Feeding Interactions and How They Influence Child Obesity

This is Part 2 of the blog series: Looking at Childhood Obesity through a Different Lens. Here, I take a different look at child weight problems, uncovering fundamental issues that deserve more attention.

The interaction between the parent and child during the execution of meals and snacks, or how children are fed is an area of childhood obesity worthy of more attention. Believe it or not, the how of feeding can influence which foods, and how much, kids eat and their weight status.

Researchers refer to these as feeding styles and feeding practices. Specifically, authoritarian and permissive feeding styles are associated with higher weights and a neglectful feeding style may cause children to be more insecure and/or focused on food. You can find more details about feeding styles here.

While feeding styles are the overarching approach parents use when executing the job of feeding, feeding practices are the daily tactics parents use to get kids to perform with eating, such as eating certain foods, or specific amounts.

These day-to-day feeding practices such as restricting, rewarding, and pressuring have also been shown to correlate with higher weight status.

These stories help to illuminate the subtle, yet powerful, impact feeding styles and practices have on children’s weight.

Using Restriction to Control or Reverse Weight Gain

Sally knew her 14 year-old daughter, Amber, was gaining weight, so she doubled down on her efforts to minimize sweets and junk food in the house. Sally encouraged her daughter to eat healthy foods and exercise every day. Amber put her best foot forward at home to appease her mom, and ate what she wanted whenever she was out of her mother’s sight. While the home was a model of healthy foods and tight control over unhealthy foods, Amber’s weight continued to rise.

What’s going on?

Sally was using restriction, making sweets and junk food a ‘no-no’ or scarcely available, in an effort to control her daughter’s weight. Sally had good intentions, and thought she was doing Amber a favor. By controlling and eliminating sweets and junk food, surely Amber would be less likely to eat them, and would stop gaining weight.

The problem was that Amber had been exposed to these foods for years, and she liked them. She also had the resources to obtain them—and the smarts to do it secretly. In the end, she was getting them, outside of her home, and this was a contributor to her ongoing weight gain.

Food for Thought: Research suggests that the use of food restriction (especially sweets) with children contributes to weight gain, rather than weight control or reduction.

What can parents do?

While cleaning out the cupboard seems like the right thing to do, some children will react to this and become overly focused on restricted foods and may seek them out on their own. As an alternative, parents can allow these foods occasionally, in smaller portions, and label them as Fun Foods. Be sure to acknowledge these foods as delicious but not the best foods for eating all the time or in large quantities.

My child will go crazy if I have these in the house! For some children, this may be true. I encourage parents to set house boundaries about kitchen and food management (The Kitchen is Closed; The 90:10 Rule; and asking for food before taking), seeking more help if needed.

Pressuring Kids to Eat More

Josie was afraid her toddler Sam wasn’t eating enough or a good variety, so she helped him eat. She spoon-fed him, even though he was old enough to eat on his own. She gave him the foods she knew he would eat—chicken nuggets, macaroni and cheese, corn, fries and chocolate milk. Lastly, she pushed him to finish his meal. It always gave her peace of mind when he finished a meal. What didn’t set well with her was that Sam was gaining weight too fast.

What’s Going On?

Josie was pushing and using pressure to get Sam to eat ‘enough’ and catering to his food preferences. As a result, Sam was overeating.

While Josie was allaying her own fears about Sam getting enough to eat, the problem was that Sam was learning to ignore his appetite and internal signals of feeling satisfied or full. At such a young age, this could influence a lifetime habit of overeating.

Food for Thought: Research shows that children who are pressured or prompted to eat more may lose the connection with internal regulators of hunger and fullness, which may lead to overeating and weight gain.

What Can Parents Do?

Parents can remember to trust their child and his personal internal regulation system. Offering a variety of foods at meals and snacks, and allowing children to take the lead on eating the amounts that are right for them is key. Parents can use family-style meals, the Dinner Bar, and take the lead on providing nutritious and balanced meals, letting kids eat to their satisfaction.

My child doesn’t know when to stop eating! Some children eat more because they don’t have a sense of fullness, have developed a habit of eating without hunger, or they eat out of fear they won’t get enough (or the foods they want). Parents can help their young children identify fullness and satisfaction with language (happy belly vs. hungry belly), distraction if boredom or emotional eating has set in, and offer regular nourishing meals and snacks to stay on top of normal hunger cycles.

