Skip to main content
SpringerLink
Log in

Using structural equation modeling to understand family and psychological factors of childhood obesity: from socioeconomic disadvantage to loss of control eating

  • Original Article
  • Published:
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Purpose

Current study aimed to empirically test the Hemmingsson’s theoretical model of childhood obesity which emphasizing the importance of family environment and the emotional distress of parents as influential variables in the emotional distress of the child and subsequent weight gain. This study also tested the hypothesis that the emotional distress of the child triggers a weight gain-inducing behavior (loss of control eating) to suppress negative emotions.

Methods

Families of 220 Spanish children participated in the study (28.2% normal, 35.1% overweight and 32.2% obesity), aged between 8 and 12. The evaluation included a clinical interview and a battery of questionnaires.

Results

Structural equation models were computed according to the steps proposed by theoretical model. Fit indices were acceptable suggesting that the data adequately fit the hypothesized model. Path coefficients in the final model were statistically significant showing a relationship between socioeconomic status, the emotional distress of parents, family environment, the emotional distress of children, loss of control eating and child’s BMI Z-score.

Conclusion

Considering this relation between emotional distress and child weight status, childhood obesity intervention programs may benefit from targeting family environment and the potential role that food is playing in the regulation of children’s distress.

Level of evidence

Level III: Cohort analytic study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Puder JJ, Munsch S (2010) Psychological correlates of childhood obesity. Int J Obes (Lond) 34:S37–S43. https://doi.org/10.1038/ijo.2010.238

    Article  Google Scholar 

  2. Çolpan M, Eray Ş, Eren E, Vural AP (2018) Perceived expressed emotion, emotional and behavioral problems and self-esteem in obese adolescents: a case-control study. J Clin Res Pediatr Endocrinol. https://doi.org/10.4274/jcrpe.0101

    Article  PubMed  PubMed Central  Google Scholar 

  3. Halliday JA, Palma CL, Mellor D, Green J, Renzaho AMN (2014) The relationship between family functioning and child and adolescent overweight and obesity: a systematic review. Int J Obes 38:480–493. https://doi.org/10.1038/ijo.2013.213

    Article  CAS  Google Scholar 

  4. Benton PM, Skouteris H, Hayden M (2015) Does maternal psychopathology increase the risk of pre-schooler obesity? A systematic review. Appetite 87:259–282. https://doi.org/10.1016/j.appet.2014.12.227

    Article  PubMed  Google Scholar 

  5. Kalarchian MA, Marcus MD (2012) Psychiatric comorbidity of childhood obesity. Int Rev Psychiatry 24:241–246. https://doi.org/10.3109/09540261.2012.678818

    Article  PubMed  Google Scholar 

  6. Byrne ME, LeMay-Russell S, Tanofsky-Kraff M (2019) Loss-of-Control Eating and obesity among children and adolescents. Curr Obes Rep 8:33–42. https://doi.org/10.1007/s13679-019-0327-1

    Article  PubMed  Google Scholar 

  7. Hemmingsson E (2018) Early childhood obesity risk factors: socioeconomic adversity, family dysfunction, offspring distress, and junk food self-medication. Curr Obes Rep 7:204–209. https://doi.org/10.1007/s13679-018-0310-2

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hemmingsson E (2014) A new model of the role of psychological and emotional distress in promoting obesity: conceptual review with implications for treatment and prevention. Obes Rev 15:769–779

    Article  CAS  Google Scholar 

  9. Frederick CB, Snellman K, Putnam RD (2014) Increasing socioeconomic disparities in adolescent obesity. Proc Natl Acad Sci 111:1338–1342. https://doi.org/10.1073/pnas.1321355110

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Leehr EJ, Krohmer K, Schag K, Dresler T, Zipfel S, Giel KE (2015) Emotion regulation model in binge eating disorder and obesity -a systematic review. Neurosci Biobehav Rev 49:125–134

    Article  Google Scholar 

  11. Tanofsky-Kraff M, Yanovski SZ, Schvey NA, Olsen CH, Gustafson J, Yanovski JA (2009) A prospective study of loss of control eating for body weight gain in children at high risk for adult obesity. Int J Eat Disord 42:26–30. https://doi.org/10.1002/eat.20580

    Article  PubMed  PubMed Central  Google Scholar 

  12. Goossens L, Braet C, Van Vlierberghe L, Mels S (2009) Loss of control over-eating in overweight youngsters: the role of anxiety, depression and emotional eating. Eur Eat Disord Rev 17:68–78. https://doi.org/10.1002/erv.892

