Mother knows best? Feeding styles and child obesity

What junior brings to the table

As we noted earlier, children may exhibit a variety of behaviors and attitudes about food, some of which may be genetically or culturally mediated. Eating in the absence of hunger (EAH) is an example of a behavioral phenotype that is relatively stable in individual children, and is also believed to be genetically mediated.

Imagine two school-age children who have just finished lunch on a Saturday afternoon. Both children are presumably satiated. An hour later, one child asks her mother for a snack, even though she couldn’t possibly be hungry. The other child, offered popcorn by a teenage brother watching a football game, turns it down and runs off to play. The first child is displaying a behavioral phenotype of high EAH. The second child has low EAH.

Children with high EAH seem to eat in response to social cues in the environment; they don’t have to be hungry. Children with low EAH, once they are satiated, are relatively impervious to prompts to eat from the environment. Children with high EAH have a higher body mass index (BMI), and are more likely to be overweight. These children presumably elicit responses from their parents that are different from responses to low EAH children, and require different types of parenting where food is concerned.

The issue: Children who demand food, even when they’re not hungry.

Why it matters: Eating in the absence of hunger (EAH) is a behavioral phenotype that seems to be genetic, and has been linked to a higher risk of becoming overweight. Mothers may be reluctant to withhold food from a child who seems to be “always hungry.” It may be worthwhile to help mothers recognize that a child like this may have a genetically-driven behavioral trait that puts her or him at risk, and to therefore try to figure out whether the child is truly hungry before providing food.

Starting the conversation: “Some parents tell me they have to remind their kids to eat, and others tell me their children are always looking for food, even when they’ve just eaten a good meal. What is your child like? Is it hard to figure out whether your child is really hungry? How do you tell? What do you do if the child says he’s hungry, but you’re pretty sure he can’t be? Why do you think your child says she’s hungry when she probably isn’t? Are there times of day when this seems to happen? After school but before dinner time, when the child may be bored? After dinner but before bedtime, when she’s probably tired? Can you think of anything you could do to make the child less likely to think she’s hungry?”

A child with an innately voracious eating style is also more likely to become overweight. Infants with a fast and strong suck are more likely to become overweight by the time they are 2 to 3 years old. And children who eat fast and chew each bite less are more likely to be overweight even by the time they’re a year and a half old. These “good eaters” may elicit joy and praise from grandmothers the world over, but their mothers’ response may be different, depending on her own goals.

For example, a mother who has struggled with her own weight most of her life may view this type of voracious eating as a harbinger of future weight problems, and may, for that reason, adopt a particularly restrictive feeding style. On the other hand, a mother whose vision of a healthy child is one who is actually overweight may encourage and reinforce this type of eating with more frequent and enthusiastic feedings.

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