The association between alexithymia and eating behavior in children and adolescents

Lisa M Shank; Marian Tanofsky-Kraff; Nichole R Kelly; Manuela Jaramillo; Sarah G Rubin; Deborah R Altman; Meghan E Byrne; Sarah LeMay-Russell; Natasha A Schvey; Miranda M Broadney; Sheila M Brady; Shanna B Yang; Amber B Courville; Sophie Ramirez; Alexa C Crist; Susan Z Yanovski; Jack A Yanovski

doi:10.1016/j.appet.2019.104381

The association between alexithymia and eating behavior in children and adolescents

Appetite. 2019 Nov 1:142:104381. doi: 10.1016/j.appet.2019.104381. Epub 2019 Jul 22.

Authors

Lisa M Shank¹, Marian Tanofsky-Kraff², Nichole R Kelly³, Manuela Jaramillo⁴, Sarah G Rubin⁴, Deborah R Altman⁵, Meghan E Byrne⁵, Sarah LeMay-Russell⁵, Natasha A Schvey⁵, Miranda M Broadney⁴, Sheila M Brady⁴, Shanna B Yang⁶, Amber B Courville⁶, Sophie Ramirez⁴, Alexa C Crist⁴, Susan Z Yanovski⁷, Jack A Yanovski⁴

Affiliations

¹ Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA; Metis Foundation, 300 Convent St #1330, San Antonio, TX, 78205, USA.
² Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA. Electronic address: marian.tanofsky-kraff@usuhs.edu.
³ Department of Counseling Psychology and Human Services, and Prevention Science, College of Education, 5207 University of Oregon, Eugene, OR, 97403-5207, USA.
⁴ Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA.
⁵ Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA.
⁶ Nutrition Department, Clinical Research Center, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA.
⁷ Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA; Office of Obesity Research, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), DHHS, Bethesda, MD, 20892, USA.

Abstract

Objective: Alexithymia, or the difficulty identifying or describing one's own emotions, may be a risk factor for dysregulated eating and excess weight gain. However, the relationships between alexithymia and eating behaviors in community samples of non-clinical youth have not been well-characterized. We hypothesized that alexithymia would be positively associated with disordered and disinhibited eating in a community-based sample of boys and girls without an eating disorder.

Method: Two hundred children (8-17 years old) across the weight spectrum completed an interview to assess loss of control (LOC) eating and eating-related psychopathology, a laboratory test meal designed to induce disinhibited eating, and questionnaires to assess alexithymia, eating in the absence of hunger, and emotional eating. Linear and logistic regressions were conducted to examine the relationship between alexithymia and eating variables, with age, sex, race, and fat mass as covariates. Test meal analyses also adjusted for lean mass. Given the overlap between alexithymia and depression, all models were repeated with depressive symptoms as an additional covariate.

Results: Alexithymia was associated with an increased likelihood of reporting LOC eating (p < .05). Moreover, alexithymia was positively associated with disordered eating attitudes, emotional eating, and eating in the absence of hunger (ps < .05). Greater alexithymia was associated with more carbohydrate and less fat intake at the test meal (ps < .05). After adjusting for depressive symptoms, alexithymia remained associated with eating in the absence of hunger and carbohydrate and fat intake (ps < .05).

Discussion: In healthy children, alexithymia is associated with some facets of eating behavior and food intake. If supported prospectively, these preliminary findings suggest alexithymia may be a modifiable risk factor to reduce disordered eating and excess weight gain in youth.

Keywords: Adolescents; Alexithymia; BMI-z; Body mass index standard deviation score; Children; Disinhibited eating; Disordered eating; Food intake; LOC eating; Loss of control eating; adjusted for age and sex.

Publication types

Research Support, N.I.H., Intramural

MeSH terms

Adolescent
Adolescent Behavior / psychology*
Affective Symptoms / psychology*
Body Weight
Child
Child Behavior / psychology*
Eating / psychology*
Emotions
Feeding Behavior / psychology*
Feeding and Eating Disorders / psychology
Female
Humans
Hunger
Male

Abstract

Publication types

MeSH terms

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