Research report Mealtime family interactions in home environments of children with loss of control eating § Julia Czaja a, *, Andrea Sabrina Hartmann b , Winfried Rief b , Anja Hilbert b,c a Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany b Philipps University of Marburg, Department of Psychology, Gutenbergstr. 18, 25032 Marburg, Germany c Department of Psychology, University of Fribourg, Rue P.-A. de Faucigny 2, 1700 Fribourg, Switzerland Introduction Parental behavior is associated with the development of the eating behavior of their children (for review see Scaglioni, Salvioni, & Galimberti, 2008). Experimental studies (Fisher & Birch, 2000; Fisher, Mitchell, Smiciklas-Wright, & Birch, 2002) and self-reports (Klesges, Malott, Boschee, & Weber, 1986) have indicated that a number of problematic parent–child interaction patterns are associated with fruit intake, physical activity, and overweight in children. Whether families of children with overeating or binge eating display more negative interaction patterns during regular family mealtimes requires further exploration. Binge eating is the main criterion of binge eating disorder (BED; Diagnostic and Statistical Manual of Mental Disorders, DSM-IV-TR; American Psychiatric Association, APA, 2000) and is defined as eating a large amount of food accompanied by a sense of loss of control (LOC) over eating. Although relatively few children fulfill the diagnostic criteria of BED (Glasofer et al., 2007; Levine, Ringham, Kalarchian, Wisniewski, & Marcus, 2006), in an expert interview, 9.3% of children ages 6–13 years reported LOC eating independent of the amount of food consumed (Tanofsky-Kraff et al., 2004). Therefore, recent criteria proposed for children of 12 years and younger therefore also focus on the loss of control rather than the amount of food consumed (Tanofsky-Kraff, Marcus, Yanovski, & Yanovski, 2008). LOC eating is associated with increased eating disorder and general psychopathology, over- weight, and obesity in youth (Glasofer et al., 2007; Goldschmidt et al., 2008; Goossens, Braet, & Decaluwe, 2007; Hilbert & Czaja, 2009; Levine et al., 2006; Shapiro et al., 2007) and predicts further weight gain (Tanofsky-Kraff et al., 2009). A number of experimental studies have suggested that a child’s self-regulation of his or her feeding behavior, especially overeating, is influenced by the degree of parental control and restriction of food (Drucker, Hammer, Agras, & Bryson, 1999; Fisher & Birch, 1999, 2000). In the laboratory, children with obesity ate faster in the presence of their mother compared to when alone (Laessle, Uhl, Appetite 56 (2011) 587–593 ARTICLE INFO Article history: Received 5 October 2010 Received in revised form 20 January 2011 Accepted 24 January 2011 Available online 1 February 2011 Keywords: Naturalistic test meal Family interactions Loss of control eating Children Ecological validity ABSTRACT Experimental and self-report studies have shown that parents have a strong influence on their normal or overweight children’s eating behavior, i.e. through parental feeding behavior or communication. Studies in children with loss of control (LOC) eating that have investigated this relationship are scarce, and ecologically valid observational studies are missing. This study examined family functioning at mealtimes in home environments in 43 families of a child with LOC eating and 31 families of a child without LOC eating; the children were 8–13 years old. Familial interactions, child eating behavior, and parental mealtime behavior were assessed using the Mealtime Family Interaction Coding System, observation of bite speed of the child, and self-report questionnaires. Less healthy patterns of communication (U = 201.53, p < .01) and interpersonal involvement (U = 207.54, p < .01) and more maladaptive overall family functioning (U = 233.52, p < .05) were observed but not self-reported in families of a child with LOC eating compared to those without LOC eating. Children with LOC eating (M = 4.73, SD = 1.88) ate faster than controls (M = 3.71, SD = 1.19; p < .05), with highest bite speed in a group with high recurrent LOC eating (p < .01). The results indicate that maladaptive patterns of family functioning during family mealtimes are present in LOC eating in children and are associated with the child’s eating behavior. Parent–child communication training should be tested as an intervention for children with LOC episodes. ß 2011 Elsevier Ltd. All rights reserved. § This research was part of a project supported by grant HI 1111/1-1 awarded to A. Hilbert from the German Research Foundation and by grant 01GP0491 from the German Ministry of Education and Research. * Corresponding author. E-mail addresses: Julia.Czaja@uk-sh.de, julecmail@web.de (J. Czaja), andrea.hartmann@staff.uni-marburg.de (A.S. Hartmann), rief@staff.uni-marburg.de (W. Rief), anja.hilbert@unifr.ch (A. Hilbert). Contents lists available at ScienceDirect Appetite journal homepage: www.elsevier.com/locate/appet 0195-6663/$ – see front matter ß 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.appet.2011.01.030