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Children of Parents with Eating Disorders

  • Eating Disorders (S Wonderlich and JM Lavender, Section Editors)
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Abstract

Purpose of Review

Our primary goal in this article is to review recent findings (from 2015 and on) concerning children of parents with eating disorders. This review addresses the question of whether the offspring of parents with past or present eating disorders have adverse outcomes. This update is timely and informative because recent research includes controlled studies and large cohort designs and earlier reviews relied on case report evidence.

Recent Findings

Despite substantial diversity in study design, sample size, and parental eating disorder definition, overall, existing research suggests that the children of parents with eating disorders exhibit compromised development: a greater risk of perinatal complications; a tendency toward extremes of growth at birth; greater problems in feeding and eating behaviors and greater incidence of eating disorder symptoms; more psychological and socioemotional difficulties; and more negative qualities to parent-child interactions. Data on children’s cognitive outcomes is thus far inconsistent.

Summary

Given the relatively high incidence of eating disorder history in individuals of childbearing age, research into its potential effects on children is necessary. However, the methodological shortcomings and a limited evidence base caution in drawing conclusions. Nevertheless, mental health services should address the possible problems that these children face and offer tailored programs.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Arcelus J, Mitchell AJ, Wales J, Nielsen S. Mortality rates in patients with anorexia nervosa and other eating disorders: a meta-analysis of 36 studies. Arch Gen Psychiatry. 2011;68(7):724–31.

    Article  Google Scholar 

  2. Gravina G, Milano W, Nebbiai G, Piccione C, Capasso A. Medical complications in anorexia and bulimia nervosa. Endocr Metab Immune Disord Drug Targets. in press

  3. Smink FR, Van Hoeken D, Hoek HW. Epidemiology of eating disorders: incidence, prevalence and mortality rates. Curr Psychiatry Rep. 2012;14(4):406–14.

    Article  Google Scholar 

  4. Stice E, Marti CN, Rohde P. Prevalence, incidence, impairment, and course of the proposed DSM-5 eating disorder diagnoses in an 8-year prospective community study of young women. J Abnorm Psychol. 2013;122(2):445–57.

    Article  Google Scholar 

  5. Colby SL, Ortman JM. Projections of the size and composition of the US population: 2014 to 2060, current population reports. Washington, DC: US Census Bureau; 2017.

    Google Scholar 

  6. Stein A, Pearson RM, Goodman SH, Rapa E, Rahman A, McCallum M, et al. Effects of perinatal mental disorders on the fetus and child. Lancet. 2014;384(9956):1800–19.

    Article  Google Scholar 

  7. Jenkins JM, McGowan P, Knafo-Noam A. Parent–offspring transaction: mechanisms and the value of within family designs. Horm Behav. 2016;77:53–61.

    Article  Google Scholar 

  8. • Barona M, Nybo Andersen AM, Micali N. Childhood psychopathology in children of women with eating disorders. Acta Psychiatr Scand. 2016;134(4):295–304. This article investigates the effects of maternal eating disorders on child psychopathology, cognitive, motor, and language development.

    Article  CAS  Google Scholar 

  9. Barona M, Taborelli E, Corfield F, Pawlby S, Easter A, Schmidt U, et al. Neurobehavioural and cognitive development in infants born to mothers with eating disorders. J Child Psychol Psychiatry. 2017;58(8):931–8.

    Article  Google Scholar 

  10. Bould H, Sovio U, Koupil I, Dalman C, Micali N, Lewis G, et al. Do eating disorders in parents predict eating disorders in children? Evidence from a Swedish cohort. Acta Psychiatr Scand. 2015;132(1):51–9.

    Article  CAS  Google Scholar 

  11. Cimino S, Cerniglia L, Paciello M. Mothers with depression, anxiety or eating disorders: outcomes on their children and the role of paternal psychological profiles. Child Psychiatry Hum Dev. 2015;46(2):228–36.

    Article  Google Scholar 

  12. • Cimino S, Cerniglia L, Porreca A, Simonelli A, Ronconi L, Ballarotto G. Mothers and fathers with binge eating disorder and their 18–36 months old children: a longitudinal study on parent–infant interactions and offspring’s emotional–behavioral profiles. Front Psychol. 2016;7:580. This research highlights the negative influence across multiple child development domains that is linked to parental binge-eating disorder.

