3503 Restrictive feeding and excessive hunger in young children with obesity: A case series

OBJECTIVES/SPECIFIC AIMS: The purpose of this case series is to show how helping parents instill a non-restrictive, structure-based (i.e., authoritative) approach to feeding is useful in addressing family food conflicts in a clinical child obesity treatment program. METHODS/STUDY POPULATION: Case reports are presented for 3 young children (two 8-year-old males and one 7-year-old female) with obesity (BMI ≥ 95(th) percentile for age and sex). Patients underwent family-based treatment at Brenner FIT® (Families In Training), an interdisciplinary tertiary weight management clinic. RESULTS/ANTICIPATED RESULTS: All patients experienced a period of rapid weight gain and/or severe onset obesity. Parents reported a combination of problematic eating behaviors (e.g., sneaking food, frequent complaints of hunger, vomiting from rapid consumption). Families implemented structure-based feeding with a meal-snack schedule and allowed children to eat until they were full from the food provided at meal-snack times. BMI z-score decreased from 2.19 to 2.07 in patient 1 and from 2.43 to 2.09 in patient 2 (follow-up weight was not available for patient 3). DISCUSSION/SIGNIFICANCE OF IMPACT: The improvements observed by our clinical program after families lifted restriction and instituted authoritative feeding is anecdotal evidence for the ecological validity of existing empirical work. Randomized controlled trials are needed to examine causality.