A Prospective Study of Psychological Predictors of Body Fat Gain Among Children at High Risk for Adult Obesity

Strong predictors of adult obesity include having overweight parents and having been overweight during middle childhood.1 However, the specific mechanisms promoting weight gain for such children remain unclear. Among the genetic and environmental factors that underlie the propensity to gain weight, behavioral and psychological phenotypes are important potential targets because they may be amenable to modification. Limited prospective data support the importance of depressive symptoms and self-reported dieting and binge eating for development of overweight. Some,2–5 but not all,6,7 longitudinal studies found major depression or depressive symptoms to be predisposing factors for later weight gain among children and adolescents. Self-reported dieting5,8,9 and binge eating8,9 were found to be associated with gains in self-reported BMI9,10 and measured BMI5,8 among preadolescents and adolescents. However, no study examined variables of disturbed eating patterns in combination with depressive symptoms among young children at high risk for adult obesity. Furthermore, no prior study examined body fat mass to investigate how these psychological factors affect gain of adipose tissue rather than gain of total body mass. Therefore, we assessed prospectively the relationships of children’s self-reported binge eating and dieting behaviors, depressive symptoms, and disordered eating attitudes to increases in body fat mass among children thought to be at high risk for adult obesity. We hypothesized that each psychological variable at baseline would contribute significantly to fat mass gain.