    Article  Google Scholar 

  13. de Barse LM, Tharner A, Micali N, Jaddoe VV, Hofman A, Verhulst FC, et al. Does maternal history of eating disorders predict mothers’ feeding practices and preschoolers’ emotional eating? Appetite. 2015;85:1–7.

    Article  Google Scholar 

  14. Easter A, Solmi F, Bye A, Taborelli E, Corfield F, Schmidt U, et al. Antenatal and postnatal psychopathology among women with current and past eating disorders: longitudinal patterns. Eur Eat Disord Rev. 2015;23(1):19–27.

    Article  Google Scholar 

  15. • Easter A, Taborelli E, Bye A, Zunszain P, Pariante C, Treasure J, et al. Perinatal hypothalamic-pituitary-adrenal axis regulation among women with eating disorders and their infants. Psychoneuroendocrinology. 2017;76:127–34. This article explores the effects of perinatal eating disorders on infants’ HPA axis; known to impact infant stress regulation.

    Article  CAS  Google Scholar 

  16. Kazmi N, Gaunt TR, Relton C, Micali N. Maternal eating disorders affect offspring cord blood DNA methylation: a prospective study. Clin Epigenetics. 2017;9(1):120.

    Article  Google Scholar 

  17. •• Lydecker JA, Grilo CM. Fathers and mothers with eating-disorder psychopathology: associations with child eating-disorder behaviors. J Pychosom Res. 2016;86:63–9. This study suggests that parental eating disorder behavior significantly increases the likelihood of children exhibiting eating disordered behavior.

    Article  Google Scholar 

  18. • Lydecker JA, Grilo CM. Children of parents with BED have more eating behavior disturbance than children of parents with obesity or healthy weight. Int J Eat Disord. 2017;50(6):648–56. A paper highlighting the increased presence of eating disorder pathology in children of parents with binge-eating disorder.

    Article  Google Scholar 

  19. Micali N, Stemann Larsen P, Strandberg-Larsen K, Nybo Andersen AM. Size at birth and preterm birth in women with lifetime eating disorders: a prospective population-based study. BJOG Int J Obstet Gynaecol. 2016;123(8):1301–10.

    Article  CAS  Google Scholar 

  20. • Nguyen AN, de Barse LM, Tiemeier H, Jaddoe VW, Franco OH, Jansen PW, et al. Maternal history of eating disorders: diet quality during pregnancy and infant feeding. Appetite. 2017;109:108–14. This article highlights that mothers with a maternal history of eating disorders were less likely to breastfeed, however at 1 year had superior diet quality to the control.

    Article  Google Scholar 

  21. Perrin EM, Von Holle A, Zerwas S, Skinner AC, Reba-Harrelson L, Hamer RM, et al. Weight-for-length trajectories in the first year of life in children of mothers with eating disorders in a large Norwegian cohort. Int J Eat Disord. 2015;48(4):406–14.

    Article  Google Scholar 

  22. •• Sadeh-Sharvit S, Levy-Shiff R, Feldman T, Ram A, Gur E, Zubery E, et al. Child feeding perceptions among mothers with eating disorders. Appetite. 2015;95:67–73. A qualitative study emphasizing the challenges that mothers with eating disorders experience in managing issues regarding their child’s shape, weight, and feeding practices.

    Article  Google Scholar 

  23. Sadeh-Sharvit S, Levy-Shiff R, Lock JD. Maternal eating disorder history and toddlers’ neurodevelopmental outcomes: a brief report. Eat Disord. 2016;24(2):198–205.

    Article  Google Scholar 

  24. Sadeh-Sharvit S, Levy-Shiff R, Arnow KD, Lock JD. The interactions of mothers with eating disorders with their toddlers: identifying broader risk factors. Attach Hum Dev. 2016;18(4):418–28.

    Article  Google Scholar 

  25. • Sadeh-Sharvit S, Zubery E, Mankovski E, Steiner E, Lock JD. Parent-based prevention program for the children of mothers with eating disorders: feasibility and preliminary outcomes. Eat Disord. 2016;24(4):312–25. This article describes a parent-based prevention programme pilot study and the feasability of a programme to reduce the risk of psychopathology in offspring.

    Article  Google Scholar 

  26. • Steinhausen HC, Jakobsen H, Helenius D, Munk-Jørgensen P, Strober M. A nation-wide study of the family aggregation and risk factors in anorexia nervosa over three generations. Int J Eat Disord. 2015;48(1):1–8. Intergenerational study investigating familial aggregation of anorexia nervosa.

