Binge Eating in Young Children

Fewer studies of binge eating have been conducted with young children, particularly among non-treatment-seeking samples. A recent study of 6-year-old children living in Germany found that 2% of children engaged in binge eating, according to their parents' responses to a survey administered at well-child visits (Lamerz et al., 2005). Among a nonclinical sample of girls aged 7-13 years assessed by questionnaire, 10.4% reported binge eating behaviors (Maloney, McGuire, Daniels, & Specker, 1989).

In a large survey-based study of boys and girls (9-14 years), Field et al. (1999) found that the prevalence of monthly binge eating among girls increased linearly with age; only 0.4% of 9-year-olds endorsed binge eating, but 3.6% of 14-year-olds did.

None of these investigations assessed for the full DSM-IV-TR (APA, 2000) criteria for BED. One study making use of interview methodology (EDE adapted for children) found that among non-treatment-seeking overweight (BMI greater than or equal to the 85th percentile for age, sex and race) (Frisancho, 1990) and nonoverweight children aged 6-13 years, none met full criteria for BED (Tanofsky-Kraff et al., 2004).

However, in the month prior to assessment, 6.3% reported engaging in binge episodes and 3.1% reported experiencing loss of control (LOC) while eating, although the amount of food ingested was not unambiguously large. Those with binge/LOC eating were heavier, had more adiposity and endorsed greater disordered eating cognitions than children who endorsed overeating episodes without LOC or no episodes (Tanofsky-Kraff et al.). In the studies that examined body weight, a relationship consistently emerged between overweight and the likelihood that children endorsed either binge eating or LOC eating (Field et al., 1999; Lamerz et al.; Tanofsky-Kraff et al.).

Not surprisingly, therefore, a number of researchers examining binge eating have focused specifically on samples of overweight children.

Studying non-treatment-seeking overweight (BMI greater than or equal to the 85th percentile for age, sex and race) (Frisancho, 1990) children (6-10 years), Morgan et al. (2002) found that 5.3% of the sample met criteria for BED according to self-report questionnaires and that those experiencing LOC while eating over the past six months were heavier and had greater body fat than children not experiencing LOC. Moreover, children reporting LOC had higher anxiety, more depressive symptoms, and increased body dissatisfaction than overweight children without LOC.

With the use of interview methodology with a sample of overweight (BMI greater than or equal to the 85th percentile for age, sex and race) (Frisancho) 6- to 13-year-olds, none of whom were seeking treatment, 29.5% reported LOC eating at least once in their lifetimes, but none met criteria for BED (Tanofsky-Kraff, Faden, Yanovski, Wilfley, & Yanovski, 2005).

While differences were found between children with and without LOC — the former group had greater disordered eating cognitions, ineffectiveness, negative self-esteem, and parent-reported externalizing problems — no differences were detected between groups with regard to BMI or adiposity.

Only one study has specifically examined binge eating among children in the laboratory (Mirch et al., 2006).

A sample of overweight children (6-12 years), all of whom demonstrated evidence of insulin resistance and were seeking medication weight loss treatment, were administered the Questionnaire of Eating and Weight Patterns (Spitzer, Yanovski, & Marcus, 1993) - Adolescent Version (Johnson et al., 1999) to determine the presence of binge eating. Children endorsing binge eating over the six months prior to assessment became hungrier sooner following a preload, reported a greater desire to eat, and ingested more energy during a laboratory test meal than children who did not endorse binge eating (Mirch et al.).

Such findings suggest that binge eating among young children may be an observable behavior that is distinct among a subset of overweight youths. Research is required to determine whether similar results would emerge among healthy-weight and older children who endorse binge eating.

REFERENCES

MARIAN TANOFSKY-KRAFF

Uniformed Services University of the Health Sciences and National Institute of Child Health and Human Development, Bethesda, MD 20892.
This research was supported by the Intramural Research Program of the NIH, grant ZO1-HD-00641 (NICHD, NIH) to Dr. J. Yanovski.