Ecological momentary assessment of maladaptive eating in children and adolescents with overweight or obesity

Int J Eat Disord. 2018 Jun;51(6):549-557. doi: 10.1002/eat.22864. Epub 2018 Apr 6.


Objectives: Contextual factors related to maladaptive eating behavior in youth with overweight/obesity are poorly understood. This pilot study sought to elucidate immediate internal and external cues related to perceptions of overeating and loss of control (LOC) over eating in a heterogeneous sample of children and adolescents with overweight/obesity assessed in their natural environments.

Method: Community-based youth [N = 40; 55% female (n = 22)], aged 8-14 y (M age = 11.2 ± 1.9 y), with overweight/obesity (M z-BMI = 2.07 ± 0.49) reported on all eating episodes and their physiological, environmental, affective, and interpersonal antecedents and correlates via ecological momentary assessment over a 2-week period. Generalized estimating equations were used to assess the relationship between contextual variables and degree of overeating and LOC.

Results: Eating occasions involving greater food hedonics (i.e., perceived palatability of food being consumed) were associated with greater LOC severity (within-subjects effect: B = 0.01, p = .015), although youth with lower overall levels of food hedonics reported higher LOC severity ratings on average (between-subjects effect: B = -0.04, p = .005). Youth reporting higher overall cravings reported higher average ratings of LOC severity (between-subjects effect: B = 0.20, p = .001). Finally, youth reporting greater overall influence of others on eating behavior evidenced greater average levels of overeating severity (between-subjects effect: B = 0.17, p < .001).

Discussion: Eating-related factors appear to be most strongly associated with LOC severity, while environmental factors were most associated with overeating severity. Interventions targeting maladaptive eating in youth with overweight/obesity may benefit from helping youth incorporate palatable foods and satisfy cravings in a planned and controlled manner, and enhancing awareness of social-contextual effects on eating.

Keywords: adolescent; binge eating; child; ecological momentary assessment; loss of control; obesity; overeating.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Child
  • Ecological Momentary Assessment / standards*
  • Female
  • Humans
  • Hyperphagia / psychology*
  • Male
  • Obesity / psychology*
  • Overweight / psychology*