    Article  Google Scholar 

  27. • Torgersen L, Ystrom E, Siega-Riz AM, Berg CK, Zerwas SC, Reichborn-Kjennerud T, et al. Maternal eating disorder and infant diet: a latent class analysis based on the Norwegian Mother and Child Cohort Study (MoBa). Appetite. 2015;84:291–8. This study suggests that maternal eating disorders affect infant diet.

    Article  Google Scholar 

  28. •• Watson HJ, Zerwas S, Torgersen L, Gustavson K, Diemer EW, Knudsen GP, et al. Maternal eating disorders and perinatal outcomes: a three-generation study in the Norwegian Mother and Child Cohort Study. J Abnorm Psychol. 2017;126(5):552. A key cohort study spanning three generations; supporting the findings that exposure to eating disorders increases negative health outcomes in pregnant women and their offspring.

    Article  Google Scholar 

  29. Torgersen L, Ystrom E, Haugen M, Meltzer HM, Von Holle A, Berg CK, et al. Breastfeeding practice in mothers with eating disorders. Matern Child Nutr. 2010;6(3):243–52.

    PubMed  Google Scholar 

  30. Clinton D, McKinlay W. Attitudes to food, eating and weight in acutely ill and recovered anorectics. Br J Clin Psychol. 1986;25(1):61–7.

    Article  Google Scholar 

  31. Fichter MM, Quadflieg N, Hedlund S. Long-term course of binge eating disorder and bulimia nervosa: relevance for nosology and diagnostic criteria. Int J Eat Disord. 2008;41(7):577–86.

    Article  Google Scholar 

  32. Löwe B, Zipfel S, Buchholz C, Dupont Y, Reas D, Herzog W. Long-term outcome of anorexia nervosa in a prospective 21-year follow-up study. Psychol Med. 2001;31(5):881–90.

    Article  Google Scholar 

  33. Strober M, Freeman R, Morrell W. The long-term course of severe anorexia nervosa in adolescents: survival analysis of recovery, relapse, and outcome predictors over 10–15 years in a prospective study. Int J Eat Disord. 1997;22(4):339–60.

    Article  CAS  Google Scholar 

  34. Zipfel S, Löwe B, Reas DL, Deter H-C, Herzog W. Long-term prognosis in anorexia nervosa: lessons from a 21-year follow-up study. Lancet. 2000;355(9205):721–2.

    Article  CAS  Google Scholar 

  35. Bardone-Cone AM, Fitzsimmons-Craft EE, Harney MB, Maldonado CR, Lawson MA, Smith R, et al. The inter-relationships between vegetarianism and eating disorders among females. J Acad Nutr Diet. 2012;112(8):1247–52.

    Article  Google Scholar 

  36. Elmore DK, de Castro JM. Meal patterns of normal, untreated bulimia nervosa and recovered bulimic women. Physiol Behav. 1991;49(1):99–105.

    Article  CAS  Google Scholar 

  37. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association; 2000.

    Google Scholar 

  38. Eddy KT, Dorer DJ, Franko DL, Tahilani K, Thompson-Brenner H, Herzog DB. Diagnostic crossover in anorexia nervosa and bulimia nervosa: implications for DSM-V. Am J Psychiatry. 2008;165(2):245–50.

    Article  Google Scholar 

  39. Tozzi F, Thornton L, Klump K, Bulik C, Fichter M, Halmi K, et al. Symptom fluctuation in eating disorders: correlates of diagnostic crossover. Am J Psychiatry. 2005;162:732–40.

    Article  Google Scholar 

  40. Park RJ, Senior R, Stein A. The offspring of mothers with eating disorders. Eur Child Adolesc Psychiatry. 2003;12(1):i110–9.

    PubMed  Google Scholar 

  41. Patel P, Wheatcroft R, Park RJ, Stein A. The children of mothers with eating disorders. Clin Child Fam Psychol Rev. 2002;5(1):1–19.

    Article  Google Scholar 

  42. Coulthard H, Blissett J, Harris G. The relationship between parental eating problems and children's feeding behavior: a selective review of the literature. Eat Behav. 2004;5(2):103–15.

