Impact of Psychosocial Factors on External Eating in a Pediatric Obese Population

Background: The increasing prevalence of pediatric obesity necessitates a better understanding of the psychosocial correlates of factors associated with obesity. External eating is one such factor. Research has demonstrated that obese individuals engage in external eating behaviors (i.e. lack the ability to refrain from eating when seeing food). This study examined whether psychosocial factors (attention problems, hyperactivity, and anxiety) impact external eating behavior in obese children.

Methods: Data from 28 severely obese children (BMI > 85%ile, mean age = 9.54, SD = 0.84; 13 males, 15 females) participating in a pediatric weight management program were included. Participants completed the Dutch Eating Behavior Questionnaire and their parents completed the Behavior Assessment System for Children - Parent Report.

Results: Multiple Regression was used to determine whether attention problems, anxiety, and hyperactivity were predictors of external eating behaviors. The overall model significantly predicted external eating behavior (F (3, 24) = 3.517, p = 0.03, R2 = 0.03); though the individual variables were not significant predictors.

Conclusions: The study results suggests that attention problems, anxiety, and hyperactivity together may render obese children more susceptible to engaging in external eating behaviors. This association may result from children's inattentiveness to internal signals of satiety and/or decreased ability to resist various cues in the environment (e.g. sight and smell of food). Therefore, addressing symptoms like attention problems, anxiety, and hyperactivity as well as assisting obese children increase their sensitivity to internal cues is critical in both the prevention and treatment of pediatric obesity and overeating.