Distress at the Dinner Table? Observed Mealtime Interactions among Treatment-Seeking Families of Obese Children.

BACKGROUND: Although family-based, behavioral interventions for pediatric obesity require caregivers to make major changes to dietary intake and the family meal, few studies have examined family functioning, and specifically, mealtime behaviors among families of treatment-seeking obese children. The current study compared mealtime family functioning of treatment-seeking obese children and nonobese demographically matched comparisons using a multimethod design.
METHODS: Participants included the families of 27 obese children (BMI ≥95(th) percentile; M body mass index (BMI) z-score values [M zBMI] = 2.55) at the time of treatment initiation and 27 families of nonobese children (M zBMI = 0.17). Each family's evening meal was videotaped and coded for observed family functioning using the Mealtime Interaction Coding System (MICS). Caregivers completed a demographics form and a measure of family mealtime climate.
RESULTS: Caregivers of obese children self-reported greater mealtime challenges and a less positive meal environment than non-obese comparisons. There were no significant group differences in observed family mealtime interactions.
CONCLUSION: Interestingly, although group means on the observational measure of mealtime family functioning were not significantly different, caregivers of obese children reported greater mealtime stress. Accordingly, it is important in the context of treatment to address caregiver perceptions of mealtime challenges and to examine the extent to which these self-reported challenges affect implementation of treatment recommendations and treatment outcomes.