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Parental and Child Characteristics Related to Early-Onset Disordered Eating: A Systematic Review

Larsen, Pernille Stemann MSc; Strandberg-Larsen, Katrine MSc, PhD; Micali, Nadia MD, PhD; Andersen, Anne-Marie Nybo MD, PhD

doi: 10.1097/HRP.0000000000000073

Learning Objectives After participating in this activity, learners should be better able to:

• Evaluate the evidence regarding parental and child characteristics related to early-onset disordered eating.

Eating disorders are rare in children, but disordered eating is common. Understanding the phenomenology of disordered eating in childhood can aid prevention of full-blown eating disorders. The purpose of this review is to systematically extract and synthesize the evidence on parental and child characteristics related to early-onset disordered eating. Systematic searches were conducted in PubMED/MEDLINE, EMBASE, and PsycInfo using the following search terms: eating disorder, disordered eating, problem eating, anorexia nervosa, bulimia nervosa, binge eating, child, preadolescent, and early onset. Studies published from 1990 to 2013 addressing parental and child characteristics of disordered eating in children aged 6 to 12 years were eligible for inclusion. The search was restricted to studies with cross-sectional, case-control, or longitudinal designs, studies in English, and with abstracts available. Forty-four studies fit these criteria. Most studies were based on community samples with a cross-sectional design. The included studies varied considerably in size, instruments used to assess early-onset disordered eating, and parental and child characteristics investigated. Important determinants included the following: higher body weight, previously reported disordered eating, body dissatisfaction, depression, parental disordered eating, and parental comments/concerns about child’s weight and eating. The findings were inconsistent for sex, age, socioeconomic status, ethnicity, self-esteem/worth, and parental body weight. In conclusion, characteristics related to early-onset disordered eating have mainly been explored with a cross-sectional design. Full understanding of causal pathways will require good-quality longitudinal studies designed to address the influence of parental eating behaviors, mental and physical health, family interactions, and child growth patterns.

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From Section of Social Medicine, Department of Public Health, University of Copenhagen (Mrs. Larsen and Drs. Strandberg-Larsen and Nybo Andersen); Behavioral and Brain Sciences Unit, University College London Institute of Child Health (Dr. Micali).

Supported, in part, by research career grant from Health Sciences, University of Copenhagen (Mrs. Larsen), and by an exchange grant from the Royal Society, UK (Dr. Micali).

Original manuscript received 22 May 2014; revised manuscript received 8 September 2014, accepted for publication subject to revision 16 October 2014; revised manuscripts received 21 October and 12 November 2014.

Correspondence: Pernille Stemann Larsen, Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, DK-1014 Copenhagen K, Denmark. Email:

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© 2015 President and Fellows of Harvard College
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