Natural course of preadolescent loss of control eating

Abstract

Cross-sectional evidence shows that loss of control (LOC) eating is a common and psychopathologically relevant experience in preadolescence. This study sought to investigate the natural course of preadolescent LOC eating in relation to psychopathology and body weight trajectory. A community sample of 55 children ages 8-13 years with LOC eating, defined as at least one episode of LOC eating within the past 3 months (LOC+), and 59 matched children without LOC history (LOC-), were assessed with the Eating Disorder Examination adapted for Children and self-report questionnaires every 6 months over a 2-year follow-up. Of the LOC+ children, 54.5% of children remitted from LOC eating, 3.6% showed persistent LOC eating, and 41.8% showed recurring LOC eating over the follow-up period. Of the LOC- children, 19% revealed an onset of LOC episodes, mostly with a low level of stability. Multilevel modeling showed that LOC eating predicted a partial binge eating disorder diagnosis and greater global eating disorder psychopathology, but not depressive symptoms or growth in body fatness. Between-person higher shape concern and weight-related teasing, as well as within-person decreases in shape concern and increases in depression, predicted a greater likelihood of subsequent LOC eating. The results indicate a moderate stability of LOC eating in preadolescent children, with prognostic significance for clinically relevant eating problems and eating disorder psychopathology.