    Article  PubMed  Google Scholar 

  13. Haushofer J, Fehr E (2014) On the psychology of poverty. Science (80) 344:862–867. https://doi.org/10.1126/science.1232491

    Article  CAS  Google Scholar 

  14. Matthews KA, Gallo LC (2011) Psychological perspectives on pathways linking socioeconomic status and physical health. Annu Rev Psychol 62:501–530. https://doi.org/10.1146/annurev.psych.031809.130711

    Article  PubMed  PubMed Central  Google Scholar 

  15. Braveman P, Gottlieb L (2014) The social determinants of health: it’s time to consider the causes of the causes. Public Health Rep 129:19–31. https://doi.org/10.1177/00333549141291s206

    Article  PubMed  PubMed Central  Google Scholar 

  16. Reiss F (2013) Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. Soc Sci Med 90:24–31. https://doi.org/10.1016/j.socscimed.2013.04.026

    Article  PubMed  Google Scholar 

  17. Goodman SH, Rouse MH, Connell AM, Broth MR, Hall CM, Heyward D (2011) Maternal depression and child psychopathology: a meta-analytic review. Clin Child Fam Psychol Rev 14:1–27. https://doi.org/10.1007/s10567-010-0080-1

    Article  PubMed  Google Scholar 

  18. Crawford NA, Schrock M, Woodruff-Borden J (2011) Child internalizing symptoms: contributions of child temperament, maternal negative affect, and family functioning. Child Psychiatry Hum Dev 42:53–64. https://doi.org/10.1007/s10578-010-0202-5

    Article  PubMed  Google Scholar 

  19. Siegenthaler E, Munder T, Egger M (2012) Effect of preventive interventions in mentally ill parents on the mental health of the offspring: systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry 51:8-17.e8. https://doi.org/10.1016/j.jaac.2011.10.018

    Article  PubMed  Google Scholar 

  20. McConley RL, Mrug S, Gilliland MJ, Lowry R, Elliott MN, Schuster MA, Bogart LM, Franzini L, Escobar-Chaves SL, Franklin FA (2011) Mediators of maternal depression and family structure on child bmi: parenting quality and risk factors for child overweight. Obesity 19:345–352. https://doi.org/10.1038/oby.2010.177

    Article  PubMed  Google Scholar 

  21. López CC, Raimann TX, Gaete PMV (2015) Prevención de los trastornos de conducta alimentaria en la era de la obesidad: rol del clínico. Rev Médica Clínica Las Condes 26:24–33. https://doi.org/10.1016/j.rmclc.2014.12.003

    Article  Google Scholar 

  22. Peris TS, Miklowitz DJ (2015) Parental expressed emotion and youth psychopathology: new directions for an old construct. Child Psychiatry Hum Dev 46:863–873. https://doi.org/10.1007/s10578-014-0526-7

    Article  PubMed  PubMed Central  Google Scholar 

  23. Tanofsky-Kraff M, Marcus MD, Yanovski SZ, Yanovski JA (2008) Loss of control eating disorder in children age 12 years and younger: proposed research criteria. Eat Behav 9:360–365. https://doi.org/10.1016/j.eatbeh.2008.03.002

    Article  PubMed  PubMed Central  Google Scholar 

  24. He J, Cai Z, Fan X (2017) Prevalence of binge and loss of control eating among children and adolescents with overweight and obesity: an exploratory meta-analysis. Int J Eat Disord 50:91–103. https://doi.org/10.1002/eat.22661

    Article  PubMed  Google Scholar 

  25. Hilbert A, Tuschen-Caffier B, Czaja J (2010) Eating behavior and familial interactions of children with loss of control eating: a laboratory test meal study. Am J Clin Nutr 91:510–518. https://doi.org/10.3945/ajcn.2009.28843

    Article  CAS  PubMed  Google Scholar 

  26. Czaja J, Hartmann AS, Rief W, Hilbert A (2011) Mealtime family interactions in home environments of children with loss of control eating. Appetite 56:587–593. https://doi.org/10.1016/j.appet.2011.01.030

    Article  PubMed  Google Scholar 

  27. Hilbert A, Hartmann AS, Czaja J, Schoebi D (2013) Natural course of preadolescent loss of control eating. J Abnorm Psychol 122:684–693. https://doi.org/10.1037/a0033330

