Caregiver and adolescent intuitive eating behavior: associations with weight change during family-based treatment for anorexia nervosa

Jillian D Nelson; Paige J Trojanowski; Claire M Aarnio-Peterson; Sarah Fischer; Leah Adams; Abigail Matthews

doi:10.1007/s40519-023-01557-0

Caregiver and adolescent intuitive eating behavior: associations with weight change during family-based treatment for anorexia nervosa

Eat Weight Disord. 2023 Mar 25;28(1):32. doi: 10.1007/s40519-023-01557-0.

Authors

Jillian D Nelson¹, Paige J Trojanowski², Claire M Aarnio-Peterson^{3

4}, Sarah Fischer², Leah Adams², Abigail Matthews^{3

4}

Affiliations

¹ Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA. jnelso2@gmu.edu.
² Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.
³ Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
⁴ Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Abstract

Purpose: Intuitive eating (IE) is an adaptive eating construct for which little research exists in eating disorder (ED) samples. IE is negatively correlated with disordered eating behaviors in healthy adolescents and adults, and similar associations have been found in adults with EDs. This study aims to examine IE in a treatment seeking sample of adolescents and their caregivers to understand the role of IE in weight gain during FBT.

Methods: Descriptive statistics and bivariate correlations were calculated in a sample of 47 pairs of adolescent patients and their caregivers who initiated outpatient FBT at a large academic medical center. Analyses examined associations between caregiver and adolescent IE on the Intuitive Eating Scale (IES), change in percent expected body weight (%EBW) by session 4 and end of treatment (EOT), clinical impairment, and ED pathology.

Results: Significant correlations were found between aspects of adolescent IE, ED symptoms, and clinical impairment. Caregiver IES scores (Reliance on Hunger and Satiety Cues, Body-Food Choice Congruence, IES Total) were negatively related to adolescent ED symptoms (EDE-Q Weight Concerns, EDE-Q Shape Concerns, EDE-Q Global) at baseline. Caregiver IE (Eating for Physical Rather than Emotional Reasons) was positively associated with adolescent weight gain at FBT session 4 and EOT, even when statistically adjusting for gender and initial level of care.

Conclusion: Study results were consistent with past research indicating adolescent IE is negatively associated with ED behaviors, cognitions, and impairment. This study is the first to provide evidence that caregiver IE is positively associated with adolescent weight gain in FBT and is the first to provide evidence that caregiver IE is negatively related to adolescent ED symptoms. Future research should examine adolescent and caregiver IE throughout FBT to understand the role of IE in treatment response.

Level of evidence: Level III: Evidence obtained from cohort or case-control analytic studies.

Keywords: Adolescents; Anorexia nervosa; Family-based treatment; Intuitive eating.

MeSH terms

Adolescent
Adult
Anorexia Nervosa* / psychology
Anorexia Nervosa* / therapy
Caregivers
Family Therapy / methods
Feeding Behavior
Feeding and Eating Disorders* / therapy
Humans
Weight Gain