    Article  CAS  Google Scholar 

  43. McGee M, Bainbridge S, Fontaine-Bisson B. A crucial role for maternal dietary methyl donor intake in epigenetic programming and fetal growth outcomes. Nutr Rev. 2018;76(6):469–78.

    Article  Google Scholar 

  44. Pauwels S, Ghosh M, Duca RC, Bekaert B, Freson K, Huybrechts I, et al. Maternal intake of methyl-group donors affects DNA methylation of metabolic genes in infants. Clin Epigenetics. 2017;9(1):16.

    Article  Google Scholar 

  45. Boraska V, Franklin CS, Floyd JA, Thornton LM, Huckins LM, Southam L, et al. A genome-wide association study of anorexia nervosa. Mol Psychiatry. 2014;19(10):1085–94.

    Article  CAS  Google Scholar 

  46. Duncan LE, Yilmaz Z, Gaspar H, Walters R, Goldstein J, Anttila V, et al. Significant locus and metabolic genetic correlations revealed in genome-wide association study of anorexia nervosa. Am J Psychiatry. 2017;174(9):850–8.

    Article  Google Scholar 

  47. Watson H, Yilmaz Z, Thornton L, Hübel C, Coleman JRI, Bryois J, et al. Anorexia nervosa genome-wide associations study dentifies eight loci and implicates metabo-psychiatric origins. 2018. Manuscript submitted for publication.

  48. Javaras KN, Laird NM, Reichborn-Kjennerud T, Bulik CM, Pope HG, Hudson JI. Familiality and heritability of binge eating disorder: results of a case-control family study and a twin study. Int J Eat Disord. 2008;41(2):174–9.

    Article  Google Scholar 

  49. Yilmaz Z, Hardaway JA, Bulik CM. Genetics and epigenetics of eating disorders. Adv Genomics Genet. 2015;5:131.

    CAS  PubMed  PubMed Central  Google Scholar 

  50. Tabler J, Utz RL, Smith KR, Hanson HA, Geist C. Variation in reproductive outcomes of women with histories of bulimia nervosa, anorexia nervosa, or eating disorder not otherwise specified relative to the general population and closest-aged sisters. Int J Eat Disord. 2018;51:102–11.

    Article  Google Scholar 

  51. Watson HJ, Torgersen L, Zerwas S, Reichborn-Kjennerud T, Knoph C, Stoltenberg C, et al. Eating disorders, pregnancy, and the postpartum period: findings from the Norwegian Mother and Child Cohort Study (MoBa). Nor Epidemiol. 2014;24(1–2):51.

    PubMed  PubMed Central  Google Scholar 

  52. Easter A, Naumann U, Northstone K, Schmidt U, Treasure J, Micali N. A longitudinal investigation of nutrition and dietary patterns in children of mothers with eating disorders. J Pediatr. 2013;163(1):173–8. e1.

    Article  Google Scholar 

  53. Yilmaz Z, Gottfredson N, Zerwas S, Bulik C, Micali N. Developmental premorbid BMI trajectories of adolescents with eating disorders in a longitudinal population cohort. J Am Acad Child Adolesc Psychiatry. in press

  54. Agras S, Hammer L, McNicholas F. A prospective study of the influence of eating-disordered mothers on their children. Int J Eat Disord. 1999;25(3):253–62.

    Article  CAS  Google Scholar 

  55. Cooper PJ, Whelan E, Woolgar M, Morrell J, Murray L. Association between childhood feeding problems and maternal eating disorder: role of the family environment. Br J Psychiatry. 2004;184(3):210–5.

    Article  Google Scholar 

  56. Reba-Harrelson L, Von Holle A, Hamer RM, Torgersen L, Reichborn-Kjennerud T, Bulik CM. Patterns of maternal feeding and child eating associated with eating disorders in the Norwegian Mother and Child Cohort Study (MoBa). Eat Behav. 2010;11(1):54–61.

    Article  Google Scholar 

  57. Zerwas S, Von Holle A, Torgersen L, Reichborn-Kjennerud T, Stoltenberg C, Bulik CM. Maternal eating disorders and infant temperament: findings from the Norwegian Mother and Child Cohort Study. Int J Eat Disord. 2012;45(4):546–55. https://doi.org/10.1002/eat.20983.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Micali N, Stavola B, Ploubidis GB, Simonoff E, Treasure J. The effects of maternal eating disorders on offspring childhood and early adolescent psychiatric disorders. Int J Eat Disord. 2014;47(4):385–93.

