Parental Influences on Obesity and Subclinical Bulimia Nervosa

The connections between the quality of the parent-child relationship and disordered eating patterns in the child have been a topic of interest for a long time. For example, overweight children have a two- to fourfold risk of becoming obese as adults, and women with bulimia nervosa report much more conflict, hostility, and anger in their families than do control women (Am J Psychiatry 1985; 142:1321). Two recent studies have revealed some consequences of parental effects.

Obese children: eating increased when mother was present

In the first study, Dr. Reinhold G. Laessle and colleagues at the University of Trier, Germany, recruited 80 obese and normal-weight children 8 to 12 years of age (36 girls, 44 boys) and evaluated their eating styles with and without their mothers being present in the laboratory (Int J Eat Disord 2001;30:447).

They found that the eating behavior of obese children differed significantly from that of normal-weight children only when the mother was present in the laboratory. In the presence of their mothers, overweight children ate faster, took larger bites, and accelerated their rate of eating toward the end of the meal. The scientists theorized that the accelerated eating might be the result of former reinforcing processes during family meals, when the mother may have urged the child to eat faster and to take larger bites to clean the plates faster. Another possibility is that the presence of their mother may have increased stress and anxiety among the obese children, which led to faster eating and bigger bites as a coping mechanism.

Marital discord and subclinical bulimia nervosa

In a second study, a twin registry was used to investigate the relationship between parental relationships and subclinical bulimia nervosa. The Virginia Twin Registry is a population-based longitudinal study of Caucasian female twins, and includes a systematic review of all birth records in the Commonwealth of Virginia since 1918.

The researchers used reports of twin lifetime psychopathology obtained from 2,163 individuals, including both members of 1,033 pairs of twins. Both parents provided information about the quality of the parental relationship and parental lifetime psychopathology (Int J Eat Disord 2001; 30:389). A diagnosis of BN was made with the Structured Clinical Interview for DSM-III-R (SCID). And a second interview added questions about the severity of bulimic symptoms.

As might be expected, the poorer the marital relationship, the greater the chance that the offspring would have subclinical bulimia nervosa. An unhappy marriage also predicted the presence of generalized anxiety disorder and alcohol dependence. These results support the notion that when the parental relationship is filled with conflict and hostility, it can at least partially act as a risk factor for subclinical bulimia nervosa.