Disordered Eating & Weight: Parental Concerns

A new study in the Journal of Nutrition Education and Behavior examined parental concerns about child disordered eating among families participating in a long-term, motivational interviewing (MI)-based behavioral intervention.

Disordered eating refers to a range of unhealthy eating-related thoughts and behaviors, such as loss of control eating, excessive concern about weight or shape, or restrictive eating, that may not meet the criteria for a diagnosed eating disorder. Researchers found that nearly half (44.9%) of parents reported at least one concern related to disordered eating at the start of the intervention.

The research evaluated parents of children aged 3–11 years with high body weights enrolled in the Population Effects of Motivational Interviewing on Pediatric Obesity in Primary Care (BMI²+) study. The intervention included up to six MI-based nutrition counseling calls with study registered dietitians, which most parents completed over the course of approximately 2.0–2.5 years.

Given the developmental stages of the children in this study, parents played a central role in influencing their children’s behavioral changes, with food-related parenting practices and the home environment serving as key factors in driving these changes.

The most common parental concerns expressed were the loss of control eating and preoccupation with weight or shape. Children with higher BMIs and those perceived by parents as overweight or obese were significantly more likely to have parents report concerns.

However, the study observed no significant changes in parental concerns over time, suggesting that the MI-based counseling approach, delivered remotely by registered dietitians, did not exacerbate or resolve disordered eating concerns during the intervention. Importantly, baseline concerns did not affect whether families remained engaged in the program.

“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 lead investigator Kendrin R. Sonneville, ScD, RD, Department of Nutritional Sciences, University of Michigan School of Public Health.

“Motivational interviewing may provide a protective environment that encourages healthy routines without reinforcing weight stigma or unhealthy weight-control behaviors.”

These findings highlight the importance of sensitive, developmentally appropriate screening tools for disordered eating in pediatric populations, especially younger children, for whom validated measures are limited. The authors emphasize that guidance from trained clinicians and registered dietitians may help families navigate weight-related behaviors in ways that support both physical and emotional well-being.