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Emotional Eating in Preschoolers

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Emotional Eating in Preschoolers EMOTIONAL EATING IN PRESCHOOLERS Molly Meers A Thesis Submitted to the Graduate College of Bowling Green State University in partial fulfillment of the requirements for the degree of MASTER OF ARTS August 2010 Committee: Dara Musher-Eizenman, Advisor Robert A. Carels William H. O‘Brien ii ABSTRACT Dara Musher-Eizenman, Advisor The purpose of the current study was to determine whether emotional eating occurs in preschoolers using a behavioral measure. Based on Macht‘s (2007) five-way model of how emotions affect eating behavior, it was hypothesized that some preschoolers would increase food intake due to moderate negative emotions. This study utilized an eating in the absence of hunger research paradigm to measure the difference in caloric intake between negative and neutral mood induction conditions. The current study also examined the relationship between emotional eating and parental feeding behaviors, own eating behaviors, and the child‘s emotion regulation skills. Thirty 4- to 6-year-old children and the parent most involved with feeding were recruited for this study. Emotional eating was not pervasive in this sample. However, there were noteworthy individual differences associated with consuming a greater amount of calories in the negative mood condition than in the neutral mood condition. Child self-report of emotional eating was more predictive of greater caloric intake in the negative mood condition than was parent-report of the child‘s emotional eating. In addition, individual differences in emotion regulation skills were more predictive of greater caloric intake in the negative mood condition than parents own eating and feeding behaviors. However, when parent report of emotional eating was used as the emotional eating outcome variable rather than the behavioral measure, parental feeding for emotion regulation was most predictive of greater caloric intake in the negative mood condition. iii TABLE OF CONTENTS Page INTRODUCTION…. ............................................................................................................ 1 Emotional Eating in Adults ........................................................................................ 5 Emotional Eating in Children ................................................................................... 7 The Current Study ...................................................................................................... 11 METHOD ............................................................................................................................. 13 Participants…. ............................................................................................................ 13 Parent Measures ......................................................................................................... 13 Demographic Information .............................................................................. 13 Parental Feeding Practices ............................................................................. 14 Child Emotional Eating.................................................................................. 14 Parental Eating Style ...................................................................................... 15 Emotion Regulation Skills ............................................................................. 16 Child Measures .......................................................................................................... 16 Self-Report of Emotional Eating ................................................................... 16 Weight and Height ......................................................................................... 16 Caloric Intake ................................................................................................. 17 Behavioral Measure of Emotional Eating ...................................................... 17 Procedure …… .......................................................................................................... 17 RESULTS .............................................................................................................................. 22 Preliminary Analyses ................................................................................................. 22 Primary Analyses ....................................................................................................... 23 iv DISCUSSION………. ........................................................................................................... 28 Limitations...….. ........................................................................................................ 31 Future Directions ....................................................................................................... 32 Clinical Applications ................................................................................................. 34 REFERENCES ...................................................................................................................... 35 APPENDIX A. COMPREHENSIVE FEEDING PRACTICES QUESTIONNAIRE ......... 43 APPENDIX B. PARENT REPORT OF EMOTIONAL EATING ...................................... 46 APPENDIX C. DUTCH EATING BEHAVIOR QUESTIONNAIRE ................................ 47 APPENDIX D. EMOTION REGULATION CHECKLIST ................................................. 49 APPENDIX E. CHILD SELF-REPORT OF EMOTIONAL EATING ................................ 51 v LIST OF FIGURES/TABLES Figure/Table Page 1 Macht‘s five-way model of how emotions induce changes in eating behavior ......... 3 2 Hunger assessment figure array ................................................................................. 18 3 Mood assessment smiley face array ........................................................................... 18 4 Means and standard deviations of key study variables .............................................. 50 5 Calories consumed by condition in the subsample .................................................... 52 6 Calories consumed by condition in the full sample ................................................... 53 Emotional Eating 1 INTRODUCTION Overweight is a prevalent health concern in the United States (Hedley et al., 2004; Ogden et al., 2006). Rates of overweight for children, adolescents, and adults have been steadily increasing in recent years (Hadley et al., 2006). Data from the National Health and Nutrition Survey obtained in 2003-2004 report that 17.1% of a sample (n=3958) of children and adolescents aged 2 to 19 years old were overweight while 66.3% of a sample (n=4431) of adults over the age of 20 were overweight (Odgen et al., 2006). Overweight was determined by sex and age specific BMI criteria from the Centers for Disease Control and Prevention; and defined for children and adolescents as a BMI at or above the 95th percentile. While some research has shown that overweight and obesity have strong genetic components (Poulsen & Vaag, 2003; Maes, Neal, & Eaves, 1997), other research has shown that overweight and obesity are related to certain behaviors (Hu, Li, Colditz, Willett, & Manson, 2003; Liebman et al., 2003). Eating behaviors in particular have received a great deal of empirical attention in their relationship to weight outcomes. One type of eating behavior that is associated with excess weight gain is eating in the absence of hunger. Eating in the absence of hunger (EAH) is the continuation of eating behavior or initiation of eating behavior without the presence of physiological hunger cues (Tanofsky-Kraff et al., 2008). EAH is thought to promote excess weight gain and has been found to predict overweight status in children (Fisher & Birch, 2002; Tanofsky-Kraff et al., 2008) and adults (Hill, Oliver, & Rogers, 1992). Three types of eating in the absence of hunger that have received considerable attention in the literature include external eating, emotional eating, and overeating as a consequence of dietary restraint (Van Strien & Oosterveld, 2008). External eating occurs in response to environmental food cues such as sight or smell (Van Strien & Oosterveld, 2008), Emotional Eating 2 emotional eating occurs as a response to emotional arousal (Wallis & Hetherington, 2004), and overeating also occurs as a response to failed attempts to restrict food intake (Herman & Polivy, 1985). Emotional eating, external eating, and dietary restraint have been associated with bingeing, excessive snacking, and weight gain (van Strien & Oosterveld, 2008). The focus of the current study is emotional eating which is described in greater detail below. Emotional eating is a response to emotions that occurs when consumption of food is changed or the non-nutritive consumption of food is initiated in response to emotional stimuli. While tendency toward emotional eating is thought to be a characteristic of an individual that is stable over time, there is variability in emotional eating responses across individuals and types of emotions (Snoek, Rutger, Engels, Janssens, & van Strien, 2007). Due to this variability, a variety of models have been proposed to explain the relationship between eating behavior and emotions. The most comprehensive model that has been proposed to explain this relationship is Macht‘s (2007) five-way model of emotional eating (see Figure 1). In this model there are five ways in which emotions are proposed to induce changes in eating behavior. First, emotions may be aroused by food stimuli, which affects food choice. For example, infants have been found to have hedonic
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