    Article  Google Scholar 

  59. Apter G, Bobin A, Genet M-C, Gratier M, Devouche E. Update on mental health of infants and children of parents affected with mental health issues. Curr Psychiatry Rep. 2017;19(10):72.

    Article  Google Scholar 

  60. Kothari R, Rosinska M, Treasure J, Micali N. The early cognitive development of children at high risk of developing an eating disorder. Eur Eat Disord Rev. 2014;22(2):152–6.

    Article  Google Scholar 

  61. Lopez C, Stahl D, Tchanturia K. Estimated intelligence quotient in anorexia nervosa: a systematic review and meta-analysis of the literature. Ann General Psychiatry. 2010;9(1):40.

    Article  Google Scholar 

  62. Reupert A, Maybery D, Nicholson J, Göpfert M, Seeman MV, editors. Parental psychiatric disorder: distressed parents and their families. 3rd ed. Cambridge: Cambridge University Press; 2015.

    Google Scholar 

  63. Hoffman ER, Hodges EA, Propper C, Zipkin EC, Bentley ME, Ward DS, et al. Behavioral and psychophysiological responsiveness during child feeding in mothers with histories of eating disorders: a pilot study. J Psychopathol Behav Assess. 2013;35(4):578–91.

    Article  Google Scholar 

  64. Franzen U, Gerlinghoff M. Parenting by patients with eating disorders: experiences with a mother-child group. Eat Disord. 1997;5(1):5–14.

    Article  Google Scholar 

  65. Beck AT. Depression: clinical, experimental, and theoretical aspects. Pennsylvania: University of Pennsylvania Press; 1967.

    Google Scholar 

  66. Limburg K, Watson HJ, Hagger MS, Egan SJ. The relationship between perfectionism and psychopathology: a meta-analysis. J Clin Psychol. 2017;73(10):1301–26.

    Article  Google Scholar 

  67. Reupert A, Drost L, Nicholson J, van Doesum K. Healthy development in children of parents who are emotionally ill. Encyclopedia of primary prevention and health promotion: Springer; 2014. p. 692–702.

  68. Sadeh-Sharvit S, Levy-Shiff R, Ram A, Gur E, Zubery E, Steiner E, et al. Mothers with eating disorders: the environmental factors affecting eating-related emotional difficulties in their offspring. In: Latzer Y, Stein D, editors. Bio-psycho-social contributions to understanding eating disorders. Cham: Springer International Publishing; 2016. p. 77–90.

    Google Scholar 

  69. Barnett S, Buckroyd J, Windle K. Using group therapy to support eating disordered mothers with their children: the relevance for primary care. Prim Health Care Res Dev. 2006;7(1):39–49.

    Article  Google Scholar 

  70. Bryant-Waugh R, Turner H, East P, Gamble C. Developing a parenting skills-and-support intervention for mothers with eating disorders and pre-school children part 1: qualitative investigation of issues to include. Eur Eat Disord Rev. 2007;15(5):350–6.

    Article  Google Scholar 

  71. Runfola CD, Zucker NL, Holle AV, Mazzeo S, Hodges EA, Perrin EM, et al. NURTURE: development and pilot testing of a novel parenting intervention for mothers with histories of an eating disorder. Int J Eat Disord. 2014;47(1):1–12.

    Article  Google Scholar 

  72. Stein A, Woolley H, Senior R, Hertzmann L, Lovel M, Lee J, et al. Treating disturbances in the relationship between mothers with bulimic eating disorders and their infants: a randomized, controlled trial of video feedback. Am J Psychiatry. 2006;163(5):899–906.

    Article  Google Scholar 

  73. Tuval-Mashiach R, Ram A, Shapiro T, Shenhav S, Gur E. Negotiating maternal identity: mothers with eating disorders discuss their coping. Eat Disord. 2012;21(1):37–52. https://doi.org/10.1080/10640266.2012.689210.

    Article  Google Scholar 

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Correspondence to Hunna J. Watson.

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Hunna J. Watson, Amy O’Brien, and Shiri Sadeh-Sharvit declare no conflict of interest.

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This article is part of the Topical Collection on Eating Disorders

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Watson, H.J., O’Brien, A. & Sadeh-Sharvit, S. Children of Parents with Eating Disorders. Curr Psychiatry Rep 20, 101 (2018). https://doi.org/10.1007/s11920-018-0970-3

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