An exploratory study on the intergenerational transmission of dieting proneness within an eating disorder population

  • Elizabeth A. ClaydonEmail author
  • Christa L. Lilly
  • Stephanie C. Zerwas
  • Keith J. Zullig
  • Danielle M. Davidov
  • Lesley Cottrell
Original Article


An Exploratory Study on the Intergenerational Transmission of Dieting Proneness within an Eating Disorder Population (IRB Protocol Number: 160928271).


Parents and families are not the sole factor in eating disorder (ED) development and their involvement in recovery is crucial. However, parents provide a social and environmental context for a child’s eating and weight that cannot be completely discounted. The purpose of this study was to explore the intergenerational transmission of dieting behavior within an ED sample.


Participants (N = 65) were recruited for this cross-sectional study through four distinct ED treatment sites. Participants completed a questionnaire that was developed previously to examine parental feedback as predictor variables, as well as completing the Eating Pathology Severity Index (EPSI) as an outcome variable. A total of 60 completed the questionnaire items of interest to be included in the analyses. SAS JMP® 13.0 was used for descriptive analyses, correlations, and multivariable linear regressions.


Results of the multivariable linear regression showed that the amount of variance explained by the final model for eating pathology severity (via the EPSI) doubled when parental feedback was included (Model 1: R2= 0.09, Model 2: R2= 0.20). Additionally, there was a significant relationship between the “Negative Direct Parental Feedback Subscale” and EPSI total scores (ß = 14.1; SD = 7.0; p = 0.05).


These findings of increased eating pathology associated with direct parental feedback in a clinical population of ED participants even when controlling for parental ED history suggests greater attention is needed within the ED literature on social and environmental factors and their potential associations with eating pathology.

Level of evidence

Level V, descriptive study.


Disordered eating Dieting behaviors Fat talk Family fat talk Eating disorders Intergenerational transmission 



This research was supported, in part, by Grant #6R49CE002109-05-06 from the National Center for Injury Prevention and Control, CDC, to the West Virginia University Injury Control Research Center. Contents are solely the responsibility of the authors and do not represent official views of the CDC.


This research was supported, in part, by Grant #1R49CE002109 from the National Center for Injury Prevention and Control, CDC, to the West Virginia University Injury Control Research Center. Contents are solely the responsibility of the authors and do not represent official views of the CDC.

Compliance with ethical standards

Conflict of interest

S.C. Zerwas has consulted with Coleman Research. No other authors have a conflict of interest to declare.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

40519_2019_745_MOESM1_ESM.docx (28 kb)
Supplementary material 1 (DOCX 28 kb)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Social and Behavioral Sciences, West Virginia University School of Public Health, Robert C. Byrd Health Sciences Center, One Medical Center DriveWest Virginia UniversityMorgantownUSA
  2. 2.Department of BiostatisticsWest Virginia University School of Public HealthMorgantownUSA
  3. 3.Department of PsychiatryUNC School of MedicineChapel HillUSA
  4. 4.Department of PediatricsWest Virginia University School of MedicineMorgantownUSA

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