    Article  PubMed  Google Scholar 

  28. Kelly NR, Tanofsky-Kraff M, Vannucci A, Altschul AM, Ranzenhofer LM, Schvey NA, Shank LM, Brady SM, Galescu O, Kozlosky M, Yanovski SZ, Yanovski JA (2016) Emotion dysregulation and loss-of-control eating in children and adolescents. Heal Psychol 35:1110–1119. https://doi.org/10.1037/hea0000389

    Article  Google Scholar 

  29. Puhl RM, Heuer CA (2010) Obesity stigma: important considerations for public health. Am J Public Health 100:1019–1028. https://doi.org/10.2105/AJPH.2009.159491

    Article  PubMed  PubMed Central  Google Scholar 

  30. Andreyeva T, Puhl RM, Brownell KD (2008) Changes in perceived weight discrimination among Americans, 1995–1996 through 2004–2006. Obesity 16:1129–1134. https://doi.org/10.1038/oby.2008.35

    Article  PubMed  Google Scholar 

  31. Wang F, Veugelers PJ (2008) Self-esteem and cognitive development in the era of the childhood obesity epidemic. Obes Rev 9:615–623. https://doi.org/10.1111/j.1467-789X.2008.00507.x

    Article  CAS  PubMed  Google Scholar 

  32. Wang F, Wild TC, Kipp W, Kuhle S, Veugelers PJ (2009) The influence of childhood obesity on the development of self-esteem. Health Rep 20:21–27

    CAS  PubMed  Google Scholar 

  33. de Portela Santana ML, da Costa RH, Mora Giral M, Raich RM (2012) La epidemiología y los factores de riesgo de los trastornos alimentarios en la adolescencia; una revisión. Nutr Hosp 27:391–401

    Google Scholar 

  34. Booth JN, Tomporowski PD, Boyle JME, Ness AR, Joinson C, Leary SD, Reilly JJ (2014) Obesity impairs academic attainment in adolescence: findings from ALSPAC, a UK cohort. Int J Obes (Lond) 38:1335–1342. https://doi.org/10.1038/ijo.2014.40

    Article  CAS  Google Scholar 

  35. Karnehed N, Rasmussen F, Hemmingsson T, Tynelius P (2006) Obesity and attained education: cohort study of more than 700,000 Swedish men. Obesity 14:1421–1428. https://doi.org/10.1038/oby.2006.161

    Article  PubMed  Google Scholar 

  36. Miller AC, Polgreen LA, Segre EM, Polgreen PM (2019) Variations in marginal taste perception by body mass index classification: a randomized controlled trial. J Acad Nutr Diet. https://doi.org/10.1016/j.jand.2019.05.018

    Article  PubMed  PubMed Central  Google Scholar 

  37. Parent MB, Darling JN, Henderson YO (2014) Remembering to eat: Hippocampal regulation of meal onset. Am J Physiol Regul Integr Comp Physiol 306:R701–R713. https://doi.org/10.1152/ajpregu.00496.2013

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Spinosa J, Christiansen P, Dickson JM, Lorenzetti V, Hardman CA (2019) From socioeconomic disadvantage to obesity: the mediating role of psychological distress and emotional eating. Obesity 27:559–564. https://doi.org/10.1002/oby.22402

    Article  PubMed  Google Scholar 

  39. Hollingshead AB (2011) Four factor index of social status. Yale J Sociol 8:21–53

    Google Scholar 

  40. Guillén-Riquelme A, Buela-Casal G (2011) Actualización psicométrica y funcionamiento diferencial de los ítems en el State Trait Anxiety Inventory (STAI). Psicothema 23:510–515

    PubMed  Google Scholar 

  41. Sanz J, Vazquez C (2003) Adaptación española del Inventario para la depresión de Beck-II: propiedades psicométricas en población general. Análisis y Modif Conduct 29:239–288

    Google Scholar 

  42. Martínez-Pampliega A, Iraurgi I, Galíndez E, Sanz M (2006) Family Adaptability and Cohesion Evaluation Scale (FACES): Desarrollo de una versión de 20 ítems en español. Int J Clin Heal Psychol 6:317–338

    Google Scholar 

  43. Sepulveda AR, Anastasiadou D, Rodríguez L, Almendros C, Andrés P, Vaz F, Graell M (2014) Spanish validation of the Family Questionnaire (FQ) in families of patients with an eating disorder. Psicothema 26:321–327. https://doi.org/10.7334/psicothema2013.310

