Mom and child behaviors

So far, we have considered the feeding behaviors of mothers and children separately. We now turn to the rather limited data available on how the interaction of these factors affects the risk of overweight.

The way a child’s EAH affects and is affected by maternal feeding behavior is a classic example. EAH is an independent risk factor for obesity, but its effect can be modified by parenting practices. These parenting behaviors, in turn, may feed back to either promote or reduce EAH. Studies have shown that children of obese mothers demonstrate more EAH than children of non-obese mothers, and disinhibition in maternal eating style has been linked to more EAH in their children.

But these data cannot distinguish between nature and nurture, inherited and learned behavior. Do these mothers and children exhibit disinhibition and EAH because they share a similar genetic makeup, or do the children learn these behaviors from their mothers?

The science seems to suggest that both factors—genetic endowment and learning—are involved. A mother faced with either an overweight child or a child exhibiting robust EAH must decide how to respond. Not surprisingly, the more EAH the child demonstrates and the higher the child’s BMI, the more restrictive the mother tends to be in her feeding practices.

That response, though understandable, seems to have the unfortunate effect of leading over time to greater EAH and greater additional weight gain, particularly in children who are already overweight. When overweight children with EAH are restricted at home, they may be more likely to overeat and consume unhealthy foods at a friend’s house or at school, where mom can’t enforce restrictions.

The mother with an overweight child who exhibits a great deal of EAH is in a catch-22. Without the external control provided by her restrictions, the child’s food intake may be excessive. But the more control she tries to exert, the less—in theory—the child is able to develop internal controls and respond appropriately to hunger and satiety. Research does not provide any clear-cut recommendations on how to intervene effectively in this situation.

Temperament may also impact the interaction between mother and child. The child who is temperamentally negative, emotional, easily angered, poorly adaptable, and intense is more like to be overweight. These temperamental characteristics have been linked to more frequent tantrums (see “If I don’t let him have the food he wants, he throws a fit”) over food, which are in turn linked to a greater risk of becoming overweight. The mother coping with a difficult child might not only use food to quell a tantrum, but also be faced with more food tantrums rooted in the child’s intense and persistent temperament.