Parental Eating Disorders

Good dietary behaviour is crucial in ensuring healthy growth and development for

children. Parents influence their children’s dietary behaviour through the promotion

of positive eating habits and a balanced and nutritious diet. Parents’ own dietary

behaviour is strongly linked to that of their children, especially early in life. In

particular, there is strong evidence that parental eating disorders can have a sizeable

impact on a child’s well-being, affecting it in a wide range of ways (Martini et al.,

2020). According to the HSE’s National Clinical Programme for Eating Disorders, an

estimated 188,895 people in Ireland will experience an eating disorder at some point

in their lives.18

Many studies argue for the existence of intergenerational eating disorders. One study

found that children of women with eating disorders are at increased risk of

developing anorexia or bulimia (Kothari et al., 2013), whilst the longitudinal Growing

Up Today Study (GUTS) found that young girls (9-15yrs) were over twice as likely to

purge at least weekly if their mother has a history of an eating disorder (Field et al.,

2008).

Focussing specifically on parents with binge-eating disorders, studies suggest that

such parents are significantly more likely to report binge-eating amongst their

children. Through a survey provided to parents of children ages 5-15 years old,

researchers noted that parents with eating disorders, regardless of weight status,

were more likely than parents with no eating disorder to report child binge-eating

(Lydecker & Grilo, 2017).

Parental eating disorders have also been linked with the feeding styles they employ

with their children. Some studies have noted that mothers with either binge-eating

disorders or bulimia are also more likely to report a restrictive feeding style for their

child (Hoffman et al., 2012; Reba-Harrelson et al, 2010). Restrictive feeding styles

include the strict limiting of certain types of foods as well as increased control over a

child’s dietary intake. The prevalence of binge-eating disorders amongst mothers also

predicts increased frequency of other non-responsive feeding practices (Saltzman et

al., 2016). The authors found that prevalence of binge-eating by the mother when the

18https://www.bodywhys.ie/media-research/statistics/

child was age 3 predicted increased use of non-responsive feeding practices two

years later. Restrictive and non-responsive feeding practices are also known to be

associated with increased risk of weight gain and development of unhealthy eating

habits amongst pre-school and school aged children (Lindsay et al., 2017).

Further research has established links between parental eating disorders and a range

of negative outcomes for children, including cognitive, neuropsychological and socio-

emotional issues. Findings from the Avon Longitudinal Study of Parents and Children

(ALSPAC; Kothari et al., 2013) showed that children of women with anorexia had

decreased attention control, while children of women with bulimia had decreased

visual-spatial functioning. Further research using data from ALSPAC (Micali et al.,

2014. found that children of mothers who had a pre-pregnancy eating disorder were

more likely to develop an emotional disorder diagnosis.

For Growing Up in Ireland, these questions should be included on the self-complete

module for the primary caregiver as they are likely to be of a sensitive nature.

Recommendation for Cohort 24 at 3 years:

•Few longitudinal studies, and none in Ireland, explore the long-term effects of maternal eating disorders on child development. Including this topic in the forthcoming wave will allow researchers to explore all of the aforementioned associations.

•There are numerous multi-item scales that can be employed. However, these scales often include in excess of 20 items or a clinical interview for diagnosis. A more appropriate approach for Growing Up in Ireland could be to include a direct question about a previous or existing eating disorder diagnosis (a), and a routed question on the nature of that disorder (b):

•a) “Do you currently or have you ever had an eating disorder?” Yes / No

•b) “What type of eating disorder do/did you have?” Anorexia / Bulimia / Binge Eating Disorder / Other

Screen use while eating