Young children who have a strong urge to eat when they see, taste or smell appetising food could be more at risk of developing eating disorder symptoms in adolescence, a new study has indicated.

Researchers say four or five-years-olds with a significantly high food responsiveness are more likely to report eating disorder signs aged 12 to 14, including binge eating, uncontrolled eating, emotional eating, and restrained eating.

While the team behind the findings say it could lead to prevention strategies for those children more at risk, they also stressed that eagerness for food at a young age is common and is just one potential risk factor.

Researchers looked at data from just over 3,600 young people living in the UK and the Netherlands to explore how appetite traits in younger years may be linked to eating disorder symptoms a decade later.

Co-senior author Dr Clare Llewellyn, from University College London (UCL), said: “While the role of appetite in the development of obesity has been studied for many decades, this is the first study to comprehensively examine the role of appetite traits in the development of eating disorder symptoms.

“Eating disorders can be harder to treat effectively once they develop and so it would be better to prevent them from occurring in the first place.

“Our work in identifying risk factors in early life aims to support the development of possible prevention strategies. These could, for instance, involve providing extra support to children at higher risk.”

One of the key findings was the link between higher food responsiveness and a 47% increase in the risk of developing binge eating symptoms.

The team also find that having a strong desire for food in younger years was associated with a 16% increase in the odds of restrained eating, which is when someone limits their food consumption to try to lose weight or avoid putting on weight.

Similarly, emotional overeating during the younger years was found to be linked to greater odds of developing compensatory behaviours, such as fasting, missing meals and over-exercising as a way to avoid putting on weight.

Conversely, researchers identified some appetite behaviours in childhood which appear to reduce the risk of developing eating disorder symptoms in the teenage years.

For example, feeling full more quickly and for longer was associated with a lower risk of uncontrolled eating and compensatory behaviours.

Eating more slowly was also linked to less risk of developing compensatory behaviours and restrained eating in adolescence.

Fussiness about food, not eating when feeling low, and food enjoyment in childhood were not linked to later eating disorder symptoms.

Co-lead author Dr Ivonne Derks, from UCL, said: “Although our study cannot prove causality, our findings suggest food cue responsiveness may be one predisposing risk factor for the onset of eating disorder symptoms in adolescence.

“However, high responsiveness to food is also a normal and very common behaviour and should be seen as just one potential risk factor among many rather than something to cause parents worry.”

Co-lead author Dr Zeynep Nas, also from UCL, went on to say: “A healthy food environment is an environment in which healthy foods are available and more prominent, salient and affordable than less healthy options. This also includes wider access to food such as what types of food outlets are available in our neighbourhood and what food we see on TV.

“Responsive feeding is about providing nutritious food at set mealtimes and snack times, and then allowing the child to decide what to eat and how much to eat (if anything at all) without pressuring them.”

Read the study in The Lancet Child & Adolescent Health.

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