    Article  PubMed  Google Scholar 

  44. Cano-Prous A, Martín-Lanas R, Moyá-Querejeta J, Beunza-Nuin MI, Lahortiga-Ramos F, García-Granero M (2014) Psychometric properties of a Spanish version of the Dyadic Adjustment Scale. Int J Clin Heal Psychol 14:137–144. https://doi.org/10.1016/S1697-2600(14)70047-X

    Article  Google Scholar 

  45. Seisdedos N (1990) STAIC, Cuestionario de autoevaluación. Madrid TEA Ediciones, SA

    Google Scholar 

  46. Davanzo P, Kerwin L, Nikore V, Esparza C, Forness S, Murrelle L (2004) Spanish translation and reliability testing of the child depression inventory. Child Psychiatry Hum Dev 35:75–92. https://doi.org/10.1023/B:CHUD.0000039321.56041.cd

    Article  PubMed  Google Scholar 

  47. De Gracia M, Marcó M, Trujano P (2007) Factores asociados a la conducta alimentaria en preadolescentes. Psicothema 19:646–653

    PubMed  Google Scholar 

  48. Ulloa RE, Ortiz S, Higuera F, Nogales I, Fresán A, Apiquian R, Cortés J, Arechavaleta B, Foulliux C, Martínez P, Hernández L, Domínguez E, De La Peña F (2006) Interrater reliability of the Spanish version of schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL). Actas Esp Psiquiatr 34:36–40

    CAS  PubMed  Google Scholar 

  49. Sánchez-Cruz JJ, Jiménez-Moleón JJ, Fernández-Quesada F, Sánchez MJ (2013) Prevalencia de obesidad infantil y juvenil en España en 2012. Rev Esp Cardiol 66:371–376. https://doi.org/10.1016/j.recesp.2012.10.016

    Article  PubMed  Google Scholar 

  50. Jöreskog KG (1993) Testing structural equation models. Testing structural equation models. Sage, pp 294–316

    Google Scholar 

  51. Hu LT, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model 6:1–55. https://doi.org/10.1080/10705519909540118

    Article  Google Scholar 

  52. National Research Council, Institute of Medicine (2009) Associations between depression in: parents and parenting child health, and child psychological functioning in depression in parents, parenting, and children: opportunities to improve identification, treatment, and prevention. National Academies Press, USA

    Google Scholar 

  53. Duclos J, Vibert S, Mattar L, Godart N (2012) Expressed emotion in families of patients with eating disorders: a review of the literature. Curr Psychiatry Rev 8:183–202. https://doi.org/10.2174/157340012800792975

    Article  Google Scholar 

  54. Hanington L, Heron J, Stein A, Ramchandani P (2012) Parental depression and child outcomes—is marital conflict the missing link? Child Care Health Dev 38:520–529. https://doi.org/10.1111/j.1365-2214.2011.01270.x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Dingemans A, Danner U, Parks M (2017) Emotion regulation in binge eating disorder: a review. Nutrients 9:1274. https://doi.org/10.3390/nu9111274

    Article  PubMed Central  Google Scholar 

  56. Lewis G, Rice F, Harold GT, Collishaw S, Thapar A (2011) Investigating environmental links between parent depression and child depressive/anxiety symptoms using an assisted conception design. J Am Acad Child Adolesc Psychiatry 50:451-459.e1. https://doi.org/10.1016/j.jaac.2011.01.015

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This study was funded by the Ministry of Science and Innovation, National Plan R + D + I 2008/11 (PSI2011-23127).

Author information

Authors and Affiliations

  1. Faculty of Psychology, Department of Biological and Health Psychology, Universidad Autónoma de Madrid, Madrid, Spain

    Ana Rosa Sepúlveda, Tatiana Lacruz, Santos Solano, Marta Rojo, Francisco J. Román & Miriam Blanco

Authors
  1. Ana Rosa Sepúlveda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tatiana Lacruz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Santos Solano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marta Rojo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Francisco J. Román
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Miriam Blanco
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ana Rosa Sepúlveda.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures were approved by the Ethics Committee of the Faculty of Psychology (Autonomous University of Madrid), Child Hospital Niño Jesus and Primary Care Commission.

Informed consent

All participants gave their written informed consent.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix 1

Appendix 1

See Table 4

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sepúlveda, A.R., Lacruz, T., Solano, S. et al. Using structural equation modeling to understand family and psychological factors of childhood obesity: from socioeconomic disadvantage to loss of control eating. Eat Weight Disord 27, 1809–1819 (2022). https://doi.org/10.1007/s40519-021-01323-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40519-021-01323-0

Keywords

Search

Navigation