Prospective associations between appetitive traits and parental feeding practices in childhood and eating disorder symptoms and diagnoses in adolescence and early adulthood: The Twins Early Development Study

Background: Certain appetitive traits and parental feeding practices in childhood have been associated with risk of eating disorder (ED) symptoms in early adolescence. However, prospective relationships with ED symptoms beyond early adolescence are unknown. Methods: Data were from n=6909 participants from the Twins Early Development Study. At 10 years, parents reported on children’s appetitive traits and their feeding practices. Twins self-reported on weight and shape preoccupation at 16 years, and on binge-eating symptoms, body pre-occupation and ED diagnoses at 21 years. Regression analyses (generalised linear, ordinal linear and binary logistic) were adjusted for clustering of families, sex, gestational age, socioeconomic position, age at outcome assessment and additionally adjusted for child BMI at 10 years. Results: Higher food enjoyment in childhood was associated with higher binge-eating (B=0.13; 95%CI=0.04, 0.22) and body preoccupation symptoms (females only, B=0.64; 95%CI= 0.13, 1.16) in early adulthood. Greater satiety responsiveness was associated with lower body preoccupation (B=-0.70; -0.99, -0.41). Slower eating was associated with less body preoccupation and fewer binge-eating symptoms. Parental restriction increased the odds of Bulimia Nervosa diagnosis (OR=1.24; 1.04, 1.48) and was associated with higher weight and shape preoccupation (OR=1.24; 1.12, 1.37), body preoccupation (B=0.15; 0.08, 0.22) and binge-eating symptoms (B= 0.86; 0.57, 1.15). Conclusion: Children who enjoy food more and whose parents exert greater restriction over their food intake may be at higher risk of developing ED symptoms (e.g., binge-eating and body preoccupation), while slower eating and greater satiety responsiveness may play protective roles.