Parental concerns about disordered eating common in overweight children

Parents of children with a high weight often have concerns about child disordered eating, according to a recent study published in the Journal of Nutrition Education and Behavior.¹

These parents were participating in a motivational interviewing (MI)-based behavioral intervention, with nearly half of participants reporting at least 1 concern related to disordered eating at the start of the intervention. These included concerns over the loss of controlled eating and preoccupation with weight or shape.

“This study shows that concerns about disordered eating behaviors are common among parents of young children with high weights, but these concerns do not appear to worsen when families engage in supportive, autonomy-focused counseling,” said Kendrin R. Sonneville, ScD, RD, lead investigator from the University of Michigan School of Public Health.

Study design and intervention approach

The study was conducted to determine the prevalence of these concerns and evaluate how they are influenced by the intervention.² Pediatric clinicians with a fluency in English or Spanish, employment by an enrolled practice for at least 1 year before the trial, and membership in the Pediatric Research in Office Settings were eligible.

Eligibility criteria for parents included being an adult able to speak English or Spanish, while criteria for children included being aged 3 to 11 years at enrollment and having at least 1 body mass index (BMI) percentile over the 85^th percentile within 2 years of the intervention. Children with a behavioral or physical health diagnosis were excluded.

Parents underwent 6 MI-based nutrition counseling calls with registered dietitians (RDs) across a period of approximately 2 to 2.5 years. During this time, RDs used MI skills and open-ended questions to determine parents’ values and strengths, concerns about child’s eating habits, and a goal for their child.

Through autonomy support, parents increased their confidence to implement the changes needed to achieve their goals. Four office visits between parents and pediatric clinicians were also recommended during the study period.

Assessment of disordered eating concerns

Initial screening questions captured parents’ concerns about loss of control eating, weight loss, weight and shape preoccupation, and dietary restriction. Parental concern was reported as a binary variable during baseline and at calls 3 and 6. Sociodemographic data was also collected at baseline.

There were 214 children included in the analysis, 50% of whom were female, 36.9% Hispanic, and 72% privately insured. Concern about disordered eating for their child was reported by 44.9% of parents at baseline. Parents of girls were more likely to report concerns about wight and shape preoccupation at baseline vs boys, with rates of 25.2% and 13.1%, respectively.

BMI above the 95^th percentile was also linked to loss of control eating habit concerns at baseline. A rate of 42.9% was reported for concerns about loss of control eating by parents who perceived their child to be a little overweight or obese, vs 12.8% of those without this perception. Rates of concern about weight and shape perception at baseline were also reported, at 26.9% vs 9.6%, respectively.

Changes in parental concerns over time

These concerns did not significantly differ between baseline and follow-up. The rate of concerns about child disordered eating declined from 46.1% to 36.5% at follow-up. Nineteen percent of parents reporting concerns at baseline did not at follow-up, while the development of concerns during this period was reported by 10% of parents.

Overall, this data indicated high rates of disordered eating concerns, with no significant alterations throughout the intervention. Investigators recommend future research examine the influence of behavioral intervention components on disordered eating risk over time.

“While research is needed to inform periodic screening practices across a variety of intervention conditions, all health care providers are encouraged to be aware of the risk of disordered eating among youth with high weights and have referral mechanisms for appropriate treatment in place,” wrote investigators.

Reference

1. Parental concerns about child disordered eating common among youth with high weights in behavioral intervention. Elsevier. January 15, 2026. Accessed February 04, 2026. https://www.eurekalert.org/news-releases/1112853
2. Goodman LP, Delacroix E, McNally S. Parental concerns about child disordered eating among youth with high weights participating in a motivational interviewing-based behavioral intervention. Journal of Nutrition Education and Behavior. 2026;58(1):4-14. doi:10.1016/j.jneb.2025.09.005