Are Overweight Kids Gluttons?

October 2009
Family Meals Focus #40

According to media reports of a study by researchers at the University of Buffalo, the way to keep children from being fat is banning fat friends from eating together. Participants eating with a friend ate substantially more than did participants eating with an unfamiliar peer. Furthermore, overweight youth who ate with an overweight partner (friend or unfamiliar peer) consumed more food than did overweight participants who ate with a nonoverweight eating partner.1

The research is unethical. In my view, any research that purports to address children's eating behavior without considering feeding dynamics is unethical. The finding of this study is that fat kids are gluttons. It is similar in its premise to the highly controversial 1996 book, The Bell Curve, that maintained that people are poor and/or jobless and self-defeating because they have low IQ, and that IQ is related to race. In both cases, authors ignore the effect of environment. With respect to the children studied, authors failed to take into account the antecedents of children's behavior in the feeding relationship between parents and children. Being perceived as obese, children likely had been fed in a restrained fashion. (See FMF #39) As a consequence, they are afraid of going hungry, food-preoccupied, and therefore likely overeat when they can. That is, when they get out from under conditions of restraint, they are likely to eat more. Eating with a lean child apparently replicates the same restraint conditions they experience with their parents; eating with another fat child does not.

Trait or state? Many researchers make the same error, and ascribe flawed food-selection and food-consumption traits to overweight children when, in reality, the flaw springs from state: from interactions in the environment. For instance, Leann Birch and her students, who have done much of the confirmatory research on feeding dynamics, found that children of overweight mothers, and/or children with a higher percentage of body fat, show greater preference for fat,2 and children with higher weight status tend to regulate energy intake less precisely.3 If you stop there with the interpretations of the studies, the inevitable conclusion is that fat children are gluttons. However, the Birch studies did look at feeding dynamics, and distorted feeding dynamics was the culprit in children's inability to regulate. In the first study, mothers' fatness and related dietary restraint strongly correlated with children's fat preference and fat intake. In the second study, mothers who were more controlling of their children's food intake had children who showed less ability to self-regulate energy intake. In both studies, distorted feeding dynamics was the confounding factor.

It's all in the way you ask the question Salvy, et al's premise was that there is something inherently abnormal about overweight children's eating that makes them fat. Let's lay out the premise about overweight children from the feeding dynamics perspective: It is normal for children to eat the amount of food they need to grow in a way that is constitutionally appropriate for them. If they do not, why not? What is interfering with the child's natural ability?

Framing the question from the perspective of feeding dynamics refocuses from trait to state. In most cases, children's inability to regulate food intake has to do with distortion in the feeding relationship: Parents fail to do their jobs with the what when and where of feeding and/or they intrude on the child's prerogative with eating,with choosing whether or how much to eat.

References

1. Salvy SJ, Howard M, Read M, Mele E. The presence of friends increases food intake in youth. Am J Clin Nutr. 2009;90:282-7.

2. Fisher JO, Birch LL. Fat preferences and fat consumption of 3 to 5-year-old children are related to parental adiposity. J Am Diet Assoc. 1995;95:759-764.

3. Johnson SL, Birch LL. Parents' and children's adiposity and eating style. Pediatrics. 1994;94:653-661.

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