关联。
父母在治疗期间的改变与孩子的改变相关。未来需要进行纵向研究，以检查饮食紊乱何时出现，并明确与孩子年龄和父母暴食症相关的关键干预时机。还需要进一步的临床研究来评估在家庭层面治疗饮食紊乱的有效性。
先前的横断面研究发现，与没有饮食失调精神病理学的父母相比，患有暴食症的父母更有可能有从事暴食行为的孩子。本研究是对父母在暴食症随机对照试验中接受治疗时孩子变化的初步探索。在本研究中，父母暴食行为的改变与孩子秘密进食和食物囤积的减少相关。
