Patterns of Eating Disorder Pathology are Associated with Weight Change in Family-Based Behavioral Obesity Treatment

OBJECTIVE: Children with overweight/obesity have elevated eating disorder (ED) pathology, which may increase their risk for clinical EDs. The current study identified patterns of ED pathology in children with overweight/obesity entering family-based behavioral weight loss treatment (FBT), and examined whether children with distinct patterns differed in their ED pathology and zBMI change across FBT. METHODS: Before participating in 16-session FBT, children (N=241) completed surveys/interviews assessing ED pathology [emotional eating, shape/weight/eating concerns, restraint, and loss of control (LOC)]. Shape/weight concerns and LOC were also assessed post-treatment. Child height/weight were measured at baseline and post-treatment. Latent class analysis identified patterns of ED pathology. Repeated-measures ANOVA examined changes in zBMI and ED pathology. RESULTS: Four patterns of ED pathology were identified: Low ED Pathology, Shape and Weight Concerns, Only Loss of Control, and High ED Pathology. Shape/weight concerns decreased across treatment, with highest decreases in patterns characterized by high shape and weight concerns. All groups experienced significant decreases in zBMI; however, children with the highest ED pathology did not achieve clinically significant weight loss. CONCLUSIONS: ED pathology decreased after FBT, decreasing ED risk. While all children achieved zBMI reductions, further research is needed to enhance outcomes for children with high ED pathology.