Mealtime family interactions in home environments of children with loss of control eating.

Experimental and self-report studies have shown that parents have a strong influence on their normal or overweight children's eating behavior, i.e. through parental feeding behavior or communication. Studies in children with loss of control (LOC) eating that have investigated this relationship are scarce, and ecologically valid observational studies are missing. This study examined family functioning at mealtimes in home environments in 43 families of a child with LOC eating and 31 families of a child without LOC eating; the children were 8-13 years old. Familial interactions, child eating behavior, and parental mealtime behavior were assessed using the Mealtime Family Interaction Coding System, observation of bite speed of the child, and self-report questionnaires. Less healthy patterns of communication (U=201.53, p<.01) and interpersonal involvement (U=207.54, p<.01) and more maladaptive overall family functioning (U=233.52, p<.05) were observed but not self-reported in families of a child with LOC eating compared to those without LOC eating. Children with LOC eating (M=4.73, SD=1.88) ate faster than controls (M=3.71, SD=1.19; p<.05), with highest bite speed in a group with high recurrent LOC eating (p<.01). The results indicate that maladaptive patterns of family functioning during family mealtimes are present in LOC eating in children and are associated with the child's eating behavior. Parent-child communication training should be tested as an intervention for children with LOC episodes.