Rewarding for Performance

Tim didn’t like broccoli, but he would eat it so he could have dessert. He didn’t like chicken either, but if he choked it down, he could get more mashed potatoes. Every night the same ritual ensued—“Tim, if you eat this certain food, then you can have this reward (usually dessert, but sometime more potatoes or entrée).”

The problem with rewarding kids to get them to eat certain foods or amounts is that it may solidify food preferences for the reward food, such as dessert. Also, while Tim ate the healthy food, he minimized its effect by following up with dessert. As a result, his diet had a significant sweets component, and too many calories for his growth needs.

Food for Thought: Research shows that children who are rewarded with food ultimately prefer or value the reward food rather than the healthy food. This can translate to eating more sweets, and possibly higher weight status.

What Can Parents Do?

While getting kids to eat healthy food is important to many parents, using rewards or bribery may be counter-productive in the long run. Instead, treat all foods equally, offering desserts occasionally and with a ‘no strings attached’ attitude (meaning kids get dessert whether they eat well or not). Work towards developing a neutral attitude that works for all foods, even sweets.

My child won’t eat vegetables unless I offer a treat! It can take some children a long time (years) to accept vegetables. If you are in the habit of rewarding with sweets, it may take your child even longer. Make sure to offer vegetables in a variety of forms, frequently, and with a neutral attitude. Even I didn’t like broccoli until I went to college! Be persistent in exposing your child, be a good role model and eat your veggies, and above all, be patient.

The truth is, many parents use an approach and attitude with feeding that is based in good intentions— to get kids to eat better and the right amounts of food for their health. However, in the case of childhood weight challenges, certain feeding styles and practices may contribute to the problem, rather than correct it, even with the best of intentions.

Do you see other connections with feeding and childhood weight? Share in the comments below.

Disclaimer: the stories and characters outlined here are made up to detail common scenarios. 

Comments

  1. says

    Feeding styles are a provocative topic. Interestingly I have read the research by Stang and Loth (ADAJ, 2011) on this topic that suggests the propensity for a child to gain weight is what provokes the feeding style. It is easy to presume that the feeding response is what causes the weight gain. Not necessarily so.

    While an effort to restrict or limit intake can trigger resistant, oppositional or sneaking behavior, the parenting style may not be the primary factor influencing the child’s weight.
    We live in an incredibly indulgent environment. An effort to limit intake to some may play out like excessive restriction, especially when thinner children are not similarly limited.

    I once planned a birthday party for my son who has been a fast gainer ever since birth despite being exclusively breastfed. We declined the typical kids menu and extra treats of candy and popcorn, ordering sandwiches from the adult menu with a vegetable platter, a fruit platter and unsweetened drinks. We served cake and ice cream. The party planner commented that she understood we needed to order this way for our son, but then exclaimed, “But I don’t understand why you need to deprive the other children.”

    • says

      Bonnie,
      Thanks for your comments. All the studies on feeding styles are associative in nature–not causal. Unfortunately, it’s very hard to study this topic and draw the conclusion that feeding styles cause obesity. But there are a number of studies that show feeding tendencies (style and practices) are correlated with weight gain/overweight/obesity. Which came first–the weight gain tendency or the style? Who knows, but we do know that feeding styles are trans-generational–handed down from our parents and grandparents; and yes, there is research that indicates restrictive or controlling feeding (which is a practice associated with a style) may be a reaction to the child’s weight status.
      While we don’t have black and white answers on this, it’s clear to me there is an influence, not only from the research studies (which is a fairly young area of research) but also from my experiences working with children and their families. Not all families will demonstrate feeding styles/practices as a strong influence, but for those families who have gotten the food “right” and the exercise “right” and are not seeing significant progress/improvement with weight, often the feeding style and practices are a prominent factor to address.

      You bring up an interesting point that i think gets overlooked–the fast gainer (and by contrast, the slow gainer)–each child will grow and gain and eat with their own blueprint (genetic, developmental stage, and eating personality)–and we need to help parents figure this out for their own child, not by society’s standards.

      My upcoming book, Fearless Feeding, helps address and explain these topics (plus much more!) around feeding so parents can be equipped with this information before problems begin. Appreciate your comments!

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