It is becoming increasingly clear that obesity is not caused primarily by a simple energy imbalance. Serious metabolic dysfunction characterised by insulin resistance, that results in modification to normal physiological processes, has been identified in obese individuals and reported in the literature. However, behavioural aspects are also associated with weight gain and evidence is growing to suggest that cognitive modification of food selection and consumption are more important in the development of obesity than was previously considered. Further, adult adiposity and obesity risk may be associated with behavioural and cognitive patterns that originate in early childhood. One such pattern of behaviour that may be learned during childhood is parental reinforcement during feeding, in order to encourage increased food intake. Because this overrides the normal appetite centres of the developing brain, this pattern of behaviour may result in learned overeating patterns.
Researchers1 have investigated the association of maternal eating prompts with child adiposity in 1218 children. Subjects were videotaped eating a meal at ages 15, 24 and 36 months. Following adjustment for race and sex, and the maternal education level, socioeconomic status, weight and any depressive symptom, the results showed that a higher ratio of assertive to non-assertive feeding prompts and increased feeding intrusiveness were associated with adiposity. In turn, the number of assertive prompts and intrusiveness were associated with lower maternal education level and being non-white. These findings add to previous studies that have shown that maternal behaviour can influence the eating response of the child and be predictive of weight gain. Overriding the natural instinct of the child to stop eating when full, may therefore detrimentally affects the inherent weight control mechanisms of the child, and lead to a slow but significant accretion of weight over time.
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