Food-Focused Toddlers at Higher Risk for Eating Disorders as Teens

Toddlers who are really into their food might have a higher risk of developing an eating disorder once they enter adolescence, a new study shows.

Kids ages 4 and 5 with a strong urge to eat when teased with tasty food appear more likely to report a range of eating disorder symptoms by ages 12 to 14, researchers report Feb. 20 in The Lancet Child & Adolescent Health journal.

For example, teens who responded to food most strongly as a toddler were nearly three times more likely to report binge eating symptoms as those who were least interested in food, results show.

“Although our study cannot prove causality, our findings suggest food cue responsiveness may be one predisposing risk factor for the onset of eating disorder symptoms in adolescence,” said researcher Ivonne Derks, with the University College London Institute of Epidemiology & Health Care.

“However, high responsiveness to food is also a normal and very common behavior and should be seen as just one potential risk factor among many rather than something to cause parents worry,” Derks added in a university news release.

High food responsiveness is defined as the urge to eat when seeing, smelling or tasting good food, researchers said in background notes.

For the study, researchers analyzed data from 3,670 youngsters in the U.K. and the Netherlands to see how appetite traits in early childhood might relate to eating disorders that emerge as much as a decade later.

Parents reported kids’ appetite traits at ages 4 and 5, and the adolescents themselves reported eating disorder symptoms when surveyed again at ages 12 to 14.

Toddlers with high food responsiveness were 47% more likely to have symptoms of binge eating, results show.

Researchers also found a 16% greater likelihood of food-focused kids developing restrained eating, where a person restricts food intake to lose weight or avoid weight gain.

Emotional overeating in early childhood also was linked with higher odds of engaging in eating behaviors intended to avoid weight gain. Called “compensatory behaviors,” these include skipping meals, fasting and excessive exercise.

However, some appetite traits in toddlers appear to protect against eating disorders.

For example, kids who felt full more quickly after eating and felt full for longer wound up with lower odds of uncontrolled eating and compensatory behaviors as a teen, researchers said.

A slower pace of eating as a toddler also was linked to lower risk of compensatory behaviors and restrained eating, results show.

Overall, about 10% of teens reported binge eating symptoms, and half reported at least one compensatory behavior, results show.

These findings could help kids avoid eating disorders as they mature, said researcher Clare Llewellyn, with the University College London Institute of Epidemiology & Health Care.

“Eating disorders can be harder to treat effectively once they develop, and so it would be better to prevent them from occurring in the first place,” Llewellyn said. “Our work in identifying risk factors in early life aims to support the development of possible prevention strategies. These could, for instance, involve providing extra support to children at higher risk.”

Parents can help by providing a healthy food environment for their toddlers and engaging in responsive feeding, said lead researcher Zenynep Nas, with the University College London Institute of Epidemiology & Health Care.

“A healthy food environment is an environment in which healthy foods are available and more prominent, salient and affordable than less healthy options,” Nas said. “Responsive feeding is about providing nutritious food at set mealtimes and snack times, and then allowing the child to decide what to eat and how much to eat [if anything at all] without pressuring them.”

More information

The National Institute of Mental Health has more about eating disorders.

SOURCE: University College London, news release, Feb. 20, 2024